Important Legal Information
Please read the information in each link below carefully. Your application for insurance coverage under the Federal Long Term Care Insurance Program (FLTCIP) - received either online or via downloading, completing, and mailing a paper application - confirms that you have read and understand the information below.
- Applying and underwriting
- Authorization to use and disclose health information
- Authorization for automatic bank withdrawal or payroll/annuity deduction
- If you select automatic bank withdrawal as your payment method, by signing the "Automatic bank withdrawal" portion of the section titled "Billing Options" on the application, you authorize Long Term Care Partners to
initiate automatic bank withdrawals from the account number provided on your voided check or savings deposit slip. Withdrawals begin the month after you are approved and continue on third business day of every month. You further understand
that any past due premium is collected by withdrawing up to two months of premium from your account until your premium payments are current.
If you select someone else's pay or annuity/pension as your payment method, you understand that person (the payor) must sign the "Someone else's pay or annuity/pension" portion in the section titled "Billing Options" on the
application. Further, you confirm the signature is the payor's signature. By their signature, the payor authorizes Long Term Care Partners to deduct from their pay or annuity/pension that amount necessary to pay the FLTCIP premiums for this applicant.
- Agreement and acknowledgment
- Online application consent (online applications only)
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Federal family members can apply for coverage anytime—you do not have to wait for the next open season. Premiums are based on your age and the premium rates in effect at the time we receive your application—the younger you are when you apply, the lower your premium will be.