By Rokeya Sultana, Collin LIVING WELL Magazine
The recent federal health care reform legislation includes a little noticed provision that creates a voluntary national insurance program for long-term care known as the Community Living Assistance Services and Supports program (CLASS), or CLASS Act. According to the Kaiser Foundation, it is the “sleeper” in health reform.
CLASS is a new voluntary, federally administered insurance program created under the Affordable Care Act (ACA).
Most working adults age 18 or older will be able to voluntarily enroll for CLASS either directly or through their employers, without answering questions about their health.
Those who enroll and meet the benefit eligibility requirements will receive benefits to purchase long-term services and supports such as (but not limited to) personal assistance, homemaker services, specialized transportation and assistive technology to help them address their care needs.
CLASS is not an entitlement program. Some people will not be eligible to enroll and some people who enroll will never meet the requirements to receive benefits.
Pre-existing medical conditions will not disqualify someone from enrolling. Individuals who enroll will be eligible to receive benefits if they meet specific requirements regarding functional limitation, earnings, and premium payment. Enrollees pay the premiums. Benefits will be paid from premiums and earnings on those premiums. Taxpayer funds will not be used to pay benefits.
The need for long-term care can strike anyone at any age. While many people who need long-term care are age 65 or older, a person can need long-term care services at any age. Forty percent of people currently receiving long-term care are adults 18 to 64 years old.
Will Medicare and/or my health insurance pay for any long-term care services I might need?
Generally, no. Medicare pays for nursing home care and/or home care only under limited circumstances after a hospital stay and only for a limited time period. Medicare and health insurance pay for acute care generally needed for a defined period of time with the expectation you will recover or your condition will improve. Long-term care is chronic care (ongoing and long lasting). It’s not acute care.
Rokeya Sultana is the owner of Accessible Home Health Care, a full service home health care provider. You may visit their website www.accessiblecollin.com or call them at 972-516-4384.