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Updates on Medicare, Medicaid, and Assistance Programs for Seniors - Annual Convention 2011

Join Cathy Roberts, Senior Paralegal at Empire Justice Center, as she presents key updates from the October 12, 2011 Annual Convention of the Statewide Senior Action Council in East Greenbush, NY. This session covers important changes in Medicare and Medicaid, including new Medicare Part D enrollment periods, significant Medicaid service limitations, and essential information on Food Stamps and the Home Energy Assistance Program (HEAP). Learn how these changes affect seniors and discover resources available for assistance.

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Updates on Medicare, Medicaid, and Assistance Programs for Seniors - Annual Convention 2011

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Presentation Transcript

  1. Benefits update StateWide Senior Action Council annual convention East Greenbush, NY October 12, 2011 Presenter: Cathy Roberts, Senior Paralegal Empire Justice Center, Albany, NY

  2. Today’s presentation A review of changes affecting: Medicare Medicaid Food stamps HEAP (Home Energy Assistance Program)

  3. Medicare update: what’s new in 2012

  4. Medicare Part D • New open enrollment period: Oct 15 - Dec 7 • Special enrollment period for 5 star plans • Higher Part D premiums for higher income beneficiaries • Gradual closing of coverage gap • 14% discount for generics • 50% discount for brand name drugs • $0 drug co-pays for HCBS Medicaid waiver participants

  5. Medicare Advantage • Same change to open enrollment period: • Oct 15 - Dec 7 • Preventive services must be free • Other limitations on cost sharing: • Chemotherapy • Dialysis • Skilled nursing facility

  6. Original Medicare • Mental health co-pays reduced to 40% • Were 45% in 2011 • Coming soon: • Info regarding Part A and B premiums, deductibles, etc.

  7. Programs that help with Medicare cost-sharing

  8. What’s new in Medicaid

  9. No more Medicaid “wrap” for dual eligibles • Medicaid no longer pays for any Part D covered drugs (as of 10/1/2011) • Medicaid continues to cover: • Part B drugs (co-insurance) • Benzodiazepines • Barbiturates • Prescription vitamins • Certain OTC drugs

  10. New limitations in Medicaid services • Affects access to: • Compression stockings • Prescription footwear • Enteral nutritional formula • Level 1 personal care services • Physical, occupational and speech therapy

  11. Dramatic expansion of mandatory managed care • Does not affect most Medicare beneficiaries (yet), except for: • New requirements governing managed long term care (MLTC). • Beginning in NYC in May 2012: • Anyone needing personal care for more than 120 days will be required to enroll in an MLTC plan

  12. Reduction in reimbursement rates to providers • Decreased reimbursement rates may affect access to care, especially: • Home care services • Adult dental care

  13. Food Stamps (aka SNAP: Supplemental Nutrition Assistance Program)

  14. Many eligible seniors are not participating • Estimated “take-up” rate for seniors: 34% • Recent changes have improved access • No asset test for most seniors • No in-person interview required • Can apply by mail or internet • Most seniors getting Part D Extra Help or EPIC premium assistance can qualify • For more info, go to https://www.mybenefits.ny.gov/

  15. HEAP: Home Energy Assistance Program

  16. Cuts on the federal level will drastically affect New Yorkthis winter • Shorter HEAP season: • Regular HEAP opens Nov 16, 2011 • Emergency HEAP not expected to open until January 3, 2012 • Significant reduction in benefit levels: • Most households will get 30-40% less than • what they got last year • More info is available at http://otda.ny.gov/programs/heap/

  17. Where to go for help • Health Insurance Information Counseling and Assistance Program (HIICAP) • NYS toll-free helpline: 1-800-701-0501 • 1-800-MEDICARE or www.medicare.gov • Social Security Administration • (to enroll in Medicare): 1-800-772-1213 or www.socialsecurity.gov • Food stamps and HEAP: • https://www.mybenefits.ny.gov/

  18. Questions? • www.nyhealthaccess.org • My contact information: • Cathy Roberts, Senior Paralegal • Empire Justice Center • 119 Washington Avenue • Albany, NY 12210 • 1-800-635-0355 x 112 • croberts@empirejustice.org • www.empirejustice.org

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