HIICAP program benefits and services

by William C. Lane, Ph.D.
Posted 6/30/19

I am taking the month of July off. So, this column first appeared in this space slightly more than three years ago. I realized that so many of our readers may be new to Medicare, it was time to again …

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HIICAP program benefits and services

Posted

I am taking the month of July off. So, this column first appeared in this space slightly more than three years ago. I realized that so many of our readers may be new to Medicare, it was time to again review the services offered by the Health Information, Insurance Counseling and Assistance Program (HIICAP).

So, this article is devoted to providing readers with a broad overview of the program and how it serves the needs of Oneida County residents. Many of the topics covered here will form the basis for in-depth articles that will appear over the next year.

What is HIICAP? The Oneida County Office for Aging & Continuing Care/NYConnects provides the HIICAP program as part of a network of health insurance counseling programs covering all counties in New York. In addition to the local staff counselors, the program is also supported by a network of more than 500 fully trained volunteer counselors across the state.

Counselors offer unbiased counseling, information and assistance. The HIICAP program receives Federal Assistance from the Centers for Medicare and Medicaid Services (CMS) as well as funding from the state. The mission of HIICAP is to both provide assistance and educate residents about Original Medicare Parts A and B, Medicare Advantage plans and Medicare Part D prescription drug programs as well as numerous other health insurance issues.

In addition to the above programs, HIICAP also provides information on all the programs that assist residents in paying their premiums and co-pays. These programs include the Elderly Pharmaceutical Insurance Coverage (EPIC) Program, Medicare Savings Programs, “Extra Help” prescription assistance and pharmacy discount programs. These programs may pay all or part of your monthly costs, offer discounts or provide full medical coverage.

Who can use the HIICAP program? The Oneida County HIICAP Program serves all Medicare beneficiaries over age 65 and their caregivers as well as those who will soon become Medicare eligible. The HIICAP program also serves:

• People younger than age 65 who are eligible for Medicare due to a disability.

• People needing information on long-term care insurance.

• Dual eligibles, those now eligible for both Medicare and Medicaid.

To use the Oneida HIICAP services, you must reside in Oneida County. Counseling and assistance is provided by highly trained counselors, either over the telephone or during visits to one of the counseling centers. All the information you provide the counselors is held in strict confidence. The most common HIICAP services are:

• Facilitating initial enrollment into Medicare Parts A, B and D.

• Explaining the benefits covered under Medicare Parts A and B.

• Selecting a Medicare Part D prescription drug plan. Once you have made your initial choice, your coverage should be reviewed annually during the fall open enrollment period.

• Explaining the differences between original Medicare and Medicare Advantage Plans.

• Providing information about supplemental insurance programs, usually called Medigap plans, that cover all or a portion of those charges not covered by Medicare.

• Helping clients resolve specific health insurance problems.

• Looking to see if you may be eligible for additional help in paying for your health care costs through programs such as EPIC or Extra Help.

• Helping with special problems that may arise during the year, such as loss of coverage through no fault of your own.

• Assistance in processing doctor and hospital bills, preparing health insurance claims and, if necessary, filling Medicare appeals.

• Assistance to consumers who believe they have been the victims of fraud or abuse related to health insurance coverage.

Is there a cost for HIICAP services? No, the program is free. There are no fees or co-pays. As noted above, HIICAP counseling services are funded by CMS, New York and Oneida County.

How do you access HIICAP services in Oneida County?

Oneida County HIICAP is a program of the Oneida County Office for the Aging/Continuing Care/NYConnects. For information regarding Medicare, Medicaid, Medicare Supplemental Health and long term care coverage contact the Oneida County Office for the Aging/Continuing Care/NYConnects at 315-798-5456.

On Tuesday and Thursday between hours of 10 a.m. and 2 p.m., you can visit a counselor at Copper City Community Connection, 305 E. Locust St. It is a good idea to call the Center at 315-337-1648 to make sure a counselor will be available.

In Utica you can see a HIICAP counselor on Monday, Wednesday or Friday between the hours of 10 a.m. and 2 p.m. at the North Utica Community Center located at 50 Riverside Drive in Utica. You can reach the Utica center at 315-724-8680.

More information is available on the Oneida County Office for the Aging/Continuing Care/NY Connects website. The HIICAP link is http://www.ocgov.net/oneida/ofa/hiicap.

The state-wide HIICAP web site is maintained by the New York State Office for the Aging. The link is http://www.aging.ny.gov/HealthBenefits/Index.cfm.

Help with Medicare related issues can also be found at the Medicare website, www.medicare.gov.

The Medicare program also offers the Medicare Resources help line. The number is 1- 800-633-4227.

While many people only associate the HIICAP program with Medicare Part D Open Enrollment period held every fall, as noted above the program offers many more services on a year-round basis.

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

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