Learn More About the Long-Term Care Coverage Offered by Your Plan

August 2023
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You may not have it marked on your roadmap to retirement, but knowing your long-term care options is a crucial step in planning for the future.

Life changes can be unexpected, and most health insurance plans don’t cover services such as nursing home care or in-home care to assist with activities of daily living. Anyone at any age may need these services, and the cost can quickly deplete savings. VRS administers long-term care programs that can help you plan for these situations.

What is long-term care? Long-term care services provide help with everyday life tasks because of a prolonged health problem or following a major illness, injury or surgery.

Examples include:

  • Care in a nursing home or hospice facility.
  • Assisted living facility care.
  • Community-based care.
  • Home healthcare services.
  • Informal caregiving.
  • Alternative or transitional care.

Am I covered? You are covered if you participate in either the Virginia Sickness and Disability Program (VSDP) or the Virginia Local Disability Program (VLDP), which depends on your plan and your employer. You can continue these programs at affordable group rates when you retire.

  • VSDP Long-Term Care Plan: For state employees in Plan 1, Plan 2 and the Hybrid Retirement Plan.
  • VLDP Long-Term Care Plan: For political subdivision and school division employees in the Hybrid Retirement Plan whose employer participates in VLDP. If your employer doesn’t participate in VLDP, contact your Human Resource office for more information on whether the comparable program offered includes long-term care.

The maximum daily benefit amount for both plans is $96, with a lifetime maximum of $70,080. You are eligible for benefits under your long-term care plan if a licensed healthcare practitioner certifies that you are unable to perform at least two activities of daily living or have a severe cognitive impairment. Activities of daily living include bathing, getting in and out of bed, dressing, using the bathroom and eating.

Note: If you are a member of the Judicial Retirement System (JRS), or a political subdivision or school division employee in Plan 1 or Plan 2, you are covered under VRS disability retirement. If you are a member of JRS or a state employee in Plan 1 hired before January 1, 1999, who did not choose VSDP during one of two open enrollment periods offered in 1999 and 2002, you are also covered under VRS disability retirement.

Can I buy more coverage? Yes, if you are between the ages of 18 and 75. The Commonwealth of Virginia (COV) Voluntary Group Long Term Care Insurance Program is available for purchase. This is an optional employee-paid benefit that helps with long-term care expenses.

If you are age 65 and under and apply within 60 days of employment, you are eligible to enroll with reduced medical underwriting (proof of good health). Eligible family members between the ages of 18 and 75 may also apply for coverage if they undergo full medical underwriting.

If you are eligible for the VSDP Long-Term Care Plan, the VLDP Long-Term Care Plan or have other long-term care insurance, you may be able to coordinate with this voluntary program to obtain even more coverage.