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You are here: Home / FAQs: FLTCIP

FAQs: FLTCIP

Choose from the subcategories below to review the Frequently Asked Questions.  Click on a question to expose the answer below.   

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Eligibility

When can I apply for the Federal Long Term Care Insurance Program (FLTCIP)?

You (and your eligible family members) can apply for coverage at any time.  There are not traditional Open Seasons for FLTCIP like there are for FEHB.

Who is eligible to apply for coverage under FLTCIP?

The following people are eligible to apply for FLTCIP coverage:

  • Federal employees and retirees
  • Active and retired members of the uniformed services
  • Qualified relatives can apply (even if you do not)

Qualified relatives can apply (even if you do not):

  • current spouse, adult children & domestic partners of employees/retirees
  • parents, parents-in-law & stepparents of employees (not retirees)
  • Surviving spouses receiving a survivor benefit or basic employee death benefit

Does the FLTCIP have a Self+One or a Self+Family plan like FEHB?

No.  Each person applies individually for FLTCIP coverage and they must qualify under their own health.

Applying for Coverage

What form do I use to apply for the FLTCIP coverage?

Use this form to apply for coverage under the Federal Long-Term Care Insurance Program (FLTCIP).

You must use the full underwriting application to apply, if you fall into one of these categories:

  • Employees who did not apply within 60 days of their hire or eligibility date
  • Spouses of employees who did not apply within 60 days of marriage
  • Annuitants, including retired members of the uniformed services
  • Spouses of annuitants
  • Qualified relatives

Please note: The insurance carrier may request medical records from your primary care physician or health care practitioner. The carrier will advise you by letter if this request is necessary.

Am I automatically approved for coverage under FLTCIP?

No.  You must qualify (based on your health) for coverage.

Am I required to go through full underwriting when I apply?

Likely, yes.  You must use the full underwriting application to apply, if you fall into one of these categories:

  • Employees who did not apply within 60 days of their hire or eligibility date
  • Spouses of employees who did not apply within 60 days of marriage
  • Annuitants, including retired members of the uniformed services
  • Spouses of annuitants
  • Qualified relatives

Who gets to go through abbreviated underwriting to apply?

You can use the abbreviated underwriting application to apply, if you fall into one of these categories and apply within 60 days of becoming eligible:

  • New and newly eligible employees (including members of the uniformed services)
  • Spouses of persons in the above group
  • Newly married spouses of employees

Will pre-existing conditions keep me from getting FLTCIP?

Depending on your pre-existing condition, it is possible that it will disqualify you from getting FLTCIP coverage.  Keep in mind that getting long-term care insurance is very different than getting health insurance.

Am I able to apply on behalf of one of my eligible family members, or do they have to do it themselves?

No.  Everyone must apply on their own health record.  You are not permitted to apply for someone else.

Daily Benefit Amount

What is the Daily Benefit Amount?

The Daily Benefit Amount is the max dollar amount the LTC company will pay out each day once you are on claim.  Under the FLTCIP, you will choose between $100 - $450 per day (in $50 increments).

How do I know which amount to choose?

The cost of care varies widely based on geography and the level of care that is needed.  Carefully review various costs and locations in the FLTCIP Cost of Care Map. 

Benefit Period Options

What is the Benefit Period?

The Benefit Period is the length of time the LTC company will pay out the Daily Benefit Amount once you are on claim.

How do I know how long I want the coverage to last once I go on claim?

For many people this simply feels like a guess.  It is hard to know how long you may need this coverage (given that you are healthy when you apply).  Since we don't know the answer to that question, perhaps a better way to look at this is to ask yourself the question, "How long do I want someone else to pay the bill before I start?"  Remember, the longer the benefit period, the higher the premium for the coverage.  

Can my benefit last longer than the benefit period I choose?

Yes.  If the care you need costs less than your Daily Benefit Amount, then it will stretch out over a longer period of time.  For instance, if you have a DBA of $100/day for 2 years, but the care you need only costs $50/day, it will last you for 4 years.

Inflation Protection Options

What are the Inflation Protection options?

Adding inflation protection helps the value of your coverage keep pace with the rising costs of long term care services.

There are two approaches:

  • Automatic Compound Inflation Option (ACIO)
  • Future Purchase Option (FPO)

Automatic Compound Inflation

Automatic Compound Inflation Options

You choose the amount:

  • 4% increase of benefits each year
  • 5% increase of benefits each year

In essence, your Daily Benefit Amount automatically increases by 4% or 5%, compounded annually.

Under this option, your premium stays the same even when your benefits go up each year.

Inflation Protection

Future Purchase Option

You will receive an offer to voluntarily increase your benefits every two years to keep up with inflation with unlimited declines.

The amount of each increase offered is based on the Consumer Price Index for All Urban Consumers (CPI-U) for that year.

There is no additional underwriting required each year you accept an increase in benefits.

Your added benefit will be priced based on your attained age, so your premium will rise based on the new coverage added.

Cost of Care

How can I see how much care costs in different areas of the country?

The cost of care varies widely based on geography and the level of care that is needed.  Carefully review various costs and locations in the FLTCIP Cost of Care Map. 

General

Is there a requirement to have FLTCIP in place for 5 years immediately prior to retirement (like there is for FEHB and FEGLI)?

No.  The FLTCIP program does not require you (or your family members) to be enrolled for 5 years before you retire.  It does not carry the same 5-year rule that other programs like FEHB and and FEGLI do in order to be eligible to keep it in retirement. 

You are even permitted to enroll in FLTCIP in retirement.

What is the best age to purchase LTC insurance?

It's hard to say, but because you must qualify for LTC insurance (based on your health), and the premiums are based on your age at purchase, it stands to reason to get this coverage in place as early in life as possible.

Do I have to spend down my own assets before the insurance company will begin to pay ?

No.  By having LTC insurance, you are able to better protect the assets you have acquired so they can be used for other purposes (income for your spouse, leave assets to your children, etc.).  Essentially, by having LTC insurance, you're paying out of the LTC insurance company's pocket and not yours.

FLTCIP Open Seasons

Does FLTCIP have Open Seasons like FEHB?

No.  You (and your eligible family members) can apply for coverage at any time.  There are not traditional Open Seasons for FLTCIP like there are for FEHB.

When is the next FLTCIP Open Season?

There is not an anticipated FLTCIP Open Season.

Former Spouses

Can former spouses apply for FLTCIP coverage?

  • No. Former spouses are not eligible to apply for this insurance, even if they are receiving a survivor annuity.
  • If a federal employee and their spouse divorce, can the spouse keep their current FLTCIP coverage?

    Yes.  A former spouse is permitted to keep FLTCIP coverage even if they divorce.

    Premiums

    Are my premiums guaranteed under FLTCIP?

    Premiums are set with the expectation that they will be sufficient, but they are not guaranteed.  The premium for your group (for example, those with the same plan design or set of benefits) may only increase if it is determined to be inadequate and approved by OPM.

    Your premium may also increase if you voluntarily elect to increase your benefit (for example, with the Future Purchase Option).

    If I pay premiums for many years and never need the care, do I get a refund of my premiums?

    No.  Under the FLTCIP, there are no refunds paid if you never go on claim.

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