Rhode Island § 40-8-22 - Medical Assistance

§ 40-8-22. Protection of resources — Long-term care insurance partnership program.

(a) The department of human services shall coordinate a program entitled the Rhode Island Partnership for Long-Term Care whereby private insurance and funds may be utilized to finance long-term care. The department shall seek appropriate amendments to its state plan for medical assistance under Title XIX, 42 U.S.C. § 1396 et seq., of the Social Security Act (Medicaid), or waivers of state plan requirements, to allow protection of resources and income pursuant to this section. The protection shall be provided, to the extent approved by the federal Centers for Medicare and Medicaid Services, for any purchaser of a precertified, long-term-care policy delivered, issued for delivery, or renewed and shall last for the life of the purchaser. Notwithstanding any provision of the general laws, the resources of an individual, to the extent the resources are equal to the amount of qualifying long-term-care insurance benefits payments provided pursuant to a policy of long-term-care insurance precertified in accordance with department regulations and chapter 34.2 of title 27, shall not be considered by the department in a determination of: (1) His or her eligibility for Medicaid; (2) The amount of any Medicaid payment; or (3) In any subsequent recovery by the state of a payment for medical services. The precertified policies shall be known as “Medicaid qualifying long-term care partnership policies.”

(b) The department shall count insurance benefit payments toward resource exclusion to the extent the payments: (1) Are for services covered under the state plan for medical assistance, including nursing home care, or formal services delivered to insureds in the community as part of a care plan; (2) Are for the lower of the actual charge or the amount paid by the insurance company; and (3) Are for services provided after the individual meets the coverage requirements for long-term-care benefits established by the department for this program. The department shall adopt rules and regulations to implement the provisions of this section and relating to determining eligibility of applicants for Medicaid and the coverage requirements for long-term-care benefits.