Brief history of HIICAP can help folks to better understand SHIP program

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For the past several years I have written this monthly column which focuses on the services provided by the Oneida County Health Insurance Information Counseling and Assistance Program or HIICAP.

Beginning with this article, and continuing next month, we will examine the national and statewide development of health insurance counseling and how the Oneida County HIICAP program fits into this critical network of information services.

The State Health Insurance Assistance Program (SHIP) was created in 1990. This federal law authorized the Centers for Medicare & Medicaid Services to make funds available to states to establish and maintain health insurance assistance programs for Medicare beneficiaries. The result was a national network of information, counseling and assistance programs. In response, New York established the HIICAP program.

In 2014 the national SHIP program was transferred from CMS to the Administration on Community Living (ACL). This transfer formally recognizes that SHIP programs such as HIICAP are a major component of the network of aging services. Today all 50 states, as well as Puerto Rico, Guam, the District of Columbia and the U.S. Virgin Islands, all have active SHIP programs.  

In the beginning, the main services provided related to information regarding Medicare supplement insurance (Medigap) plans, the newly emerging Medicare Advantage plans as well as long-term care insurance and managed care options. By 2008, the newly created Medicare Part D prescription drug program had become a central focus to the point that many people seem to believe that it is the only thing HIICAP does. This is far from the truth.

Today, HIICAP programs offers insurance counseling programs to older people and their families, as well as persons with disabilities, assisting them in obtaining coverage through options including the Original Medicare program, Medicare Advantage (Part C) Plans, and Medicare Prescription Drug (Part D) Plans.

The HIICAP program continues to assist people in selecting a Medigap that best fits their needs along with assistance issues related to long-term care insurance. Also, as discussed in recent columns, HIICAP provides assistance in obtaining financial help in paying for out-of-pocket health and prescription drug coverage. 

To help us understand the HIICAP program state-wide, I asked Brenda LaMere, state HIICAP Coordinator/Director with the state Office for the Aging, to provide us with this perspective. Director LaMere has worked for NYSOFA for more than 29 years and has served as the HIICAP Director since 2006.

Q: Director LaMere, let’s start with some state-wide statistics. I know that you do not have any 2018 data that you can share, but what about 2017?

A: “When I started with HIICAP in 2006 we served an average 40,000 clients a year. Now we average over 150,000 clients each year. Just to give you one example from 2017, in that year we enrolled over 10,000 older adults into low income subsidy programs that saved New Yorkers 42.7 million dollars.”

Q: That leads us into our next topic. This column has put forward the idea that HIICAP is much more than a Medicare Part D counseling service. Can you tell our readers some of the other programs that you cover?

A: “HIICAP counselors spend a lot time across the state with dual managed care clients, those who are eligible for both Medicare and Medicaid services.” 

“We also have clients who have problems with their Medicare Advantage Plans,” she said. “The most recent example would be the expansion of WellCare programs. WellCare was providing Part D coverage, but they expanded to offer Advantage plans also. Problems have occurred because their new beneficiary cards were arriving late. At the state level we have been working very hard with WellCare to correct this problem. I want to point out that WellCare has really done an excellent job in clearing up this problem and they have been great to work with.”

LaMere continued, “There are issues that arise every year. We have people who did not receive or did not respond to an annual notice of change from their Advantage plan which can impact their Part D coverage. We also provide assistance with durable medical equipment coverage, Medicare approved contractors and Medicare billing questions. While the Medicare Part D prescription drug coverage will always be our main focus, there are many other areas of concern for our clients and counselors that occur year around.” I want to thank Director LaMere for her insights into the HIICAP program. Next month we will finish our conversation and move our focus back to Oneida County. And, I want to remind everyone again that the Oneida HIICAP program is here to serve you year round.

Who do I contact in Oneida County for help? The Oneida County Office for the Aging/Continuing Care/NY Connects Health Insurance Information, Counseling and Assistance program (HIICAP) offices provide their services at no cost to Medicare beneficiaries. HIICAP offices are found at these sites:

Copper City Community Connection, 305 E. Locust St., with hours of operation on Tuesday and Thursday from 10 a.m. to 2 p.m. While consumers are seen on a “first come, first served” basis you may call the center at 315-337-1648 to see if there are long wait times.

North Utica Senior Citizens Community Center, 50 Riverside Drive, Utica with hours of operation on Monday, Wednesday and Friday from 10 a.m. to 2 p.m. Consumers are counseled on a “first come, first served” basis. You can call ahead to see how busy the office is you may call the center’s HIICAP program at 315-724-8680.

HIICAP services are provided by Oneida County Office for Aging and Continuing Care/NY Connects. Anyone with questions about HIICAP, including issues with your Medicare Advantage Plan, should call the program directly at 315-798-5456 and press 4 in the choice list. It will direct you to someone who can assist you.

Dr. William Lane is the owner of William Lane Associates, a gerontological firm located in Homer, NY. He writes a monthly column on HIICAP related issues for the OFA. Dr. Lane does not sell insurance, work for any insurance company or recommend any insurance products.

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