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CalPERS Long-Term Care Frequently Asked Questions

Learn more about long-term care and coverage offered by CalPERS. If you have a question that isn’t addressed here, please call us at (800) 908-9119.

Q: What is long-term care?

A. Long-term care refers to the services provided to people who have difficulty managing the activities of daily living due to illness, injury, disability, cognitive disorder or aging. CalPERS Long-Term Care coverage helps pay for the high cost of care when one needs assistance with the activities of daily living, which includes bathing, dressing, toileting, transferring (such as from a bed to a chair), continence, eating or a severe cognitive impairment.

Q. Why do I need long-term care coverage?

A. CalPERS Long-Term Care coverage offers more control over how you may live your life if you need assistance with the activities of daily living as a result of injury, aging, illness, or cognitive impairment, such as Alzheimer’s disease. It provides the financial resources you may need to choose the location and type of care you receive. CalPERS Long-Term Care coverage helps to pay for care you may need.

Q. Will my family care for me?

A. Many people assume that family members will take care of them if they need long-term care. However, even the most dedicated family members will not likely be available 24 hours per day, seven days per week for a long period of time. Having a long-term care plan in place can help cover the cost of receiving care at home when family members are away. Long-term care also can make it possible for you to receive daily care without having to rely on family or friends. With CalPERS Long-Term Care coverage, you can make decisions that are right for you and your family. Please note that the CalPERS Long-Term Care Program will not reimburse family members for care they provide you.

Q. Will Medi-Cal/Medicaid, Medicare or health insurance cover my long-term care needs?

A. Long-term care is different from other health care and is not typically covered by health insurance, Medi-Cal, Medicare or Medicare supplemental policies. Medicare and Medi-Cal cover very limited long-term care services.

Q. I am still relatively young. Should I wait until I am older to get coverage?

A. Young or old, people require long-term care for a variety of reasons. At any age, whether it is due to an accident or illness, health-related impairments can change everything. While you may not need long-term care until you’ve advanced in age, your premiums are lower the earlier you get started.

Q. Would I be better off saving on my own to pay for long-term care services?

A. Not everyone is able to save enough money to cover the high cost of long-term care. Without coverage, paying for long-term care can quickly deplete even sizable savings.

Q: How long is the current average long-term care claim?

A. An analysis of CalPERS historical data shows that, on average, CalPERS Long-Term Care Program participants spent 3.4 years in claim and less than 1 percent required long-term care for more than 10 years.

Q. When will my coverage expire if I choose the three-, six- or 10-year benefit periods?

A. Your coverage does not expire unless you exhaust your total coverage or choose to terminate your plan. For example, you might initiate a claim and use one-third of your total coverage amount. Should you recover your health and close the claim, you would still have two-thirds of your total coverage amount remaining in the event of a future claim. If you choose a three-year benefit period, it is possible that your benefits will continue for a period of time longer than three years if you do not use your maximum daily benefit amount every day.

Q. Can my premium be increased?

A. Your premiums could increase in the future under certain circumstances, but only after approval by CalPERS. Should a premium increase occur, all impacted CalPERS Long-Term Care Program participants will receive a 60-day written notice. If you cannot afford the increase, or do not want to accept the premium increase, you may be given the option to adjust your coverage to an amount that would let you maintain or lower your existing premium.

Q. What if I die before I use all of my CalPERS Long-Term Care coverage benefits?

A. The CalPERS Long-Term Care Program offers an optional benefit for the return of premium at death. If you select this optional benefit and die before age 75, a percentage of your premiums will be returned to your estate, minus any benefits paid by the CalPERS Long-Term Care Program. Premiums paid for coverage protection are not refundable if you die before you use your benefits. Without the optional return of premium at death benefit, unused coverage remains with the CalPERS Long-Term Care Program for future liabilities. This optional benefit is only available at the time you submit your application. You must be between the ages of 18 and 65 at the time of application in order to select this optional benefit. See the Outline of Coverage (PDF, 708 KB) for more information.

Q. I am in a domestic partnership. Am I eligible for CalPERS Long-Term Care?

A. If both you and your domestic partner are independently eligible for CalPERS Long-Term Care through the program’s established eligibility criteria, you may both apply separately. If you are both issued policies, you will then be eligible for benefits available to married couples.

Have additional questions?

Contact CalPERS Long-Term Care customer service:
(800) 908-9119 or email to CalPERSltc@ltcg.com
Monday - Friday, 8:00 a.m. - 5:00 p.m. PT