Long-Term Care
Insurance (FLTCIP).
The Federal Long Term Care Insurance Program provides coverage for nursing home care, assisted living, home care, and adult day care. The younger you are when you enroll, the lower your premiums for life. Don't wait until retirement to investigate this coverage.
What long-term care
actually is.
Long-term care is one of the most misunderstood types of insurance. It is not short-term medical care, not hospital care, and not disability coverage. Understanding what it covers — and what it doesn't — is the first step in deciding whether you need it.
Long-term care is the assistance you need when you can no longer perform the everyday tasks of life on your own — due to chronic illness, injury, disability, or the aging process. It is not intended to cure you. It is ongoing, chronic care that you might need for the rest of your life.
Most people assume long-term care means a nursing home. In reality, long-term care is most often provided at home, in adult day care facilities, or in assisted living facilities. You choose where you receive care — and the federal program allows you to pay eligible family members to provide that care for up to one year of coverage.
Don't wait until you are close to retirement to investigate long-term care. The younger you enroll, the lower your premiums for life.
Long-term care is NOT:
The 6 Activities of Daily Living (ADLs)
Coverage is triggered when you are no longer able to perform at least 2 of these 6 ADLs — or when you have a severe cognitive impairment such as Alzheimer's disease. Your doctor must certify that long-term care is medically necessary. There is typically an elimination (waiting) period of 30–90 days or more before benefits begin.
Transferring = moving from a bed to a chair or similar. Cognitive impairment (e.g. Alzheimer's disease) also qualifies independently of ADL count.
FLTCIP — program
information & eligibility.
The Federal Long Term Care Insurance Program is administered by John Hancock Life and Health Insurance Company under contract with OPM. The program is highly recommended for investigation and purchase before retirement — when you are younger, healthier, and premiums are lower.
Get estimates from both federal and private providers
Before enrolling, request estimates from the FLTCIP and from private long-term care insurance providers to compare coverage levels and premiums. The federal program is very competitive — and no physical exam is required, only a written certification of your overall general health — but private plans occasionally offer features worth comparing.
Contact FLTCIP at 1-800-582-3337 to request their benefit booklet or to make changes to existing coverage.
Who is eligible
Eligible to apply
Most federal and U.S. Postal Service employees and annuitants, active and retired members of the uniformed services, and their qualified relatives are eligible to apply for FLTCIP coverage.
FEHB eligibility requirement
Most employees must also be eligible for the FEHB Program to apply — actual enrollment is not required. Annuitants do not have to be eligible or enrolled in FEHB. Certain medical conditions may prevent approval. You must apply to determine eligibility.
Coverage amount & premium strategy
There is no obligation to insure 100% of the cost of care. Many retirees find it cost-effective to insure below the full average daily cost — using their savings to cover the gap — in exchange for meaningfully lower monthly premiums.
The "below average cost" strategy
Consider enrolling for a daily benefit amount that is 20–30% below the average daily cost of care in your area. If you have sufficient savings to cover the gap, this approach reduces your monthly premium significantly while still protecting the bulk of your estate from being depleted by care costs.
You can also choose a shorter benefit period — 3 years rather than 5, for example — to reduce premiums further. Statistically, the average long-term care need is under 3 years for most recipients.
Key advantages of the FLTCIP program
• No physical exam required — only written health certification
• You can elect to pay eligible family members to provide care for up to one year of coverage
• More care settings available than most private plans
• Future Purchase Option (FPO) allows benefit increases over time without re-underwriting
• Coverage for home care, assisted living, adult day care, and nursing home — all covered under a single policy
Retiree perspective — real numbers
My wife and I elected the Future Purchase Option (FPO) that originally provided $125 a day coverage for 5 years — total insurance coverage of $228,125 back in 2002. Today my coverage is $237.84 a day with total lifetime coverage of $260,434 over a three-year period. When I first applied, my premium was only $41.22 per month and my wife's (a year younger) was $38.63.
We purposely signed up for an amount that was about 20–30% below the average daily cost of care, knowing we had sufficient savings to cover the difference. This strategy resulted in lower monthly premiums. In 2016 we reduced coverage from 5 to 3 years with a slight drop in daily payments to retain our current payment levels. Today my premium is $163.06 per month and my wife's is $153.23 — after 23 years of coverage. If you tried to purchase this same coverage on a private exchange, the costs would be significantly higher.
Researching the options was confusing and took a week or so. One of the key reasons we chose the federal plan was that no physical was required — only written certification of our overall general health. We joined when the program was first offered, in our early 50s. You will be less likely to deplete your estate or become a burden to your family if you have this coverage.
— Dennis V. Damp, Retired FAAFLTCIP contact
& resources.
The FLTCIP website, OPM program guidance, and the national median cost of care data to help you determine the right benefit amount.
LTCFEDS.com — official FLTCIP program website
OPM FLTCIP Guidance — program information and eligibility
Genworth Annual Median Cost of Long-Term Care — national & state data
Long-Term Care Insurance — Is It Worth the Cost?
OPM Long-Term Care — full program overview and enrollment
FLTCIP Program Phone: 1-800-582-3337
Call to request a benefit booklet, get an enrollment estimate, or make changes to existing coverage.