About the Program
The benefits and features described below are a general description of coverage under the Federal Long Term Care Insurance Program (FLTCIP) 3.0 plan. For detailed coverage information, refer to the FLTCIP 3.0 Benefit Booklet.
Note: If you're enrolled in coverage under a FLTCIP 1.0 or FLTCIP 2.0 plan, log into your My LTCFEDS online account to view your individual plan details. The introduction of the FLTCIP 3.0 plan doesn't impact your coverage. If you want to learn more about this plan, review the information below and visit the Help section for answers to frequently asked questions.
Choice of care
Care provided in a nursing home, an assisted living facility, a hospice facility, an adult day care center, and at home is covered up to 100% of your daily benefit amount.
Care received outside of the United States is covered up to 100% of your daily benefit amount.
Friends & family caregivers
Care provided at home by informal caregivers such as friends, family members, and other unlicensed caregivers is covered up to 100% of your daily benefit amount, as long as the caregiver isn't your spouse or domestic partner and didn't live with you when you became eligible for benefits. When informal care is provided by family members, it's covered for up to 500 days of care in your lifetime.
Alternate plan of care
In certain circumstances, customized benefits for services that are not specifically covered by the FLTCIP will be considered if they meet your needs and are cost-effective.
Options that help support care at home, including care planning visits, home modifications (such as installing wheelchair ramps), emergency medical response systems, durable medical equipment (such as wheelchairs, walkers, or hospital-style beds), and home safety checks, are covered up to 30 times your daily benefit amount. Caregiver training is also part of the stay-at-home benefit, but only covered up to seven times your daily benefit amount in your lifetime. This benefit can be used at any time once you're eligible for benefits, including during the waiting period.
Valuable standard features
Your coverage will not be canceled as long as you pay your premiums on time. And your coverage can't be canceled due to your age or a change in your health.
Waiver of premium
Once you've completed your waiting period, you do not have to pay premiums while you're receiving benefits.
The FLTCIP pays benefits to provide your primary caregiver with temporary relief from his or her caregiving responsibilities up to 30 times your daily benefit amount per calendar year.
If you're in an assisted living facility, a nursing home, or a hospice facility, and need to leave that facility for any reason (for example, you need to be hospitalized), the FLTCIP will pay for actual charges you incur for bed reservations up to 100% of your daily benefit amount, for up to 60 days per calendar year.
Even if you're no longer a member of an eligible group (for example, if you're an employee who leaves government employment), you can keep your coverage as long as you continue to pay the required premium and have not exhausted your maximum lifetime benefit.
No war exclusion
Unlike most other long term care insurance plans, coverage under the FLTCIP does not have a war exclusion. As a result, benefits may be payable for conditions due to war or acts of war, declared or undeclared, or service in the armed forces or auxiliary units. There is also no catastrophic event limitation.
Premium stabilization feature
This built-in feature is designed to reduce the potential need for future premium increases. As part of this feature there is an adjustable amount that is calculated as a percentage of premiums paid. Under certain conditions, this amount may be used to offset your future premium payments or provide a refund of premium death benefit to your estate or designated beneficiary. The percentage will be changed no more than once annually and it will not exceed 100% or be less than 10%.