This marks the sixth consecutive year that I have devoted a column to the annual publication Medicare & You.
For those new to Medicare, prior to the Open Enrollment period all beneficiaries receive a publication from the Centers of Medicare & Medicaid Services entitled Medicare & You (2020).
You now have a choice of receiving this publication in either electronic or paper booklet format. If you have never read this guide, I urge that you read it once from cover-to-cover. After you have become familiar with the contents, you can read the publication for updates each year.
For the first time in six years, both the front and back covers of the 2020 edition are the same as the 2019 publication. Also, the 2019 and 2020 editions have exactly the same number of pages. There were very few changes to the Medicare program this year and this is reflected in the content of the 2020 edition. Still, as usual, along with updates, some formatting changes have been made to clarify issues and improve the readability.
The inside of the front cover has been completely revised. Last year this page provided information on the distribution of the new Medicare cards. This year the focus is on eMedicare. Also, the Medicare.gov website now contains a relatively new section that allows you to look up the estimated costs of outpatient medical procedures.
To obtain this information, go to Medicare.gov/procedure-price-lookup. This year the publication emphasizes using the Medicare.gov website as well as creating your own MyMedicare.gov account.
Here is a summary of some of the changes to look for in each section.
Section 1 Signing Up for Medicare. No major changes were made to this opening section. As was the case last year, the guide states that the 2020 Part A and Part B premium amounts “were not available at the time of printing. To get the most up-to-date cost information, visit Medicare.gov later this fall.”
Section 2 Find Out if Medicare Covers Your Test, Service, or Item. This is a section that you should always review. Look for a particular procedure or service that you will use this year to see if there are any changes in the coverage.
This year no new services have been added. The only major changes in this chapter are in the descriptions of Medicare diabetes prevention program and telehealth. Page 49 contains an important list of what is not covered by Parts A and B which you should always review.
Section 3 Original Medicare. There are no significant changes to this chapter.
Section 4 Medicare Advantage Plans & Other Options. The information on Advantage plans has been updated, including the information on End-Stage Renal Disease. The coverage on Special Needs Plans has been reduced. There is a new section (page 65) on making changes to your Advantage plan coverage after Open Enrollment ends.
Section 5 Medicare Supplement Insurance (Medigap) Policies. Starting in January, people who are new to Medicare will not be allowed to purchase Part C and F Medigap plans. Those who currently have these plans can continue to purchase this coverage. See pages 69-72 for more details.
Section 6 Medicare Prescription Drug Coverage (Part D). If you are enrolled in a Medicare Advantage Plan you can now join, switch or drop a plan between Jan. 1 and March 31 each year. This chapter has other important updated information. If you are enrolled in an Advantage plan you should always review this chapter.
Section 7 Get Help Paying Your Health & Prescription Drug Costs. On page 83, it is noted that the limits on receiving Extra Help have not changed from last year. For a single person, the income limit remains at $18,210 with resources limits of less than $14,100 per year.
For a married person, the yearly income limit is $24,690 with other resources of less than $28,150 per year. The various other Extra Help programs are also explained. If you feel you might qualify for Extra Help you should contact the Oneida County Office for the Aging/Continuing Care HIICAP Program at 315-798-5456.
Section 8 Know Your Rights & Protect Yourself Against Fraud. Because of the increasing problems with fraud and scams, expect updates to this section every year.
Section 9 Get More Information. Remember, if you call 1-800 MEDICARE (633-4227) for information you can say “Agent” at any time and you will be directed away from the automated system to a customer service representative. There is also more information on fraud in this chapter. This is another chapter that is updated every year and should be reviewed.
Section 10 Definitions. There are no changes in this chapter.
Section 11 Compare Health & Prescription Drug Plans in Your Area. This section is extensively updated every year. If your copy was mailed to an upstate New York mailing address, all the information in this section will apply only to providers in upstate New York.
Who do I contact in Oneida County for help? If you find that there are changes to your plan, you want to make changes in your plan, or simply want to review your coverage the Oneida County Office for the Aging/Continuing Care/NY Connects Health Insurance Information, Counseling and Assistance program (HIICAP) offices provide these services at no cost to Medicare beneficiaries. HIICAP offices are found at the following locations:
Copper City Community Connection, formally the Ava Dorfman Senior Citizens Civic Center, 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. 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.
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 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.