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The CalPERS Long-Term Care application kit includes everything you need to apply for long-term care coverage. Long-term care requires planning, often with your financial advisor and family. Please take the time to review the entire application kit and determine what care you might need and the coverage that’s right for you. You may either download the application kit or request one be mailed to you.

Download an Application Kit to Your Computer

The application kit consists of the following documents. It is important you download all of these documents, including the customer guides.

  • Welcome Letter (PDF, 268 KB)
    Congratulations on taking a very important step regarding your future. Long-Term Care coverage can be a valuable tool in your financial and retirement planning.
  • Long-Term Care Brochure (PDF, 193 KB)
    This brochure will help you better understand Long-Term Care and the CalPERS Long-Term Care Program.
  • Outline of Coverage (PDF, 687 KB)
    The Outline of Coverage provides additional detail about CalPERS Long-Term Care plans.
  • Plan Selection Worksheet (PDF, 605 KB)
    The Plan Selection Worksheet helps guide you in completing your application form.
  • Monthly Rates Sheet (PDF, 498 KB)
    Refer to the Monthly Rates Sheet to view the estimated monthly premium costs of CalPERS Long-Term Care coverage options.
  • Program Application (PDF, 492 KB)
    Apply for CalPERS Long-Term Care. Refer to the Apply page for more information about how to complete and submit an application.
  • Customer Guides

    These guides to long-term care are produced by the California Department of Aging and California Department of Health Services to provide you more information about long-term care and long-term care coverage. They are available for download:
    Taking Care of Tomorrow (PDF, 1,851 KB)

    Before You Buy (PDF, 1,098 KB)

    What Happens When Long-Term Care Costs Rise? (PDF, 882 KB)

Receive an Application Kit by Mail

If you’d prefer to have an application kit mailed to you, click here to request one.

Illustrative Evidence of Coverage

The information provided on this website and in the CalPERS Long-Term Care application kit provides a brief description of the important features of coverage available through the CalPERS Long-Term Care Program. Only the Evidence of Coverage, which will be provided to you upon notification of your acceptance into CalPERS Long-Term Care, contains governing agreement provisions between you and the Program. This means that the Evidence of Coverage sets forth in detail the rights and obligations of both you and CalPERS. Therefore, if you purchase this coverage, or any other coverage, it is important that you read your Evidence of Coverage carefully. An illustrative copy of the Evidence of Coverage for each plan type is available for download:

Illustrative Comprehensive Plan Evidence of Coverage (PDF, 10 MB)

Illustrative California Partnership Plan Evidence of Coverage (PDF, 8 MB)