Articles

The “CLASS” Act and Planning for Home and Community Assisted-living Care

The CLASS Act was enacted to provide federal assistance for long-term home or community assisted-living care

One of the most difficult problems facing families with an aging loved one is planning for the possibility of long term care in a nursing home or assisted living facility or planning for home care to enable the individual to be cared for in the home.

The 2010 Obama Health Care legislation includes a voluntary long term care insurance program known as the CLASS Act to enable individuals to buy coverage for community living services and support if they become disabled.

It is intended to help qualified working adults with physical or cognitive limitations to plan for their future long-term care needs with a basic cash benefit. It is also designed to help individuals with physical or cognitive limitations remain in the community by purchasing non-medical services and support such as home health care and adult day care. While the CLASS ACT benefit is not designed to cover the entire cost associated with long-term care needs, it is intended to help offset the costs incurred by millions of adults with chronic and disabling conditions. The CLASS Act has a goal of reducing the costs incurred by Medicaid in providing long term care services by providing these long term care services through insurance rather than under the Medicaid program.

As originally enacted, benefits would not commence until 5 years after the commencement of premium payments. Benefits were not intended to cover all costs of long term care but to provide families with assistance in meeting these costs.

Implementation of the CLASS Act is delayed indefinitely

The CLASS ACT was scheduled to become effective on January 1, 2011 but the Secretary of Health and Human Services was given until October 2012 to develop specific details including benefits and premium structures.

However, it now appears that implementation will need to be delayed indefinitely. The Department of Health and Human Services has indicated that the plan will not be implemented unless an actuarially sound design of premiums and benefit structures can be established. The challenge for DHHS is to design a premium and benefit structure that will be self sustaining and not require subsidies from taxpayers. So far, the actuaries in the Department of Human Services have not been able to come up with a satisfactory premium schedule.

Alternatives for long term home and community assisted living care

Even if federal assistance becomes available to help with the cost of long term home and community assisted living care, you will want to plan ahead for these long term care options for you or your loved one. Alternatives include private long term care insurance, long term disability insurance, planning for home care, and planning for Medicaid eligibility.

We recommend that you plan now. There are steps you can take today that will help with long term care– and its costs — tomorrow. Call me at 207-774-2635, or e-mail me at phunt@perkinsthompson.com, if you would like more information, or legal assistance with your planning.