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Long-Term Care Plan
Eligibility
If you are a state employee participating in the Virginia Sickness and Disability Program (VSDP), you are covered under the VRS Long-Term Care Program. You pay no cost for this benefit. VRS has contracted with the Long Term Care Group, Inc. to administer benefits under the plan.
Benefits
The VSDP Long-Term Care Plan assists you in paying for nursing home care, assisted living facility care, hospice care, at-home services and community-based care. The maximum daily benefit amount is $96 with a lifetime maximum of $70,080.
Value of Your VSDP Long-Term Care Coverage
Most health insurance plans cover hospital, medical and outpatient care but not long-term care. Medicare provides for limited long-term care needs but not everyone qualifies for Medicare. The VSDP Long-Term Care Plan helps pay for eligible services not covered by other health plans or Medicare and, thus, lessens the burden on your personal resources.
Qualifying for Benefits
You are eligible for benefits when a licensed health care practitioner certifies that you:
- Are unable to perform at least two of six Activities of Daily Living without substantial assistance; or
- Have a severe cognitive impairment, such as Alzheimer’s disease, requiring substantial supervision.
How to Apply
VRS has contracted with the Long Term Care Group, Inc. to administer your benefits under the plan. Contact the Long Term Care Group, Inc. within 60 days of certification by a licensed health care practitioner that you qualify for benefits. A family member or friend can call on your behalf. A customer service representative will explain the information needed to process your claim. Within 10 days of receiving your completed application, the Long Term Care Group, Inc. will send you a written notice of your benefits.
Contact Long Term Care Group, Inc.
Long Term Care Group, Inc.
P.O. Box 64011
St. Paul, Minnesota 55164-0011
Toll free: 1-800-761-4057
Additional State Long-Term Care Coverage
You may have the option to purchase additional long-term care coverage through the Commonwealth of Virginia Long-Term Care Plan administered by VRS. This voluntary long-term care program allows you to cover yourself as well as eligible family members. You pay for the level of coverage you desire. For additional information, contact your human resource office or Aetna U.S. Healthcare toll free at 1-877-894-2470. You also can visit Aetna's Web site.
Other Long-Term Care Plans
You can coordinate your VSDP long-term care coverage with other long-term care plans you may have. Examples include:
- The voluntary long-term care plan through VRS;
- Aetna long-term care coverage you may have elected before December 1, 2007; and/or
- Other private long-term care insurance.
Contact your plan providers for more information.
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