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Information & Forms Main Page
Informational Brochures
Forms & Worksheets
Information Kit Materials
Applications & Instructions
Additional Resources
Information and Forms Icon Important information about FLTCIP materials

The following materials are outdated and should not be used by new applicants:

Click to enlarge  Image of Old Materials

If you are interested in applying for coverage under the FLTCIP, see FLTCIP 2.0 Information and Forms below to find the information you need. If you are a current enrollee, log in to your online account to view information about your coverage.

Information and Forms Icon FLTCIP 2.0 Information and Forms


All documents are in and Adobe Acrobat PDF (PDF) format unless otherwise noted. To open these materials, click on the appropriate version. For applications, go to the Apply section of this website.


Information Kit Materials

You can download each of the FLTCIP Information Kit materials independently or download the entire kit in WinZip format. You can also request an Information Kit by mail.

Name

PDF
Book 1 - Program details and rates [Description] Click here for the Adobe Acrobat PDF version.
Book 2 - Additional information[Description] Click here for the Adobe Acrobat PDF version.
NAIC Shopper's Guide to Long Term Care Insurance [Description] Click here for the Adobe Acrobat PDF version.
Entire Full Underwriting Information Kit ( - Approx. 2MB)*
Entire Abbreviated Underwriting Information Kit ( - Approx 2MB)*

* Note: The entire Information Kits are saved using WinZip Computing, Inc.'s WinZip for Windows. You can download a free evaluation copy of WinZip to open these files. If you are unsure which application you need (Full Underwriting or Abbreviated Underwriting), click here.  


Informational Brochures
 

Name

PDF
Program Overview Brochure Click here for the Adobe Acrobat PDF version.
Guide to Health Insurance for People with Medicare [Description] Click here for the Adobe Acrobat PDF version.

Forms & Worksheets
 

Name

PDF
Billing Change Form [Description] Click here for the Adobe Acrobat PDF version.
Benefits and Features Comparison Worksheet [Description] Click here for the Adobe Acrobat PDF version.
Authorization for Disclosure of Information [Description] Click here for the Adobe Acrobat PDF version.



1-800-LTC-FEDS (1-800-582-3337)  (TTY: 1-800-843-3557)

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The Federal Long Term Care Insurance Program is
sponsored by the U.S. Office of Personnel Management,
offered by John Hancock Life & Health Insurance Company, Boston, MA 02117,
and administered by Long Term Care Partners, LLC