Aging Services and Programs

What's New in Insurance and Medicare

 

PROGRAM LOWERS COSTS FOR
MEDICARE PRESCRIPTION
DRUG COVERAGE
More Medicare beneficiaries will qualify for “Extra Help” with their prescription drug costs, and be eligible to pay no more than $2.50 for generic drugs and $6.30 for each brand name drug thanks to changes to Medicare’s Low-Income Subsidy Program (also known as LIS or “Extra Help”) that take effect this year. These changes make it easier than ever for people on Medicare with limited incomes to save on their prescription drug costs.

The Centers for Medicare and Medicaid Services estimates that “Extra Help” can save eligible Medicare beneficiaries as much as $3,900 per year. It is estimated that more than 1.8 million people with Medicare may be eligible for “Extra Help,” but are not currently enrolled to take advantage of these savings.

Changes in the law enacted in the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 make it easier for Medicare beneficiaries to qualify for “Extra Help” by changing the way income and assets are counted in 2010. When determining eligibility for “Extra Help,” the Social Security Administration, which handles enrollment in the program, will no longer count life insurance policies as a resource. In addition, help received from family and friends to pay for household expenses like food, mortgage, rent and utilities will no longer count as income.

These changes to the “Extra Help” program make it easier for more people to get help paying for their prescription drugs. Even if you were turned down for “Extra Help” before, you should reapply. If you qualify, you will receive help paying for Medicare prescription drug coverage premiums, copayments and deductibles.

To qualify, Medicare beneficiaries’ incomes must be less than $16,332 a year (or $22,068 for married couples) and have resources limited to $12,640 (or $25,260 for married couples). Resources include bank accounts, stocks, and bonds, but do not include houses, cars, or life insurance policies.

There is no cost to apply for “Extra Help.” Medicare beneficiaries, family members, trusted counselors or caregivers can apply online at www.socialsecurity.gov/prescriptionhelp or call Social Security at (800) 772-1213 and ask for the Application for Help with Medicare Prescription Drug Plan Costs. TTY users should call (800) 325-0778.


  • PLANNING AHEAD WITH LONG-TERM CARE INSURANCE SECURES YOUR CHOICES AND PEACE OF MIND
  • What is long term care?
  • Long-term care is provided to people who are unable to perform the basic tasks of everyday living on their own for an extended period due to chronic medical, physical or cognitive conditions, or disabling injuries.
  • What is long term care insurance?
  • Long-term care insurance covers long-term care services provided in a nursing home, at home, in an assisted living facility, or in other community-based settings. Medicare, Medicare supplemental insurance (Medigap), and traditional health and disability insurance plans typically do not cover long-term care services.
  • Today, the cost of staying in a nursing home in New York can be very expensive – often over $90,000 a year. Home care can be very expensive, as well. Few people can afford this cost without using all their life savings. Long-term care insurance allows you to protect your assets in the event you need long term care sometime in the future, just like you protect yourself with homeowner’s insurance and auto insurance.
  • Why would I need long term care insurance?
  • In the past, people did very little planning for long-term care needs because family members were usually available to provide care. But changes in society and the family make this arrangement harder today and in the future. Smaller families, family members moving to other locations, both heads of house¬holds working, and longer life expectancy mean family members are less likely to be available as a caregiver, while you are more likely to need long term care in the future. As long-term care costs increase, quality long-term care insurance is a way to protect your financial independence.
  • How much does it cost?
  • The long-term care insurance premium depends on your purchase age and what you choose to cover – the younger you are, the lower the premium. New York State provides an income tax credit for all tax qualified long-term care insurance policies to help more people afford long-term care insurance coverage.
  • How do I find out more?

    • Long-term care insurance isn’t for everyone. To learn if it makes good financial sense for you, please contact the Department of Aging and Youth at 946-5624. A staff member can review with you which plans may provide adequate coverage at a reasonable cost.

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