Federal Long Term Care Insurance Program (FLTCIP)

The Federal Long Term Care Insurance Program, also known as FLTCIP, is a long-term insurance program offered to federal employees, U.S. Postal Service workers, and military members. For military enrollees, the program is open to active-duty and retired service members and qualified relatives.

What You Should Know About FLTCIP Before Getting Started

The Federal Long Term Care Insurance Program is not part of the annual Federal Benefit Open Season. If you are eligible for FLTCIP, you may apply online, or download a FLTCIP application to fill out.

One of the most important things to know about this insurance program is that you must be eligible for the type of insurance program called The Federal Employees’ Group Life Insurance (FEGLI) in order to apply for Federal Long Term Care Insurance.

Note that you do not have to be enrolled in FEGLI to qualify, you must simply be eligible.

An Important Detail to Remember About Insurance Open Season

According to the federal official site of the Office of Personnel Management (OPM.gov), “Outside of an open season, eligible employees can enroll or increase their FEGLI coverage by taking a physical exam or with a Qualifying Life Event,” but no such open season restriction exists for FLTCIP.

We mention open season here because it’s easy to assume that because one type of federal employee insurance (FEGLI) has an open season that FLTCIP does as well. It does not.

Certain Exclusions Apply

While federal employees and military members qualify, employees of the District of Columbia government — including service members’ spouses — do not.

Temporary, intermittent and seasonal employees working for the federal government are not considered eligible for FLTCIP regardless of other eligibility.

Certain Inclusions Also Apply

If you have a qualified relative, they may apply to get coverage under this program even if you do not.

Other eligible applicants include:

• Qualifying surviving spouses
• Anyone separated who may be eligible to receive a deferred annuity
• Any retired or separated military member entitled to “retired or retainer pay”
• Retired members of the Reserve (at the time they qualify for an annuity)
• “Gray Reservists” who are separated and not yet drawing an annuity
• Current spouses of employees or annuitants
• Adult children 18 or older of living employees, annuitants, and of surviving spouses receiving an annuity
• Parents, step-parents, and in-laws of living employees and their spouses

Those who are unmarried domestic partners may be eligible if the domestic partnership meets certain guidelines (regardless of gender or similar factors). Don’t assume your domestic partnership does not qualify.

Application Requirements for FLTCIP

As part of the application process, prospective enrollees will be required to answer health questions and be approved for enrollment.

Timing of Your Application is Important

As a newly eligible employee, if you enroll in the first 60 days, you will be subject to fewer application questions. This is true for the employee and spouse only. If you apply within the first 60 days after getting married, you also have a reduced set of questions for the spouse only.

For enrollees who apply during Long Term Care Open Season (the FLTCIP program itself does not have open seasons), there may also be fewer health questions and less frequent ones.

Applying anytime outside of the circumstances listed above will definitely result in more health questions for all eligible.

Basic Information About FLTCIP

According to its website, the FLTCIP is sponsored and regulated by the U.S. Office of Personnel Management (OPM) and supported by the strength and stability of John Hancock Life & Health Insurance. The program began in 2002, with a new contract and a set of revisions to benefits and other program details effective between 2009-2016. When a new contract was developed in 2016, benefits did not change, but premiums did increase as a result.

What FLTCIP Covers

The basic types of coverage provided by the Federal Long Term Care Insurance Program include many types of long-term care that may be required due to the following:

• Car accidents
• Sports accidents
• Injuries causing disability
• Alzheimer’s
• Stroke
• Multiple sclerosis
• Parkinson’s Disease
• Other disabling conditions
• Old age

What You Should Know About FLTCIP Plans

You are permitted to customize the amount of your benefits, choose inflation protection and determine the length of your policy. You are permitted to decrease any aspect of the program, and the premiums set for you (based on “original age”) will decrease accordingly without being required to get new underwriting or health questions.

The caveat to this is you cannot fully pay up your benefit to get credit for premiums that have already been paid for a higher coverage amount.

You may also request an increase in your FLTCIP coverage at any time, but if this is done outside an open season you are required (at the enrollee’s expense) to furnish “evidence of good health” that is acceptable to the insurance provider.

Age-based rates and a premium increase will be part of any increased insurance coverage.

The Daily Benefit Amount

Your daily benefit amount is the maximum dollar amount that may be paid on “any single day”. In cases where the cost of care (whether in-home, at a nursing home, or in an assisted living facility) is less than your daily benefit amount, the difference is carried over for later use, where applicable. Enrollees are permitted to select a daily benefit amount in pre-determined increments.

What You Should Know About The Lifetime Benefit Amount

For enrollees selecting the lifetime benefit, no maximum lifetime coverage cap applies. Those selecting coverage for a two-year plan, three-year or five-year version should know the benefit period is essentially how long the maximum lifetime benefit would theoretically last if you are getting care every day billed equal to or more than the enrollee’s daily benefit amount.

In cases where care is less than the maximum daily benefit, longer care is possible.

There is also a future purchase option allowing those who elect the kinds of yearly coverage described above to purchase more coverage every two years. An additional fee may apply in such cases.

Pricing may be informed by increases in the Medical Consumer Price Index and those who elect to purchase such additional coverage may have their premiums increase each time.

Premiums for this additional coverage are set based on the age and premium rate at the time the new increase takes effect.

Other Important Features of FLTCIP

• Insurance premiums are identical for all who elect standard coverage regardless of age or employment status. New hires and the spouses of new hires (including those who are newly married) are given “abbreviated underwriting”), which is something used to determine if the applicants are currently eligible or likely to become eligible later.
• Enrollees can opt-in to inflation protection, but it is not a requirement of the program.
• Federal Long Term Care Insurance coverage is renewable-it comes with a guarantee that you cannot have your coverage cancelled unless the enrollee stops making payments on the plan.
• Federal Long Term Care Insurance is considered “portable”; those who leave military service or federal employment (or get divorced from a spouse that makes you eligible to enroll) can keep the policy and pay the same amounts as when employed by the government.
• If you are eligible for coverage in more than one category, you are allowed to select the one you wish to apply under. This can be helpful in a variety of scenarios. One example; a military retiree who is also a newly hired federal employee can elect to sign up as a new hire and avoid the extended health questioning if the application is submitted within the 60-days-of-hire deadline.
• There is a 90-day waiting period-all enrollees must be eligible for benefits and be receiving covered services prior to the start of FLTCIP benefits.

Learn more about signing up by calling (800) 582-3337.