The annual Medicare Open Enrollment period for 2022 begins on Oct. 15 and ends on Dec. 7.
Open Enrollment will look different from last year. This year will see a return to in-person counseling sessions, but many safety precautions are in place.
Changes in the Open Enrollment Counseling Contact Procedures for 2022: After over a year of phone counseling only, the Oneida County Health Insurance, Information, Counseling and Assistance Program (HIICAP) will return to in-person counseling sessions with some important restrictions. First, when you arrive at your appointment, you must show proof of a COVID-19 vaccination. You will also be required to wear a mask at all times while you are in the building.In-person counseling sessions will be provided at the following two locations:
Copper City Community Connection (formally the Ava Dorfman Senior Citizens Civic Center), 305 E. Locust St. Assistance will be provided on Tuesday and Thursday from 9 a.m. to 2 p.m. Copper City will serve clients on a “by appointment only” basis. Do not call the center directly for an appointment. Instead, you will need to call the main office of the HIICAP program at 315-798-5456 and ask for Joan. Joan Hyde will make all the appointments for Copper City.
North Utica Senior Citizens Center, 50 Riverside Drive, Utica. Hours of operation are from 9 a.m. to 3:15 p.m. on Monday, Wednesday and Friday. Sessions are expected to run 45 minutes. Consumers will be assisted at the North Utica Center on a “first come, first served” basis. However, if you want to call ahead to see how busy the office is you may call the center’s HIICAP program at 315-724-8680.
The Oneida County Office for the Aging and Continuing Care/NY Connects HIICAP office will continue to provide counseling services by phone only as they have throughout the pandemic. If you would like to do a HIICAP counseling session over the phone call 315-798-5456 and press #2 from the choice list. In most cases you will be asked to leave your contact information on a voice mail and a staff member will return your call within 72 hours (three business days).
The Medicare Eligibility is Age 65. The Medicare eligibility age of 65 no longer coincides with Social Security’s full retirement benefit age. For years, the age of drawing full Social Security benefits was set at age 65. If you are not drawing Social Security benefits, you will not be automatically enrolled in traditional Medicare.
So, if you are turning age 65 in the near future and do not want to sign up for Social Security benefits yet, you still need to sign up for Medicare. You will pay for your Medicare premiums directly until you begin to receive Social Security benefits. Once you are receiving Social Security benefits, your Medicare Part B premium will be deducted directly from your Social Security.
You can enroll in Medicare Parts A, B and D starting three months before you turn age 65 and as late as three months after your birthday month. As an example, if you are turning age 65 on Nov. 1, your enrollment period began on Aug. 1 and ends on March 1, 2022.
This creates a seven-month initial enrollment period. If you go beyond this period, you may be subject to a permanent enrollment premium penalty or surcharge for not enrolling on time. This is a lifetime penalty based on a formula that takes into account the number of months you are late as well as the amount of Medicare monthly premiums. Keep in mind that enrollment in Medicare is done through the Social Security Administration and not during Open Enrollment. You can enroll in Medicare online (www.SocialSecurity.gov), by phone (1-800-772-1213) or, if the offices are allowing visits, at any Social Security office.
What Changes can I Make During Open Enrollment? As noted above, if you are not enrolled in Medicare Parts A and B this is not the enrollment period for you. However, for all established Medicare beneficiaries, this is the time when you can make changes to almost all your coverage options.
If you are enrolled in Original Medicare (Medicare Parts A and B along with a Part D drug plan) you can change to a Medicare Advantage Plan with or without drug coverage. If the Advantage Plan does not have a “wrap-around” drug plan, you will need to choose a new plan or remain in the one you are currently using.
If you are enrolled in a Medicare Advantage Plan you can return to Original Medicare with a separate, “stand-alone” drug plan.
If you are unhappy with your current Medicare Advantage Plan, but do not want to return to Original Medicare, you can change from one Advantage Plan to another.
You can enroll in or change to a new Part D drug plan.
You can enroll in or switch to a new Medigap supplemental insurance plan.
How much will I pay for Medicare Part D Drug Coverage? One of the errors that many beneficiaries make is that they use cost as the only factor in choosing their Part D drug coverage. Like all types of insurance, your Part D premium will depend on a number of factors. Some of these factors include:
The drugs you are taking. Each drug plan has a list of medications, known as a formulary, that will tell you if the drugs you are taking will be covered by the plan. Not all plans cover all medications and costs of the same medications can also vary from plan to plan. If a drug is not included in the formulary, it will probably mean that you will be paying something close to full price for the medication.
The exact plan you choose. Many providers offer a choice of plans with different premiums attached.
Is your preferred pharmacy in your plan’s provider network? If it is not in the network, your drugs will probably cost you more. In some cases, the cost will be much more than if you use a pharmacy that is part of the Plan network.
You are receiving Extra Help in paying for the costs associated with your Plan. We have covered the various types of Extra Help options in previous columns.HIICAP counselors can see if you qualify for one of these savings programs.
As noted in the opening paragraph, in order to receive face-to-face counseling at one of the two counseling sites you must present proof that you have received the COVID-19 vaccination. Also, you will need to wear a mask at all times while you are in the building. If you are unvaccinated, counseling will still be available by phone.
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.