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Why purchase Long Term Care Insurance (“LTCI”)?
What is Redetermination?
Redetermination is the process by which TennCare reviews the eligibility of its members. This allows TennCare to determine whether members are still eligible for coverage or if their coverage should be changed.
What is a Qualified Income Trust (QIT)?
A Qualified Income Trust, or Miller Trust, is a trust (a special bank account) that allows individuals to qualify for TennCare CHOICES benefits when their monthly income is too high to otherwise get those benefits. The bank account holds the amount of monthly income that exceeds the income cap for TennCare. The money in this account can only be used for nursing home costs or in-home nursing costs, plus several other special expenses that are listed in the trust document. A QIT cannot be used to protect or shelter assets.
Below you will find resources that provide helpful information on employment-based benefits and health insurance. You will also find details on how to seek assistance or aid from a lawyer, if necessary.
Legal Information:
Consumer Information on Employment-related Health Plans
What are Medicare Savings Programs?
Medicare Savings Programs (MSPs) are federally funded programs carried out by individual states. MSPs help low-income people with Medicare pay their premiums. Some MSPs also pay for deductibles, coinsurance, and copayments so long as certain conditions are met. You cannot receive benefits in more than one MSP.
What is a nursing home?
A nursing home is a facility for people who do not need hospital care but do need continuous nursing services on an in-patient basis. Nursing homes provide care on a 24-hour basis, 365 days per year. Services in nursing homes include nursing care, custodial and rehabilitative care (like physical, occupational, and speech therapy), and specialized care (like care for people suffering from dementia). Nursing homes also provide social, recreational, and spiritual activities for residents.
What is a Qualified Income Trust (QIT)?
A Qualified Income Trust, or Miller Trust, is a trust (a special bank account) that allows individuals to qualify for TennCare CHOICES benefits when their monthly income is too high to otherwise get those benefits. The bank account holds the amount of monthly income that exceeds the income cap for TennCare. The money in this account can only be used for nursing home costs or in-home nursing costs, plus several other special expenses that are listed in the trust document. A QIT cannot be used to protect or shelter assets.
**The following information applies only to Tennessee nursing homes. If you live in an assisted or independent living facility, the rules are different.**
What Is An Involuntary Discharge?
An involuntary discharge is when you want or need to stay in your current nursing home, but the nursing home thinks you should not stay there.
What is an assisted living facility?
An assisted living facility is any group residential program that is not licensed as a nursing home and that provides personal care and support services to people who need help with daily living activities. Assisted living facilities usually combine housing, personal services, and light medical care. They support those who are too frail to live alone but too healthy to go to a nursing home.
What is adult day care?
Adult day care programs offer daytime services for impaired older adults. Most centers are open 8 to 10 hours per day on weekdays. Most centers help the senior remain living in the community at the highest level of independence possible. Participants can delay or avoid use of more costly in-home and nursing home care by using adult day care.
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