Senior Entitlement Benefit Programs

The American Red Cross

http://www.redcross.org/ny

The American Red Cross operates assistance programs with various electric and gas utilities around the state which help persons over 60 years of age with utility emergencies. They also assist persons with disabilities and those with certain medical conditions. This Red Cross assistance may be used for many heating emergencies, such as a threatened shutoff because of an overdue bill or a broken furnace. Red Cross heating or utility help is generally given to an individual only once a year. To learn whether there is a Red Cross utility program in your county, contact the nearest Red Cross office. Phone numbers and addresses of Red Cross offices can be found under the American Red Cross in your telephone directory

 

Long Island Elder Care

BenefitsCheckUp.org

A free online screening tool that searches over 2,000 federal, state, local and private programs that help seniors pay for prescription drugs, utility bills, meals, health care and other needs.

 

Cell Phone Programs

Free or discounted cellular service for income eligible consumers.

Assurance Wireless

800-342-3377

www.assurancewireless.com

 

Safelink Wireless

800-977-3768

www.safelinkwireless.com

 

Elderly Pharmaceutical Insurance Coverage  (EPIC)

If you are 65 years of age or older,  a resident of New York State, and you meet income Guidelines, EPIC  may save you money on your prescriptions.

800-332-3742

EPIC  enrollees may be eligible for reimbursement of fees and a portion of their co-payments Under a program funded by Suffolk  County.

631-853-8200

 

Food Stamps

Coram: 631-854-3710                                  

Riverhead 631-853-8730                              

Smithtown: 631-853-8714

South West: 631-854-6600

Nassau County: 516-227-8523

 

Home Energy Assistance Program (HEAP) and Weatherization Program (WRAP)

HEAP and WRAP are energy assistance systems for people who are living on fixed incomes. Both  homeowners and renters may apply.  Applications are accepted yearly beginning in the Fall until funds are exhausted.  This program provides cash to help pay heating bills for low-income individuals and families. You can begin applying for a HEAP grant in November. HEAP provides grants on a first come, first served basis until the funds provided for each heating season run out. For more information about how to apply, contact your local office for the aging

http://www.aging.ny.gov/NYSOFA/LocalOffices.cfm

HEAP:   Suffolk       631-853-8326         

Nassau   516-227-7386  

                             

WRAP:  Suffolk    631-853-8327

Nassau               516-227-7386

 

IT-214 Circuit Breaker (NYS Department of Taxation and Finance) Up to $375 in tax credit to homeowners or renters who spend a high percentage of income on rent or property tax.

800-225-5829

www.nys.tax.gov

 

LIPA’s Critical Care Program

By filing a medical certificate,  LIPA will do the following: Your LIPA  account and meter will be tagged as “critical care”.  When severe storm is  anticipated, LIPA will call you to make advanced preparations.  If an outage occurs, every effort is made to restore your electricity as soon as possible.

800-490-0025

www.lipower.org

 

EmPower New York (NYSERDA)

http://www.nyserda.ny.gov/All-programs/Programs/EmPower-New-York

EmPower New York provides no-cost energy efficiency solutions to incomeeligible New Yorkers. Nearly 100,000 of your neighbors are saving energy and saving money with EmPower New York — without spending a dime. Some local aging offices may be able to help you apply for the EmPower NY program. Whether you own your home or rent, a participating contractor assesses if your home would benefit from free energy upgrades such as: • Air sealing to plug leaks and reduce drafts • Insulation to make your home more comfortable all year round • Replacement of inefficient refrigerators and freezers and lighting • Plus, free health and safety checks of your smoke detectors, appliances and more

Long Term Care Ombudsman Program (LTCOP)

1-800-342-9871

http://www.ltcombudsman.ny.gov

This program investigates and resolves complaints and concerns about long term care facilities such as adult homes, skilled nursing facilities, nursing homes and assisted living residences. Trained volunteers serve as certified ombudsmen who advocate for residents, assisting them, their families and the facilities in resolving problems. Technical assistance is provided by the New York State Long Term Care Ombudsman Program staff who work side by side with over 1,600 certified ombudsmen. These ombudsmen serve more than 180,000 long term care residents in the state. For more information about filing a complaint, call the number above

 

The Medicare Rights Center

1-866-815-5400

http://www.medicarerights.org/

The Centers for Medicare & Medicaid Services (CMS) contracts with Livanta, a not-for-profit organization, to improve the quality of health care provided to New York State’s Medicare beneficiaries. Livanta works to resolve beneficiary quality of care complaints and appeals to notices of non-coverage. A quality of care complaint can be made about a number of issues, injury while in a nursing home or hospital, or developing bed sores from not being moved regularly. If you live in New York and wish to file a quality of care complaint, please call the above number.

 

Medicare rights help line 800-333-4114

 

Center for Medicare Advocay   

http://www.medicareadvocacy.org/

provides comprehensive information about Medicare claims and can answer questions about coverage Medical Claims Assistance Professionals.  These consultants can help manage your parents medical paperwork, Identify errors and file appeals.  They usually charge by the project or the hour (typically about $150) Go to www.claims.org

 

NYP$

A  free pharmacy discount card sponsored by NY State. To be eligible, you must be a resident of NY state not receiving Medicaid , either (a) 50 up to 65, or (b) determined disabled by the Social Security Administration and have annual income under $35,000 if single and $50,000 if married.

800-788-6917

http://nyprescriptionsaver.fhsc.com

 

Local Real Estate Property Tax Exemption

Provides for exemption from paying up to 50% of taxes of real estate occupied as legal Residence. Application deadline of March 1st every year. Call your town division.  Homeowners age 65 and older may reduce their real property tax. Each locality sets its own maximum income standard (within limits set by law) at or below which an older property owner can qualify yearly for exemption. Contact your local assessor. Persons with disabilities may also qualify for an exemption (even if they are younger than 65), but a person cannot receive both for the same municipal tax purpose. They can, however, receive other exemptions, such as School Tax Relief (STAR), for veterans, etc. Check with assessors or clerks of your local governments and school district to determine if you have options. Your assessor’s number can be found in the “blue pages” of your phone book.

 

Residential Energy Assistance Program (REAP)

REAP can lower your electric costs if you are income eligible.  They also have free offers at times for items like light bulbs.  Ask to have your refrigerator tested for energy efficiency because you may be eligible for a new one!

800-263-6786

 

Real Property Tax Credit

http://www.aging.ny.gov/NYSOFA/LocalOffices.cfm

http://www.tax.ny.gov/pit/credits/real_property_tax_credit.htm

The “Circuit Breaker,” New York State’s income tax credit program for eligible homeowners and renters, helps elderly and moderate income homeowners and renters who pay a disproportionate amount of property tax in relation to their household income. It works like a rebate for real property taxes. File New York State income tax form IT-214 for the credit/rebate, which is available through the Department of Taxation and Finance or your local office for the aging. To inquire about this program and to find out if you are eligible, contact your local office for the aging

 

School Tax Relief (STAR)

http://www.tax.ny.gov/pit/property/star/index.htm

Eligible older homeowners can receive a significant exemption on the taxable value of their homes, resulting in considerable school property tax savings. Ask your local assessor about Enhanced STAR

 

SHIP

Go to the State Health Insurance Assistance Program with medicare claims issues.  Volunteers in each state are trained to know the appeal process and will help your parent-or you, as your parents representative-build a case and know what to ask the providers and Medicare. To find local contacts:

call 800-633-4227 or go to http://www.shiptalk.org/

 

Verizon Telephone Programs

 

Center for Customers with Disabilities

Provides free equipment for visually or hearing impaired seniors on Medicaid, SSI, Food Stamps, or VA pension.  There is a free 411 assist for visually impaired seniors.

800-974-6006

 

Verizon Lifeline and Link Up

Offers low income households a discount on their monthly phone bill if they receive Medicaid, Food Stamps, SSI, HEAP or VA pension. Link Up pays for some of the cost of initiating Telephone service for home or wireless phones.

800-483-2000

 

Medicaid

Medicaid assists with long term health needs for seniors.  There are 2 types of Medicaid Community and Long Term Home Health Care, or Chronic Care Medicaid used for skilled nursing facilities: (aka nursing homes). Seniors need to be both medically and financially eligible. Seniors who are on Supplemental Security Income (SSI) are eligible for community Medicaid automatically.

 

Community Medicaid

For seniors who want to remain in the community. Services available:

1)Medical Model Day Care

2)Medications (now through Medicare)

3)Personal Care Aide (PCA)

4)Certain Medical Expenses

 

Monthly Income Allowances                                               

Individual: $792 (+$20 exemption)

Couple:       $1,159(+$20 exemption)

 

Resource Allowances

Individual: $14,250

Couple:        $20,850

 

Nassau County

Nassau County DSS

60 Charles Lindbergh Boulevard

Uniondale, NY 11553-3656

516-227-8000

 

Suffolk County                                                                                          

Riverhead Center

893 E. Main St

Riverhead, NY 11901-2542

631-852-3710 New Applications  

631-852-3570 Open Cases

 

Smithtown  Center

200 Wireless Boulevard

Hauppauge, NY 11788

631-853-8730 New Applications

631-853-8765 Open Cases

 

Pooled Income Trusts for Community Medicaid

Disabled persons of any age receiving community Medicaid services, including home care, adult-day care and prescription drugs, are now able to use virtually all of their income to pay for their living expenses by participating in a pooled –income trust. It is no longer necessary for consumers to contribute their”excess” income to the Medicaid system as a “spend-down.” It’s called a pooled income trust because the assets of all participants are”pooled” together for the purpose of investment and management. However, you still have  your own segregated account established solely for your use. When you pass on, whatever is left over in your trust account is used for other beneficiaries of the trust, helping the charity to continue providing services to those who need them. Every month, excess income over $792, which is the Medicaid limit for a single person in New York, is transferred to the pooled income trust. You simply write a check for the amount of the excess income, and send it to the trust. You can then submit bills to be paid by the trust. So, for example, if you have Social Security income of  $1,600 a month, then you keep $792 in your own bank account and spend it as you please, and you send $808 to the trust every month. The charity then pays your bills with this money. The pooled income trust functions almost like a bill paying service. Through the trust, excess income can be used to pay for food, clothing, monthly rent or mortgage, telephone, electricity, taxes, home repairs—all living expenses except medical premiums and medical bills. The trust charges a small monthly processing fee for the service.

 

Chronic Care Medicaid

This is the type of Medicaid for nursing home placement, In a long term care setting these Services will be provided:

1)Medications

2)Certified Nurse Assistant (CAN) 24 hours a day 7 days a week

3)Skilled services: Physical Therapy, Occupational Therapy, Registered Nurses, Social Work, Dietitian

4)Room and Board

 

Monthly Income Allowances                                  

Applicant:          $50

Well Spouse:     $2,841

Resource Allowances

Applicant:          $14,250(+pre-paid funeral)

Well Spouse:     $113,640

                                                   

 

Nassau County DSS

60 Charles Lindbergh Boulevard

Uniondale, NY 11553-3656

516-227-8000

 

Medicare

For seniors 65 and over who qualify for Social Security or Railroad Retirement. Persons receiving Social Security Disability Benefits for 24 months are eligible even if under 65. You  pay premiums for coverage and co payments for most services unless you qualify for a low-income program or have other, extra insurance. To avoid permanent late penalties enroll at age 65. In order to enroll in Medicare, you must contact the social security office. Your first enrollment period lasts seven months. You have three months before the month of your 65th birthday to three months after your birthday month. There are different “Parts” to Medicare coverage. Medicare does not usually cover dental care, eyeglasses, hearing aids or health services received outside for the U.S. or long-term care services.

800-MEDICARE (800-633-4227)

www.medicare.gov

 

MEDICARE PART A

Services Covered:

1)  Hospital Care

2)  Medicare Part A pays for the first 20 days of a skilled nursing facility or inpatient rehab after a 3 day hospital stay as long as there is a skilled need. Skilled needs include, but are not limited to, physical or occupational therapy, wound care, diabetic teaching etc. If a patient no longer requires a skilled need, then Part A coverage ends and you have to pay privately or pay with Medicaid.

3)  Home Health Care as long as there is a skilled need.

4)  Hospice Care.

 

Deductibles:

1)  Out of pocket deductible before Medicare pays changes yearly. It is currently $1,132 for 2012.

2)   Once the deductible is paid, hospitalization is covered 100% for the first 60 days.  Co-pays apply after 60 days. The co-payment for days 61-90 is $283 for 2012.

3)  Once discharged from the hospital, you need to remain out of the hospital for 60 consecutive days (including day of discharge) for a new benefit period to begin. If you return to the hospital before the 60 days, your original benefit is continued where you left off.

4)   Lifetime reserve days – in hospital stays over 90 days – c o-payment is $566 in 2012.

5)   If  admitted to a skilled nursing facility, as long as a skilled need continues after day 20, then Part A will pay 80% of the facility fees up until day 100.  The additional 20% may be covered by your secondary insurance. If not you will be required to pay privately. Skilled Nursing home co-payment  for days 21-100 is $141.50 per day for 2012.

 

MEDICARE PART B

Medical Insurance (Part B) Helps pay for doctor’s services, outpatient hospital services, durable medical equipment and a number of other medical services and supplies that are not covered by Part A. Part B has premiums, deductibles and co-insurance that you must pay yourself or through coverage by another insurance plan. If choosing a fee for service plan, you must also arrange for separate prescription coverage. Preventive Health Benefits Medicare provides coverage under Part B for many health screening and preventative health tests including colorectal and breast cancer screening, diabetes screening, flu and pneumococcal vaccinations and smoking cessation among others (see your annual “Medicare and You” book)

 

Services Covered:

1)  Physician Services.

2)  Outpatient hospital care.

3)  Laboratory tests

4)  Certain Durable Medical Equipment (DME).

 

Deductibles

Out of pocket deductible before Medicare pays changes yearly.  It is currently $162 for 2012.

 

MEDICARE PART C

Medicare Advantage Managed Care Plans cover everything traditional Medicare covers and most plans cover additional services. A Medicare Health Maintenance Organization or HMO is an organized community based network of physicians, health centers, hospitals and other health care professionals that are approved by that plan. Fees may include the Part B premium or more, depending on the coverage. Part C is voluntary and does save you money when you are healthy, but does not allow you the flexibility and services you may need if you become ill. HMO’s severely restrict the care seniors are able to get outside of the network. Traditional Medicare with a supplemental plan has more services available, but is more expensive. Deductibles vary by plan.

 

MEDIGAP (SUPPLEMENTAL INSURANCE)

This insurance is intended to help cover the deductible and co-payment “gaps” in your Medicare coverage. This option gives you more control over your medical care so you can choose your doctors, specialists, and receive treatment in any facility in the U.S. There is open enrollment for the first six month period when a beneficiary (age 65 and older) enrolls in Medicare Part B.

Medigap options are offered by private companies and are labeled “A” through “L” offering different basic and extra benefits. The more benefits, the higher the premium. Medigap does not cover prescription drugs, therefore you should look into purchasing Medicare Part D for additional prescription drug coverage. An example of a Medigap policy would AARP.

 

MEDICARE PART D

Prescription Drug Program

1) It is voluntary, but there are high late enrollment penalties. If you fail to sign up for a plan during your initial enrollment period, you will be penalized, and your premiums will be permanently increased by 1% for every month you delay. It is important to sign up for a plan once eligible to avoid these fees. Plans can start as low as $20.00 a month. If you can prove that you previously had other prescription drug coverage through a retiree plan or veterans benefits, then you will not be penalized.

2)  Beneficiaries pay a deductible and a monthly premium which can be paid to the plan or deducted from monthly social security payment.

3)  Prices are negotiated by plans and protect you from high out of pocket expenses for drugs.

4)  There are tow types of Part D plans.

a) General Prescription Drug Plans (PDP’s) are free standing and only offer prescription drug benefits.

b) Medicare Advantage Plans with Prescription Drug coverage (MA-PDs) are Medicare Part C HMO’s that include drug coverage as part of their plan.

www.medicare.gov  or 800-633-4227

 

MEDICARE BUY-IN PROGRAMS

There are also Medicare programs for seniors who have an annual income at or below the poverty guidelines, but are not eligible for Medicaid.

 

Medicare Savings Program

http://www.aging.ny.gov/NYSOFA/LocalOffices.cfm

New York State and the federal government help low income Medicare beneficiaries with out- of-pocket expenses. Contact your local office for the aging to learn about Medicare Savings Programs. New plan choices are announced in October of each year

Reporting Medicare or Medicaid Fraud

1-877-678- 4697

Senior Medicare Patrol (SMP) is a federally funded program designed to combat health care waste, fraud and abuse. Every year Medicare and Medicaid loses billions of dollars to fraud. In New York State federal, state and local agencies work together to prevent this wasteful spending. SMP’s goal is to alert Medicare and Medicaid beneficiaries of illegal schemes and encourage them to examine their Medicare Summary Notices and report erroneous billing. SMP volunteers are trained to do presentations and help individuals who suspect false charges to their accounts. To report suspicious activities in your accounts call the SMO hotline above. This 24-hour hotline utilizes tele-interpreter service which can interpret up to 150 languages

 

QUALIFIED MEDICARE BENEFICIARY PROGRAM (QMG)

These plans cover your medicare premiums, deductibles and co-payment costs.

New York State Partnerships for Long Term Care

1-866-950-7526

http://www.nyspltc.org

The New York State Partnership for Long Term Care combines private long term care insurance with Medicaid to help people prepare financially for possible nursing home care, home care or other long term care services as specified under the policy. It allows New Yorkers to protect assets while remaining eligible for Medicaid Extended Coverage if their long term care needs exceed the period covered by their private partnership insurance policy.

 

SPECIFIED LOW INCOME MEDICARE BENEFICIARY PROGRAM (SLIMB)

Only pays for the Medicare Part B monthly premium, therefore you will still need to purchase Medigap insurance if you can afford to . Contact the Department of social Services for further information.

 

Social Security Retirement Benefits can be claimed as early as age 62, but the earlier they are claimed, the lower the benefit will be. for persons born after 1937, the full retirement age will gradually go up from 65 to 67. You can delay retirement up to age 70, but after that there will be no increase in benefits. Applications can be made 4 months in advance of expected retirement or at age 62, if already retired.

 

Survivors Benefits are available to a surviving spouse over the age of 60; a divorced surviving spouse over the age of 60 if the marriage lasted longer than 10 years; or a surviving spouse or divorced spouse under the age of 60, who is caring for the worker’s child who is under 16 or disabled. Benefits are also available to a surviving spouse, 50 years of age or over, who becomes disabled within seven years of the workers death; children of any age who were severely disabled before age 22 and are still disabled; dependents parents who are at least 62 and were dependent on the worker for at least one-half their financial support.

 

Disability Benefits are paid to workers and their family when the worker has difficulty working because of a physical or emotional condition or is expected  to last, or has lasted over a year or is expected to result in death. This condition must prevent the worker from doing any substantial work. The worker must meet the criteria set forth by Social Security including work credits, medical conditions, and length of disability.

 

Supplemental Security Income (SSI) is a cash benefit intended to guarantee a minimum level of income for certain people. There are four requirements for eligibility. The person must be 65 or over, blind or disabled; be a citizen of the United States; income must be less than a certain minimum amount; and assets must be less than $2000 for an individual and $3000 for a couple (home , car and other assets are exempt).

 

Suffolk Locations:

75 Oak Street

Patchogue, NY 11772

 

95 E Hoffman Avenue

Lindenhurst, NY 11757

 

510 Park Avenue

West Babylon, NY 11704

 

Nassau Locations:

211 Station Road, 5th floor

Mineola, NY 11501

 

84 North Main Street

Freeport, NY 11520

 

5-27 East Park Avenue, Suite 206

Long Beach, NY 11561

 

1121 Old Walt Whitman Road

Melville, NY 11747

Go Direct

You can have your Social Security and Supplemental Security Income (SSI) payments made direct deposit. It eliminates the risk of lost or stolen checks, reduces fraud, helps protect against identity theft and gives people more control over their money.

800-333-1795 or visit www.godirect.com

 

Tax Laws for Caregivers

Dependency-Special Rule for Parent:  You may be eligible to file as head of household if your qualifying person is your father or mother even if they do not live with you. You must be able to claim an exemption for them, and pay more than half the cost of their main home up keep for the entire year. You are keeping up a main home for your father or mother if you pay more than half the cost of keeping your parent in a facility.

 

Standard Mileage Rate 2011: 51 cents per mile for business miles, 19 cents per mile driven for medical or moving purposes, 14 cents per mile driven in service of charitable organizations.

 

Credit for the Elderly or the disabled: You can take the credit for the elderly or the disabled if you are a qualified individual and your income is not more than certain limits. You are a qualified individual for this credit if you are a U.S. citizen or resident alien and either of the following applies; 1) You were age 65 or older at the end of 2008, 2) You were under age 65 at the end of 2008 and all three of the following statements are true. A) You retired on permanent and total disability. B) You received taxable disability income for 2008, and C) On January 1, 2008, you had not reached mandatory retirement age.

 

Long Term Care Insurance:  Increase in Limit on Long – Term Care and Accelerated Death Benefits Exclusion for 2011 is $240 a day.


Long Term Care Premium Deductible increased for 2100:

Age 40 or under -$350.

Age 41 to 50-$660.

Age 51 to 60-$1,310.

Age 61 to 70-$3,500

Age 71 or over-$4370.

 

Whose Medical Expenses Are Deductible:  Deductible expenses include those incurred by the taxpayer, spouse or dependent. Note: The taxpayer must have been married to the spouse either at the time the spouse received the medical services, or at the time the taxpayer paid the medical expenses. A person must be a dependent of the taxpayer either at the time the medical services were provided, or at the time the taxpayer paid the medical expenses.

 

Nursing Home:  the cost of living in nursing home, including meals and lodging, is deductible if a principal reason for being there is to get medical care. If the taxpayer is in a nursing home for personal reasons, only the part of the cost that is for medical nursing care is deductible.

 

Nursing Services-Non-professional: Deductions for medical expenses include amounts paid for nursing services.  The services do not have to be performed by a nurse as long as the services are of a kind performed by a nurse. Nursing services include giving medication, changing dressings, bathing, and grooming. the services can be provided in the taxpayer’s home or another care facility.

 

Estate Tax Exemption: For 2011, there is no federal estate tax. However the executors of estates where the taxpayer died in 2011 can elect to apply the 2012 exemption of $5,000,000, with a maximum estate tax of 35%. Different rules for the step up in cost basis apply in these two years, meaning some estates may find the 2012 rules more beneficial. The estate tax was reinstated in the 2010 Tax Relief Act.

 

Annual Exclusion for Gifts: The annual exclusion for gifts of present interests made to a done during the calendar year remains at $13,000. The annual exclusion for gifts to spouses who are not U.S. citizens will increase to $134,000.