What to expect from Medicare and HIICAP in 2018


As we move quickly into the new year, much of the political discussion in both Washington and Albany has focused on the new federal tax reform legislation.

So, before we turn to a brief overview of the HIICAP program, I would like to make a few comments about the recently enacted Tax Cut and Reform Act. While much has been written about this law, most of the commentary consists of speculation about the impact of these changes on our finances.

It is confusing but, for now, there appears to be nothing in this law that is directly aimed at making changes in Medicare. In particular, it did not have any direct impact on current Medicare premiums. That could certainly change but the premium information presented last month remains the same.  

Social Security. Beginning in January, Social Security recipients will get a 2 percent cost-of- living adjustment (COLA) increase in their monthly benefit payments. According to AARP, the average recipient will receive $1,404 a month, an increase from $1,377 in 2017. This represents the largest increase in Social Security benefits since 2012 when benefits were increased by 1.7 percent. 

Currently, the annual Social Security COLA is based on the Consumer Price Index or CPI. The CPI is the common way we measure inflation and is reported monthly by all the major news organizations. The new tax law moves us toward using what is called the Chained CPI.

Without going into any technical aspects of the Chained CPI, it generally measures inflation at a lower rate than the current CPI.

While it will impact certain previsions in the tax code, it is not clear that the Chained CPI will replace the current CPI in determining the Social Security COLA for 2019. If it is adopted, according to an extensive analysis by the Los Angeles Times, it will result in smaller annual increases in Social Security benefits. 

Health Insurance Information, Counseling and Assistance (HIICAP). This column tends to focus on the programs, benefits and services offered by the Oneida County Office for the Aging/Continuing Care/NY Connects HIICAP program. Since many readers may be new Medicare, beneficiaries the remainder of this column will be devoted to reviewing the broad range of services offered by HIICAP counselors.

HIICAP provides accurate, objective and unbiased information, counseling, assistance and advocacy on all aspects of Medicare, as well as private health insurance and related health coverage plans. All HIICAP services are free to everyone and/or their representatives as soon as they become eligible for Medicare. Counselors will also provide information on long term care insurance to those under age 65.

When we think of HIICAP services we automatically think of the fall open enrollment period for Medicare Part D. But, HIICAP offers many more services:

Assistance with Medicare Part A and B. This assistance includes initial sign up, disputed claims and the resolution of other related problems and issues.

Choosing between Original Medicare and a Medicare advantage plan. If you decide to gain coverage through an Advantage plan, HIICAP counselors can help you chose the plan that is right for you. If you are dissatisfied with your plan, they can assist you with either changing to another plan or returning to Original Medicare with a Part D plan. 

Elderly Pharmaceutical Insurance Coverage (EPIC). Many Oneida County residents may not be familiar with the EPIC program. EPIC is a New York State program for older adults administered by the Department of Health.

It helps more than 320,000 income-eligible persons aged 65 and older to supplement their out-of-pocket Medicare Part D drug plan costs.

To receive benefits through the EPIC program you must (1) be a resident of New York, (2) aged 65 or older, (3) have an annual income below $75,000 if single and $100,000 if married and (4) be enrolled or eligible to be enrolled in a Medicare Part D plan and not be receiving full Medicaid benefits. Many will be surprised that meet all of these requirements and qualify for the program. 

Extra Help. Anyone who has Medicare prescription drug coverage may be able to qualify for one of several Extra Help programs. These programs help low to moderate income individuals pay for such things as their monthly premiums, annual deductibles and prescription co-payments. Extra Help is estimated to be worth about $4,000 per year. If you think you might possibly be eligible contact a HIICAP counselor. Many people are surprised that they are actually eligible and how much money they can save.  

One thing that discourages many from taking advantage of Extra Help is that these benefits may be counted toward determining their eligibility for other programs.

So, for example if you accept Extra Help benefits you might lose some housing assistance. But, in most cases the loss of any current benefits is far less than the amount gained through an Extra Help program. These programs can save eligible consumers substantial amounts of money every year.

Who do I contact in Oneida County for help for any HIICAP related questions? 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 all Medicare beneficiaries. HIICAP offices are found at the following locations:

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. Again, while consumers are seen on a “first come, first served” basis you may call the Dorfman 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.

EDITOR’S NOTE: Dr. William Lane is the owner of William Lane Associates, a gerontological firm which 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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