Benefits update

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