Federal Long Term Care Insurance Program (FLTCIP)

As a Federal Employee, you can purchase Long Term Care insurance under the Federal Long Term Care Insurance Program (FLTCIP). This program provides coverage when you and your dependents are no longer able to perform everyday tasks due to chronic illness, injury, disability or the aging process. Coverage is also offered for those who are suffering from a severe cognitive complaint, such as Alzheimer’s disease.

Who is Eligible for Long Term Care?

• Federal employees who are eligible for the Federal Employees Health Benefit Program whether or not they are enrolled
• Federal or USPS annuitants, including survivor or deferred annuitants
• Retired members of the uniformed services or the “Grey Reservists”
• Qualified relatives
  • Spouses of employees
  • Spouses of annuitants
  • Same sex domestic partners
  • Surviving spouses of active and retired members of the uniformed services
  • Parents, parents-in-law and step-parents of employees listed above EXCEPT for parents, parents-in-law and step-parents of those in the uniformed services who are NOT eligible
  • Adult children (at least 18 years old, including adopted or step-children) of living employees or annuitants listed above

Long Term Care Coverage Provided

FLTCIP provides reimbursement for the actual expenses you incurred for the following expenses:

• Nursing home, assisted living or hospice facility – 100% of your daily benefit amount
• Bed reservations – 100% of your daily benefit amount limited to 60 calendar days per year
• Home care and adult day care – 100% of your daily benefit amount
• Respite services 100% of your daily benefit amount limited to 30 calendar days per year
• Formal caregiver services – 100% of your daily benefit amount
• Informal caregiver services – 100% of your daily benefit amount (Note: informal caregivers are defined as individuals who do not normally live in your home. Benefits for caregiver services provided by family members are limited to 500 days in your lifetime.)
• Hospice care at home – 100% of your daily benefit amount
• Stay-at-home benefit – 30 times your Daily Benefit Amount

Long Term Care Plan Offerings

FLTCIP offers the following four plan options, in addition to letting you customize your own plan:

• Plan A: A good choice if you are looking for lower-cost protection, if you are living in an area where long term costs are low, or if you intend to pay some of the costs in the future.
  • Daily Benefit Amount: $150.00
  • Benefit Period: Two years
  • Maximum Lifetime Benefit: $109,500
  • Waiting Period: 90 calendar days
  • Inflation Protection: 4% Automatic Compound Inflation Option, 5% Automatic Compound Inflation Option or Future Purchase Option

• Plan B: A good choice if you want protection for three years (the average stay in a nursing home) or if you are living in an area where long term costs are low.
  • Daily Benefit Amount: $150.00
  • Benefit Period: Three years
  • Maximum Lifetime Benefit: $164,250
  • Waiting Period: 90 calendar days
  • Inflation Protection: 4% Automatic Compound Inflation Option, 5% Automatic Compound Inflation Option or Future Purchase Option

• Plan C: A good choice if you want protection for three years (the average stay in a nursing home) or if you are living in an area where long term costs are close to the national average.
  • Daily Benefit Amount: $150.00
  • Benefit Period: Three years
  • Maximum Lifetime Benefit: $219,000
  • Waiting Period: 90 calendar days
  • Inflation Protection: 4% Automatic Compound Inflation Option, 5% Automatic Compound Inflation Option or Future Purchase Option

• Plan D: A good choice if you are living in an area where long term costs are close to the national average, but you want protection for a longer period of time.
  • Daily Benefit Amount: $200.00
  • Benefit Period: Five years
  • Maximum Lifetime Benefit: $365,000
  • Waiting Period: 90 calendar days
  • Inflation Protection: 4% Automatic Compound Inflation Option, 5% Automatic Compound Inflation Option or Future Purchase Option

• Customized Plan: If you choose to customize your own plan, you must use the following features:
  • Daily benefit amount options: $100, $150, $200, $250, $300, $350, $400 or $450
  • Benefit period options: two years, three years, five years or unlimited
  • Inflation protection options: 4% automatic compound inflation option, 5% compound inflation option or Future Purchase option.

Government Critical Illness Insurance

As a federal employee, you are not offered specific Government Critical Illness coverage; however, you can get insurance for a critical illness through American Benefits Exchange. You can supplement your government insurance benefits by purchasing our Critical Care Insurance.*** This product is underwritten by Madison National Life Insurance Company and marketed through American Benefits Exchange.

How Critical Illness Coverage Works

Critical Illness Insurance coverage gives you a lump sum benefit payment when a covered medical condition is diagnosed. This payment is made directly to you and you can use it in any way you choose, for:

• Treatment
• Daily household expenses
• Car payments
• Business expenses
• College tuition payments

Why Purchase Critical Illness Insurance?

• Critical Care Insurance can help you pay for out-of-pocket expenses and specialty drugs, which are not covered under your Federal plan.
• Critical Care Insurance benefit payments will help you avoid withdrawing money from your TSP accounts.
• Critical Care Insurance benefit payments will make up for lost wages due to illness.
• Serious medical conditions are very expensive.

Covered Illnesses

You will receive a benefit payment if you experience any of the following health conditions:

• Heart Attack
• Stroke
• Major Organ Failure
• Coronary Artery Bypass
• Angioplasty
• Coma
• Paralysis
• Severe Burn

Eligibility
You are eligible to apply for a Critical Illness Insurance plan if you are between ages of 18 and 64 and a permanent, legal resident of the United States. Your lawful spouse (or partner, as defined by each state) and your children through age of 24 are also eligible. Critical Illness Insurance is renewable to age 75.

***Please note: Critical Care Insurance is not available in all states. All products are available to state approval.