Medicare for 2021


As I write this month’s HIICAP article the 2021 Open Enrollment period is in full swing.

But, unfortunately so is the COVID-19 virus. According to data available on the Oneida County COVID 19 Dashboard, cases are increasing daily. So, remember to always wear a mask when going outdoors, socially distance and wash your hands often. Avoid unnecessary trips and indoor gatherings.

And while the holidays are the traditional time for large family get-togethers, this year is a very good time to rethink your plans. As cases continue to mount, please follow the Oneida County, state and CDC safety guidelines.

Open Enrollment update. By the time this article appears the 2021 the Medicare Open Enrollment period will be nearing the Dec. 7 closing date. To get an update, I spoke with Joan Hyde, Aging Services supervisor with the HIICAP program. Hyde talked with her staff about the enrollment trends that have occurred through the middle of November. According to Hyde, “Many people who have Medicare Advantage Plans are satisfied with their current coverage and are remaining with their plans.” However, a problem has emerged for those who are covered by Original Medicare and a “stand alone” Part D drug plan.

According to Hyde, the cost of drug coverage for those using stand-alone plans has increased. This is especially true for those using name brand drugs. Part of the issue is that more physicians are ordering name brand drugs as opposed to generic equivalents for their patients. She stated that HIICAP counselors have been recommending that patients ask their physicians about switching to the less expensive generics drugs and away from these more expensive name brand medications.

Research on this topic indicates that one possible reason for this is that many of our drugs are manufactured in Puerto Rico and recent storms, especially hurricane Maria in 2018, disrupted this supply chain. Some pharmacies begin using drugs manufactured in China and problems were found with many of these generics.

So, physicians became worried about drug quality and switched to prescribing name brands over generics. Keep in mind that most of the large pharmacy chains do use drugs manufactured in China. If you have any concerns about the source of your medications speak to your pharmacist.

Hyde said that counselors are finding that the new Medicare Plan Finder is challenging for many people to use. They are working with people on using the website. They are also finding that newer beneficiaries do not understand their Medicare benefits.

There is some good news for beneficiaries. Counselors are screening more clients for the Extra Help programs and Oneida County is responding to submitted applications very quickly. Many are qualifying and are receiving reimbursements going back several months. If you feel you may qualify, consult the HIICAP office. Requests for coverage under Extra Help can occur anytime during the year.

Finally, Hyde recommended that if you have only a few days to make changes in your plan and you can’t get through to a HIICAP counselor, call the national 1-800-Medicare. Medicare does have excellent counselors that help you if you can’t get through to Oneida HIICAP.

New Executive Director of the North Utica Senior Center. Sandra Soroka became the executive director of the North Utica Senior Center (Utica Center) in August when Yvonne McCluskey retired. Soroka remains as the executive director for the Neighborhood Center, a position she has held since 2006. The Neighborhood Center is open for remote activities at this time. The staff rotates and works from home.

The Utica Center remains closed for the activities for older adults including HIICAP counseling. However, the child care side is open and serves as a remote learning site for school-age children. They are currently conducting a survey about the activities and services the Utica Center offers. If you have not been contacted and wish to participate, call the Utica Center and leave a message.One of the staff will be in touch to obtain your contact information.

Later in the spring I hope to do a full article with Director Soroka on the results of the survey and their plans for restarting the center’s programming.

Medicare Part A and B premiums set for 2021. In October the Social Security Administration announced that the Cost of Living (COLA) for 2021 would be 1.3 percent. Since the average Social Security benefit is calculated to be $1,523 per month, a 1.3 percent increase will result in an increase of slightly under $20 per month for the average recipient.

Early in November the Centers for Medicare and Medicaid Services (CMS) announced that the standard monthly premium for Medicare Part B will increase by $3.90 to $148.50 per month, up from $144.60 this year. At the same time, CMS announced that the annual deductible will increase from $198 to $203 in 2021. Those with higher incomes will see higher increases.

Because of the increased health care costs related to COVID 19, many had expected both premium and deductible increases for 2021. However, history tells us that in an election year, COALs tend to be higher and premium and deducible increase lower.

What can we expect for 2022? Although nothing is certain, I think Medicare beneficiaries should brace themselves for premium increases when the full effects of this COVID-19 medical emergency have been absorbed. In addition, there will be the costs associated with the manufacture and distribution costs of a very expensive vaccine.

Who do I contact this year about Medicare Open Enrollment for 2021? As noted above, usually this paragraph directs readers to one of two locations in Oneida County where counselors are available. However, both of these facilities will remain closed for the foreseeable future. All home visits and face-to-face counseling service at all other locations have also been suspended.

All HIICAP counseling services are now being provided directly by Oneida County Office for Aging and Continuing Care/NY Connects. Anyone who needs help during the fall Open Enrollment Period call the HIICAP office directly at 315-798-5456 and select option No. 2. You will probably be asked to leave a message and your call will promptly be returned. A trained counselor will now provide with the same high-quality service over the phone that has been provided in-person for years.

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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