The New Old Age, the New York Times’ health blog, has been following the CLASS Act closely and providing details as they become available. A two-part story was posted on the blog last summer, which can be read in its entirety here. To summarize some of its key points, however, this post will go over some of the more important developments to CLASS, America’s first stab at making long-term healthcare insurance widely-available.
The following questions were fielded and answered by The New Old Age, and are summarized below:
Q: Who can enroll for CLASS?
A: Only working people can enroll for CLASS, and even then, they must pay premiums for at least five years before becoming eligible to receive benefits. These people must continue to work for three of the five years that they pay into the system. Part-time employees can enroll for CLASS, but only if they earn enough to pay Social Security taxes, and the self-employed will also be able to enroll.
Q: Does CLASS have pre-existing condition limitations?
A: CLASS is prohibited from excluding people from enrolling in the program based on pre-existing conditions.
Q: When does CLASS begin?
A: While a firm start-date has yet to be announced, most experts anticipate enrollment to begin by late 2012 or early 2013.
Q: How much will it cost to enroll in CLASS?
A: Here again, the actual cost has not yet been announced, but the Congressional Budget Office predicts that enrollees will pay around $125 per month on average. This cost will go up or down based on the enrollee’s age. Because CLASS is required by law to remain sound for 75 years, premiums can be raised to ensure that it does. Once an enrollee has paid into CLASS for 20 years, and has reached the age of 65, however, his premiums can no longer be raised.
Q: What benefits will CLASS provide?
A: The legislation requires CLASS to pay an average benefit of at least $50 a day, but this amount will vary from person to person. Before receiving benefits, enrollees must require assistance with at least two activities of daily living, such as eating and bathing, or be cognitively impaired.
Q: Will CLASS cover the costs of care in a skilled nursing facility?
A: As it now stands, CLASS benefits are not enough to cover the costs of care in a skilled nursing facility. They are, however, enough to pay for caregiver costs or time in an adult daycare program, both of which could help delay the need for around-the-clock care. It is true that nursing home care costs around $200 a day, and that CLASS will not cover this amount, but $50 a day does add up, and benefits of $2,000 per month will undoubtedly be helpful to seniors in need of assistance.
Q: Will CLASS be a burden on taxpayers?
A: As the law is now set up, CLASS cannot rely on tax dollars for sustenance.
Being a new piece of legislation, CLASS’s details are still in the making. We will post more information about the legislation as it is revealed. In the meantime, the best advice for seniors is to carefully consider their long-term healthcare needs, and plan accordingly to ensure that they can afford suitable care if the need arises. Because it is not yet possible to obtain insurance through CLASS, ALTCS planning is a must for seniors who require long-term health care. Arizona Medicaid is many times the best option for those in need of long-term care, and an Elder Law attorney may be able to help seniors obtain ALTCS eligibility with as little delay possible.