As individuals retire or age into Medicare, their insurance situation can change dramatically. There are a multitude of options open to those with Medicare. The terms are different, the prices are different, the products offered are dramatically different each year.
The purpose of this column is to give those who are eligible for Medicare, or soon to be eligible for Medicare, some understanding of their insurance options and how it could impact their health and finances.
These questions and answers are meant as a guide to help you understand the complex questions you are now thinking about. Each individual's specific situation may create a different solution. You shouldn't necessarily do what your friends, family and neighbors do.
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Janell Sluga
Q: I just received a document from Department of Social Services, telling me I have Medicaid and need to recertify. I do not have Medicaid, and I don't think I should fill out this form/application. What do you think?
A: There are many programs under the umbrella of Department of Social Services (DSS); just one of them being Medicaid. The Department of Agriculture program, Food Stamps, and HEAP, Home Energy Assistance Program, are handled at the offices of Department of Social Services. There are also many types and levels of Medicaid. Without looking at the letter, and because it is July, I would guess that you get your Medicare Part B premium paid by either New York state or the federal government.
This Medicare Part B premium is the $99.90 that is usually taken out of your Social Security check each month before you get it. This benefit comes under the heading of Department of Social Services and Medicaid, so it says "Medicaid" in the letter. You may have in the last year or prior to that time, applied for a benefit that would have that premium added back to your Social Security check. Your Social Security check would have increased and you would have gotten a letter from Social Security explaining the new payment level and why. This benefit is called the Slimb/QI-1 benefit, or the Medicare Savings Program (MSP). This benefit, like many others, needs to be recertified (or re-applied for) each year. The DSS office sends out the annual re-certifications in the month of June or July. We have recently heard from many individuals with this same question.
For anyone who has applied for or had a continuing benefit during the year for this program they are required to recertify in June and July. The form is usually mailed to them in June and due back during the month of July. Some individuals I talk with are frustrated: "I just completed this form in April, why do I have to do it again?" All individuals with this benefit have to re-certify in June. So from now on your paperwork will be due in June or July.
If you choose not to complete the form and return it back to them, your benefit will stop. That means your Social Security will go down by $99.90. I would therefore call DSS at the number on the letter and ask for help in determining what program you are in. If it is the benefit I have been talking about, definitely complete the form and send it in. You will continue to get the higher Social Security amount and this is a "gateway" benefit. Once approved there are many other benefits that you are automatically approved for, like the Low Income Subsidy (LIS) from Social Security to help with Medicare Part D costs.
There are many programs that require an annual recertification. This simply means you have to inform them of your financial standings again, including your income, your expenses and for some, your assets. Some of these programs are, Slimb/QI-1 (the one we talked about above), EPIC, Food Stamps, HEAP, and Low Income Subsidy (LIS), to just name a few. For the time it takes to complete the annual form, you get a year's worth of benefits. For most this is a very good deal.
If you look back to your approval letter when you were approved for this program, you will see the letterhead in Department of Social Services letterhead. Most individuals don't remember that or notice that when they get the recertification forms.
Now remember I am always cautious in advising completing forms and mailing them back to someone without understanding what it is and why. Always call for more information if you are unsure about the requests. If you are not comfortable with this answer or are still unsure, review it with family, the Office For the Aging or a professional in the field.
Janell Sluga is a geriatric care manager certified and works for Senior Life Matters, a program of Lutheran Senior Housing, and has worked in Chautauqua County with seniors for more than 18 years. She is HIICAP (Health Insurance Information, Counseling & Assistance Program) counselor-trained by Office for the Aging. She does not sell insurance or represent any insurance company. She is an unbiased source of insurance and education to help seniors choose the best option for them.
You may submit questions to be answered in later columns to Janell Sluga at Senior Life Matters, 737 Falconer St., Jamestown, NY 14701, or call 716-720-9797, or by email at janells@lutheran-jamestown.org. Please remember that not all questions can be answered in this format, but as many as can be, will be.