William C. Lane, Ph.D.
The annual Medicare open enrollment period for 2022 begins October 15 and ends December 7.
Open registration will be different from last year. This year will see a return to in-person counseling, but many safety precautions are in place.
Changes in the contact procedures for open enrollment counseling for 2022: After more than a year of telephone-only counseling, the Oneida County Health Insurance, Information, Counseling and Assistance Program (HIICAP) will revert to in-person counseling sessions with some significant restrictions. First of all, when you arrive for your appointment, you must show proof of COVID-19 vaccination. You will also need to wear a mask at all times while you are in the building. In-person counseling sessions will be offered at the following two locations:
Copper City Community Connection (formerly Ava Dorfman Senior Citizens Civic Center), 305 E. Locust St. Assistance will be provided Tuesdays and Thursdays from 9 am to 2 pm. Copper City will serve customers by appointment only. Do not call the center directly for an appointment. Instead, you will need to call the main HIICAP program office at 315-798-5456 and ask for Joan. Joan Hyde will make all the appointments for Copper City.
Northern Utica Elderly Center, 50 Riverside Drive, Utica. Hours of operation are 9:00 a.m. to 3:15 p.m. Monday, Wednesday and Friday. Sessions should last 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 can call the centre’s HIICAP program at 315-724-8680.
The Oneida County Office for Aging and Continuing Care / NY Connects HIICAP will continue to provide counseling services by phone only, as they have done 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 list of choices. In most cases, you will be asked to leave your contact details on a voicemail box and a member of staff will call you back within 72 hours (three business days).
Eligibility for Medicare is 65. The age of eligibility for health insurance of 65 no longer coincides with the age of full retirement from social security. For years, the age for receiving full social security benefits was set at 65. If you do not have Social Security benefits, you will not automatically be enrolled in traditional health insurance.
So if you’re 65 in the near future and don’t want to register for Social Security benefits yet, you still need to register for Medicare. You will pay your health insurance premiums directly until you start receiving Social Security benefits. Once you receive 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 from three months before you turn 65 and up to three months after your birthday month. For example, if you turn 65 on November 1, your enrollment period began on August 1 and ends on March 1, 2022.
This creates an initial registration period of seven months. If you exceed this period, you may be subject to a permanent registration bonus penalty or a surcharge for not registering on time. This is a lifetime penalty based on a formula that takes into account the number of months late as well as the amount of monthly Medicare premiums. Keep in mind that Medicare enrollment is done through the Social Security Administration and not during open enrollment. You can register for Medicare online (www.SocialSecurity.gov), by phone (1-800-772-1213) or, if the offices allow visits, at any Social Security office.
What changes can I make during an open registration? 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 any of your coverage options.
If you are enrolled in Medicare Original (Medicare Parts A and B as well as Part D drug plan), you can upgrade to a Medicare Advantage Plan with or without drug coverage. If the Advantage Plan does not have a “comprehensive” drug plan, you will need to choose a new plan or keep the one you are currently using.
If you are enrolled in a Medicare Advantage plan, you can revert to Original Medicare with a separate, “stand-alone” drug plan.
If you are not happy with your current Medicare Advantage plan, but do not want to revert to the original Medicare, you can switch from one Advantage plan to another.
You can enroll or upgrade to a new Part D drug plan.
You can subscribe or switch to a new Medigap complementary insurance.
How much will I pay for Medicare Part D drug coverage? One of the mistakes many beneficiaries make is that they use cost as the sole factor in choosing their Part D drug coverage. As with all types of insurance, your Part D premium will depend on how much you pay for. ‘a number of factors. Some of these factors include:
The medications you are taking. Every drug plan has a list of medications, known as a formulary, that will tell you if any medications you are taking will be covered by the plan. Not all plans cover all drugs, and the costs for the same drugs may also vary from plan to plan. If a drug is not included on the formulary, it will likely mean that you will be paying something close to full price for the drug.
The exact plan you choose. Many providers offer a choice of plans with different premiums attached.
Is your favorite pharmacy part of your plan’s provider network? If he’s not in the network, your medications will likely cost you more. In some cases, the cost will be much higher than if you use a pharmacy that is part of the Plan network.
You receive additional help to pay the costs associated with your plan. We have covered the different types of additional help options in the previous columns. HICAP advisors can see if you qualify for any of these savings programs.
As stated in the opening paragraph, in order to receive face-to-face counseling at one of the two counseling sites, you must show proof that you have received the COVID-19 vaccination. In addition, you will need to wear a mask at all times while you are in the building. If you are not vaccinated, advice will always be available over the phone.
Dr. William Lane is the owner of William Lane Associates, a gerontology practice located in Homer, NY. He writes a monthly column on HIICAP issues for OFA. Dr. Lane does not sell insurance, work for any insurance company, or recommend any insurance product.
