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Car Insurance Increases Can Hit Seniors Hard

Question: I just got my car insurance bill, and the price went way up. What should I do?

Answer: I just got my car insurance bill, and it also went up! In my research, it seems all the insurance costs are increasing. I also see this with Health Insurance, and the solution is the same: you should research your options and see if another insurance company could offer more reasonable coverage.

One difference between Auto Insurance and Health Insurance is the time of year you can change your coverage. Your Auto Insurance renewal date is based on the date you initially took out the policy. With Medicare Health Insurance, the time to change your coverage is usually October 15th to December 7th. For many people, that means they stay in their current coverage until that time of year, and then they decide if they need to change their coverage. However, there are also Special Enrollment Periods (SEPs) during which an individual is allowed to change their Medicare coverage.

There are over 20 SEPs available to all individuals with Medicare coverage. I will focus on two of the most commonly used SEPs: the EPIC coverage SEP & the Five Star Medicare Part D Plan SEP.

EPIC (Elderly Pharmaceutical Insurance Coverage) is a New York State Pharmacy Assistance Program that provides secondary prescription drug coverage. To qualify for EPIC, you must be a New York State Resident who is 65 or older, with an income below $75,000 for a single person, or $100,000 for a couple. You can apply for EPIC anytime you meet these criteria. If you think you qualify for EPIC and would like an application, please call the EPIC Help-Line at 1-800-332-3742, or contact my office.

EPIC uses your income from last year. Those figures can be obtained from your tax return, if you file – if you don’t file a tax return, EPIC can use your 1099 tax documents. You must include your net Social Security income. I encourage all seniors to review their income every year to see if they qualify for EPIC. Remember that EPIC will always be secondary to your Medicare Part D insurance coverage. Additionally, if you have VA coverage, EPIC cannot pay for prescriptions you get from the VA.

On top of the prescription coverage advantages, EPIC offers all members a SEP each year. This means that every year you are enrolled in EPIC, you have an additional one-time opportunity to switch your prescription drug coverage. This can be used at any time during the year, but only once each year. This SEP is the reason I often advise clients to join EPIC, even when they do not need the additional prescription drug coverage.

The second SEP I’ll discuss is the Five Star SEP. Since we have access to Five Star Plans in our area, everyone here has this SEP as an opportunity to switch their insurance. Independent Health is the only Five Star Insurance Carrier available our region. This means that if you wish to use this Five Star SEP, you may only switch your current coverage to move to an Independent Health Medicare Advantage Plan. You should evaluate your current coverage and compare it to each of the Independent Health Medicare Advantage plans to be sure they meet your needs. As always, it is important to understand the coverage offered, and that your medications are in the formulary of the plan you choose. Remember that like the EPIC SEP, the Five Star SEP can only be used once during a calendar year.

The other over 18 SEPs may be available to you, depending on a variety of circumstances. To learn more about all the SEPs, use the www.medicare.gov website then search Special Enrollment Period, and you may find one of the other SEP’s meets your needs.

I also want to stress that you should evaluate your Medicare Insurance needs regularly. Each year there are new products available, and the coverage you have will change in ways you should pay attention to. Individuals who evaluate their coverage regularly can make more advantageous insurance decisions, so they can improve coverage, save money on coverage, or even both!

Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email editorial@post-journal.com.

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