During Medicare open enrollment period, free NYS Medicare counseling program helps older adults make choices

Income-eligible beneficiaries also encouraged to enroll in Medicare savings program to save up to an estimated $7,000 annually on out-of-pocket costs

Submitted by the New York State Office for the Aging

The New York State Office for the Aging (NYSOFA) reminds older New Yorkers that free and objective counseling is available to help Medicare beneficiaries navigate their options during the Medicare open enrollment period from Oct. 15 through Dec. 7.

Open enrollment is the time when Medicare beneficiaries can make changes in their health plan or prescription drug coverage and other options. Any changes take effect Jan. 1.

The NYSOFA-administered Health Insurance Information, Counseling and Assistance Program (HIICAP) helps 248,000 New Yorkers annually to understand Medicare decisions. It also helps beneficiaries apply for programs that save older adults out-of-pocket costs such as co-payments, premiums and deductibles. Last year, HIICAP saved low-income Medicare beneficiaries an estimated $115 million through these programs. HIICAP counseling has also shown to reduce hospitalizations by 54% and emergency room visits by 14%. This free and objective assistance is provided locally by trained counselors.

For assistance, call the helpline at 1-800-701-0501. More information about HIICAP is on NYSOFA's website. 

NYSOFA Director Greg Olsen said, "Trained counselors are available to help beneficiaries or new enrollees make informed decisions about plan coverage during Medicare open enrollment, a time when many may feel overwhelmed by their choices. Best yet, this information is free, objective, and local, through NYSOFA's network of over 700 counselors statewide. By matching individuals with the right coverage levels, this assistance not only improves access to preventive health, but it also helps individuals save on health care costs and enroll in important benefits or subsidies, like the Medicare savings program, which provide vital economic security."

Heather Leddick, administrator for HIICAP in New York, said, “All Medicare beneficiaries are encouraged to take a close look at their health care needs during open enrollment, especially any changes such as new doctors who might not be in their plan’s network, prescription changes, or additional service needs. HIICAP counselors provide information and tools that empower beneficiaries to make their own informed decisions about which options match their current needs."

For income-eligible older adults, HIICAP is also available during open enrollment – and throughout the year – to assist in the application process for the Medicare savings program (MSP). The MSP was expanded in 2023 to help an additional 300,000 Medicare beneficiaries who may be potentially eligible to save up to an estimated $7,300 in Medicare-related health costs annually.

The MSP helps older adults and people with disabilities living on limited incomes by paying their Medicare Part B premiums and automatically enrolls them in “Extra Help.” This financial assistance can be a lifeline for enrollees, allowing them to maintain their Medicare coverage, access needed care, and afford other necessities.

Learn more about this program, and how to enroll, on NYSOFA's MSP information page here, including a video tutorial about the application process. 

HIICAP in Detail

During open enrollment, or at any time of the year, HIICAP can help you:

√ Understand the Medicare prescription drug benefit (Medicare Part D) and how to select the best plan.

√ Understand low-income subsidy programs, including Extra Help and MSP.

√ Find ways to pay for your medications or medical equipment.

√ Understand and apply for the Elderly Pharmaceutical Insurance Coverage (EPIC) program.

√ Choose between original Medicare and Medicare Advantage plans.

√ Understand Medicare rules and your medical bills.

√ Report possible Medicare fraud or abuse.

√ Provide information on how to appeal a decision by Medicare, your managed care provider, or other health insurance company.

√ Discover ways to fill in Medicare’s gaps.

√ Learn how to file a Medicare or Medigap complaint.

√ Learn about Medicare-covered prevention and screenings.

Protecting Yourself

Medicare experts report a higher risk of potential fraud during the open-enrollment period as well as potentially misleading marketing. Medicare has rules about how plans can and cannot communicate with you to market their insurance products. The Medicare Rights Center offers the following warnings:

√ Plans are allowed to send you mail. However, unless you are currently enrolled in the company’s plan, they are not allowed to call, email, visit your home, or approach you in public to market their plan without your permission.

√ Beware of people who pressure about making plan changes, claim to be representing Medicare, or attempt to alarm you about losing benefits unless you enroll in a particular plan.

√ Beneficiaries who believe they are a victim of fraud or identity theft should contact Medicare. More information is available at medicare.gov.

NYSOFA and Medicare also remind older adults to treat their Medicare number as they do their Social Security number and credit card information. People with Medicare should never give their personal information to anyone arriving at their home uninvited or making unsolicited phone calls selling Medicare-related products or services. If someone calls and asks for a recipient’s Medicare number or other personal information, hang up and call 1-800-MEDICARE (1-800-633-4227).