Archive for March, 2011

Affordable Care Act (ACA) Facts: Fact # 3

Tuesday, March 8th, 2011

Affordable Care Act (ACA) Facts: Follow this Series

There is a lot of speculation and discussion about what affect health care reform legislation, the Affordable Care Act (ACA), will have on seniors and more specifically, Medicare. We decided to do a series of blog posts about the facts; this is part of our ongoing posts, so please see Fact # 1 in a post dated, Feb 8, 2011 and Fact # 2 in the post dated 2/24/11.

Fact: The law will make it easier to receive and pay for long-term care at home.

As we covered in our Medicare Myths post, Medicare does not cover long term care costs. Long term care in a facility or at home is often an out of pocket expense. The Affordable Care Act has some provisions (Section 2401-2403) that allow States to apply for Federal Funding to provide in home services. Some of these programs already exist in NJ and are open to those who have or are eligible for Medicaid. Starting in 2011, the Law allows States to apply for additional funding for these Medicaid programs, often referred to as, Waiver programs.

You may have heard about the new national long-term care insurance program called CLASS (Community Living Assistance Services and Supports). According to the ACA this will become available in 2013. Full and part-time workers with salaries of at least $1,200 per year will be eligible to participate in CLASS and may choose to have the premiums deducted from their paychecks. Non-working retirees are not eligible for the program. After you have participated in CLASS for at least five years and you can no longer perform basic activities (such as eating, dressing, or bathing, or if you have Alzheimer’s disease or other forms of dementia), you are eligible to receive a daily cash benefit. This cash benefit is expected to average $50 per day and can be used to pay for anything that will help you stay at home. Examples of things it will pay for include, home care services and equipment.

Beginning in 2014 the ACA specifies that more regulations be put in place to protect spouses of those who are receiving home care services. Sometimes referred to as, “Spousal Impoverishment” rules, some states, including NJ already have these in place for those who have a spouse living in a nursing home who needs to apply for Medicaid. What the regulations do is protect the money that the other spouse needs to remain living in the community, the ACA states that this should be extended to spouses that have an ill husband or wife at home who is in need of Medicaid services.

Information in this blog was gathered from the Affordable Care Act, Centers for Medicaid and Medicare and the National Council on Aging.

For more information:

A brochure from Medicare:

http://www.medicare.gov/Publications/Pubs/pdf/11467.pdf

Webpage from the National Association of States United for Aging and Disabilities (NASUAD):

http://www.nasuad.org/affordable_care_act/nasuad_materials.html

Answers from the National Association of Area Agencies on Aging (n4a):

http://www.n4a.org/advocacy/health-care-reform/

Straight Talk for Seniors from the National Council on Aging:

http://www.ncoa.org/public-policy/health-care-reform/straight-talk/

Details about the law at Heathcare.gov

http://www.healthcare.gov/law/about/index.html