William C. Lane, Ph.D., Special to the Daily Sentinel
2023 Medicare Advantage Open Enrollment Period. While the annual fall open enrollment period has ended, we have now entered the Medicare Advantage winter open enrollment period.
This period runs from January 1 to March 31 of each year. During this period, you can switch from one Medicare Advantage plan to another or leave your current Advantage plan and enroll in Original Medicare with a Part D drug plan. However, during this period you cannot switch from Original Medicare to a Medicare plan Advantage.
As described in last month’s article, there are also special enrollment periods that allow you to make changes to your coverage due to circumstances beyond your control. For example, if you move and your current plan is no longer available in your new area, you can enroll in a different Advantage plan or return to Original Medicare with a Part D plan. Remember, if you have any problems with your coverage during the year , HIICAP counselors are available to help you. HIICAP is a year-round program.
Increase in Social Security benefits in 2023. Although we suffer the costs of high inflation, there is very good news if you receive Social Security benefits or are covered by Medicare. First, starting this month, all Social Security beneficiaries will receive a cost-of-living adjustment (COLA) in the amount of 8.7 percent. For the average beneficiary, this will mean an increase of about $140 per month and represents the largest COLA increase since 1981. At the same time, the standard monthly Part B premium will drop from $170.10 to $164.90, a decrease of $5.20. The annual deductible for all Medicare Part B beneficiaries will be reduced by $7.
More changes for 2023. In addition to the changes listed above, there are important changes that will impact many readers this new year. Please note that the income levels listed for each of these programs are estimates and are subject to change. Some of the income guidelines for these programs are based on federal poverty rates that have not yet been finalized for 2023.
Eligibility for Medicare Savings Programs. Medicare Savings Programs (MSPs) help people who meet income eligibility limits lower their Medicare costs, including help paying premiums, deductibles, and coinsurance. In 2022 there were three MSPs. However, one of these programs, the Specified Low-Income Medicare Beneficiary (SLMB), was eliminated in 2023, leaving just two programs. For each, the income levels have been increased, meaning many more New Yorkers will be eligible for MSP assistance. None of these programs have an asset test, so eligibility is based solely on your gross monthly income.
The first remaining program is the Qualified Individual (QI) program. This program only helps pay the Medicare Part B premium. Although it is called an individual program, married couples also qualify. The monthly income limits are $2,107 for individuals, up from $1,549 last year, and $2,839 for couples, an increase of $759 from last year.
The second remaining program, the Qualified Medicare Beneficiary (QMB), helps you pay your Medicare Part A and Part B premiums. While the increases in income limits are not that dramatic, they are significant. The limits have increased to $1,563 for an individual and $2,108 for a couple. Eligibility for both programs is determined by your local Department of Social Services (DSS). However, your HIICAP counselor can help you with the application process.
Extra help with Part D drug costs. Getting “Extra Help” means that Medicare helps pay for your monthly Medicare prescription drug coverage (Part D) premium, any yearly deductibles, coinsurance, and copayments. More detailed information is available on the Medicare.gov website. There are three major changes that have occurred to this program for 2023.
First, instead of applying for Extra Help through Social Security, you now apply through your local county DSS office. This means that Medicaid, MSP, and Extra Help applications are now processed through your local DSS office.
Second, the income levels for eligibility have increased substantially. The annual income limit that qualifies for extra help for an individual has increased from $20,285 in 2022 to $25,284 in 2023. In addition, the annual income for a couple has increased from $27,465 to $34,068 this year. Finally, and possibly the change that will have the biggest impact, there is no longer an asset test for Extra Help. This means that DSS will only consider annual gross income and will not consider any and all of your assets.
Oneida County HIICAP Office continues to provide in-person scheduling and counseling services over the phone as they have during the pandemic. If you would like to have a HIICAP counseling session over the phone or to schedule an appointment at one of two locations in person, please call 315-798-5456 and select number 2 from the list of options. 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). Counselors are available at the following locations:
Copper City Community Connection, 305 E. Locust St., will offer counseling sessions from 9 a.m. to 3 p.m. on Thursdays only. The HIICAP program will also be scheduled in Copper City.
northÚtica North Center for the Elderly, 50 Riverside Drive, Utica. Hours have been extended on this site. Appointments will now be accepted Monday, Wednesday, and Friday from 9 am to 3 pm Sessions are expected to last 45 minutes. Call the HIICAP office at 315-798-5456, selecting Option 2 to schedule an appointment.
How to contact HIICAP programs in other counties. Here is the contact information for HIICAP programs in various counties that border Oneida County. To get to the madison county HIICAP program call 315-697-5700 and ask to speak with a HIICAP counselor. For Herkimer County, call Catholic Charities of Herkimer County at 315-894-9917. For lewis county call 315-376-5013 and select number 2 from the list of options.
Dr. William Lane is the owner of William Lane Associates, a gerontology consulting firm located in Homer, NY. He writes a monthly column on HIICAP related issues for OFA. Dr. Lane does not sell insurance, work for any insurance company, or recommend any insurance products.