Entitlement Programs & Financial Assistance

Social Security – Click Here

Medicare - Click Here

Part A - Click Here
Part B - Click Here
Part C - Click Here
Part D - Click Here
Information/Assistance - Click Here
Medicare Savings Programs - Click Here

Insurance – Click Here

Limited Income Assistance Programs - Click Here

Medicaid – Click Here
Title XX Homemaker Service - Click Here
Supplemental Security income (SSI) – Click Here
Public Assistance - Click Here
Food Stamps - Click Here
Senior Citizen Property Tax Exemption - Click Here
STAR Program - Click Here
Circuit Breaker Tax Refund/Credit – IT 214 – Click Here
Senior Citizens Rent Increase Exemption (SCRIE) – Click Here

Property Reassessment – Click Here

Veterans’ Benefits - Click Here

Energy/Fuel Assistance – Click Here

Fuel Emergencies – Click Here

Utility Shut-Offs - Click Here

SOCIAL SECURITY

For information call 1-800-772-1213 or TTY: 1-800-325-0778.

WORKER BENEFITS

An individual who has reached full retirement age and who has worked sufficient quarters under Social Security, is entitled to Social Security retirement benefits. For retirees born in 1937, or earlier, full retirement age is 65. For those individuals born in 1938, it is 65 and 2 months. Full retirement age will gradually increase to age 67 for those born in 1960 or later. Individuals may apply for benefits starting at age 62 but the monthly payments will be smaller. Write or telephone the local Social Security office for instructions concerning filing a claim at least three months before reaching retirement age. Individuals who are disabled before 65 may apply for Social Security disability benefits.

SPOUSE BENEFITS

The spouse of a person receiving Social Security benefits is entitled to benefits even if he or she has never worked. Application can be made at age 62, but the monthly payments will be reduced.

WIDOW BENEFITS

A disabled widow/widower may apply at age 50. A widow who remarries after age 60 is entitled to the same widow(er)’s benefit as if the remarriage did not take place.

DEATH BENEFITS

Upon the death of a person covered by Social Security on his/her own work record, a sum of $255 is paid to the widow or widower only if they were living together at the time of death or to surviving children who are eligible for benefits on the decedent’s account.

EARNINGS DEDUCTION

As of January 2011, individuals age 62 to full retirement age can earn $14,160 without deduction. One dollar in benefits will be deducted for each $2.00 a worker earns over this earning limit. During the year a person reaches full retirement age, s/he can earn up to $37,680 in the months preceding full retirement age. The benefits will be reduced $1.00 for every $3.00 earned over the limit. There is no limit on earnings beginning the month an individual reaches full retirement age.

DIRECT DEPOSIT

Beginning in May 2011 persons applying for Social Security and/or SSI benefit checks must receive payments electronically. By March 2013 all Social Security and SSI payments will be made electronically. This service prevents lost or stolen checks, delayed checks in the mail, and standing in line at the bank. Benefit checks are forwarded directly to the bank for direct deposit in either a savings or checking account.

ELECTRONIC TRANSFER ACCOUNT (ETA)

The ETA is a special, new account for anyone who receives a federal benefit, wage, salary, or retirement payment. This low-cost (maximum $3.00 a month) federally insured account is designed by the U.S. Department of Treasury to allow federal payments to be received automatically, even if you don’t have a checking or savings account. Persons who open an ETA at a participating bank, savings and loan, or credit union will have their payment deposited to their account instead of getting a check in the mail. For further information about an ETA, speak with a service representative at your bank. To find out where you can open an ETA, call:
1-888-382-3311
or                                                                          
1-877-326-5833 (TTD)
www.eta-find.gov

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MEDICARE

Medicare is a health insurance program for persons age 65 and older, and for some persons under 65 who are disabled or have end-stage renal disease. To enroll in Medicare, call the local Social Security Office 3 months prior to your 65th birthday. Persons who work past age 65 should apply for Medicare even if they are not applying for Social Security benefits.

“Medicare and You” provides a summary of benefits, rights and protections, and answers to frequently asked questions. Every beneficiary should receive an updated copy each fall. To speak to a counselor, or to obtain information about Medicare, contact:

1-800-MEDICARE (1-800-633-4227)
TTY: 1-877-486-2048
www.medicare.gov

To access personalized information about one’s services and benefits, contact the following free, secure online site: www.mymedicare.gov

NOTE: Medicare benefits are subject to frequent changes.  Check nearest Social Security office for current information and for details regarding future changes.

Traditional Medicare has three parts:

PART A - MEDICARE HOSPITAL INSURANCE

Medicare Part A is available free to anyone who is at least 65 and is entitled to Social Security or Railroad Retirement benefits. Older persons not eligible for one of these benefits can purchase Medicare hospitalization insurance. It helps pay for four kinds of care:

1. Inpatient hospital care
2. Medically necessary inpatient care in a skilled nursing facility after a hospital stay
3. Home health care
4. Hospice care

Certain conditions must be met to entitle the person to any care. At the present time they are:

1. Inpatient hospital care

Medicare hospital insurance can help pay for inpatient hospital care if all four conditions are met: (a) a doctor prescribes inpatient hospital care for treatment of patient’s illness or injury; (b) the patient requires care that can only be provided in a hospital; (c) the hospital is participating in Medicare; and (d) the Utilization Review Committee of the hospital or a peer review organization does not disapprove the patient’s stay.

Medicare pays hospitals based on average costs for a particular diagnosis. This Prospective Payment System is based on diagnostic related groups, or DRGs.

Medicare patients remain entitled to all the hospital care necessary for the proper diagnosis and treatment of their illness or injury. The discharge date should be determined by the physician, based on medical needs, not by DRGs or by Medicare payments.

Concerns regarding hospital discharge date, quality of treatment, and/or denial of admission should quickly be brought to the attention of the local Peer Review Organization (PRO). The PRO for Nassau County is:

2. Medically necessary inpatient care in a nursing facility after a hospital stay

Hospital insurance can help pay for skilled nursing care in a nursing facility if all five conditions are met: (a) patient has been in a hospital at least 3 days in a row (not counting the day of discharge) before transfer to a participating nursing facility; (b) patient is transferred to the nursing facility because skilled nursing care is required for a condition which was treated in the hospital; (c) patient is admitted to the facility within a short time (generally within 30 days) after leaving the hospital; (d) a doctor certifies that patient needs and actually receives skilled nursing or skilled rehabilitation services on a daily basis; and (e) the facility’s Utilization Review Committee or a peer review organization does not disapprove the stay.

3. Home Health Care

Medicare may help pay for home health visits only if all four conditions are met: (a) the care needed includes part-time skilled nursing care, physical therapy or speech therapy; (b) patient is confined to his/her home; (c) a doctor determines that patient needs home health care and sets up a home health plan for him/her; and (d) the home health agency providing services is participating in Medicare. (If these conditions are met, either hospital insurance, Part A, or medical insurance, Part B, can pay for the care.)

4. Hospice Care

Medicare can help pay for hospice care if all three conditions are met: (a) doctor certifies that the patient is terminally ill; (b) patient chooses to receive care from hospice; and (c) care is provided by a Medicare-certified hospice program.

For a list of certified hospice programs, click here.

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PART B - MEDICARE MEDICAL INSURANCE

Medicare Part B is available but optional to all people who qualify for Part A (hospitalization insurance). The monthly premium is deducted from the Social Security check. As of January 2011, the monthly premium is $115.40, and is expected to rise again. Most older Americans purchase this medical insurance since it covers many items Part A does not cover. It can help pay for the following:

1. Doctors’ services
2. Outpatient hospital care
3. Outpatient physical therapy and speech pathology services
4. Home health care
5. Many other health services and supplies which are not covered by Medicare hospital insurance.

When seeking services, ask if the person or organizations are approved for Medicare payments.  If they are not covered, the individual will be responsible for the bill.  Empire Medicare Services, the local carrier of Medicare, reimburses 80% of the allowable charge of approved services.

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MEDICARE ADVANTAGE PLANS AND OTHER MEDICARE HEALTH PLANS (PART C)

Medicare Advantage Plans (MAPS) are alternatives to traditional fee-for-service Medicare. Generally all health care covered by Parts A and B is provided through the specific MAP plan, and many provide prescription drug coverage as part of their benefits. The enrollee may have to use the plan’s doctors and hospitals for services. MAPs can charge different copayments, coinsurance, and deductibles, and may offer extra benefits.

Medicare HMOs are Managed Care Plans. In most Medicare HMOs, there are doctors and hospitals that join the plan (called the plan’s “network.”) Enrollees usually must get their care and services from the plan’s network. The primary care physician (PCP) is the doctor an enrollee will see first for most health problems. In many HMOs, an enrollee must see the PCP before seeing any other health care provider. Enrollees are also cautioned that the Medicare HMO and traditional Medicare may refuse to pay for health care services that are obtained from providers who are outside of the plan’s network. If the Medicare HMO includes prescription drug coverage, the enrollee will pay a co-payment or coinsurance for each covered prescription (unless the enrollee has Medicare and Medicaid, and is in an institution like a nursing home.)

Medicare Preferred Provider Organizations (Medicare PPOs) use many of the same rules as Medicare HMOs (Managed Care Plans). In a PPO, an enrollee generally can see any doctor or provider that accepts Medicare and the enrollee does not need a referral to see a specialist or an out-of-network provider. However, an enrollee will usually pay more for doctors, hospitals, or other providers who are not part of the plan. PPOs generally provide more benefits for lower costs than traditional Medicare.

Medicare Special Needs Plans may limit all or most of their membership to people in certain long-term care facilities (like a nursing home), who are eligible for both Medicare and Medicaid, or have certain chronic or disabling conditions. The Plan must be designed to provide Medicare health care and services to people who can benefit the most from services such as the special expertise of the plan’s providers or focused care management. These Plans must provide Medicare prescription drug coverage. Most plans offer extra benefits and lower co-payments than are available in traditional Medicare.

The following information should be carefully considered when making a decision regarding a Medicare Advantage Plan (MAP):

• All care is coordinated by the MAP and PCP BUT, to take full advantage of the benefits, the enrollee should use the MAP’s participating doctors, hospitals and other providers. For some HMOs, there is no coverage for any out-of-network service.
• An enrollee may be able to continue to use his/her doctor as PCP IF the doctor participates in that MAP. Check with the doctor before enrolling.
• Enrollees may be required to get prior approval from the PCP for referrals to specialists for diagnostic testing and consultation.
• The enrollee’s medical expenses will be more predictable since s/he will know the MAP monthly premiums, if any, and copayments are modest.
• The MAP may provide the enrollee with additional benefits such as annual physical exams, prescription drugs, eye exams, glasses or dental care BUT it is important to clearly understand the benefits and any limitations on them, e.g., drug formularies, co-payments, cost share, etc.
• The MAP will reduce the paperwork involved in the enrollee’s health care since there are usually no claims to file BUT the enrollee must take responsibility for understanding the benefits and limitations of the plan.

The Nassau County Office for the Aging funds Family and Children’s Association to provide counseling to older persons who are considering joining a Medicare Advantage Plan or who have questions of any type regarding health care insurance and coverage. For information, call: 485-3754

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PART D - MEDICARE PRESCRIPTION INSURANCE

Helps pay for prescription medications through approved insurance plans offered by private insurers. Plans vary in the premiums charged, drugs covered, and benefits offered. Extras help in paying for premiums, co-pays, and deductibles is available for individuals with limited assets and incomes less than 150% of the federal poverty level. Late enrollment penalties apply if the beneficiary does not enroll when first eligible.  Counseling and assistance are available by contacting:

Consumers can also use the Medicare Part D – Plan Finder to locate plans that may meet one’s needs.
www.medicare.gov/find-a-plan/questions/home.aspx

MEDICARE INFORMATION AND ASSISTANCE

Medicare Rights Center

www.medicarerights.org

The Medicare Rights Center (MRC) is the largest independent source of Medicare information in the country. MRC helps older adults and persons with disabilities get good affordable health care by providing free counseling and current and comprehensive information about Medicare options and rights. MRC answers questions about coverage and assists individuals having problems accessing service. Call: 1-800-333-4114

Medicare
Medicare has an interactive portal to access personalized information regarding one’s Medicare benefits.
www.mymedicare.gov

Medicare Problems

Persons experiencing problems with Medicare bills and services, or who wish to discuss issues of possible fraud and abuse, should contact:

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MEDICARE SAVINGS PROGRAMS

The Medicare Savings Programs (MSPs) are government programs that help people with Medicare, who qualify financially, pay for some of their Medicare costs. The programs, also known as Medicare Buy In, aid people with low incomes. There are four Medicare Savings Programs, referred to as QMB (Qualified Medicare Beneficiary), SLMB (Specified Low-Income Medicare Beneficiary), QI-1 (Qualifying Individual) and QDWI (Qualified Disabled Working Individual).

Each program has a different level of financial eligibility. Depending on income and assets, qualifying individuals can have a portion of their Medicare expenses paid. Benefits may include paying for premiums, penalties, deductibles, and coinsurance. An application must be made through the Nassau County Department of Social Services. Persons who believe they may qualify, but are not sure, should call:

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INSURANCE

MEDICARE SUPPLEMENT INSURANCE (MEDIGAP)

www.cms.hhs.gov

www.hiicap.state.ny.us/mgap

Medicare Supplement Insurance (Medigap Insurance) is designed to help cover the deductible and co-payment gaps in Medicare coverage. Federal and State regulations have established minimum standards for insurance companies offering Medigap Insurance. The Center for Medicare Services (CMS) publishes the “Guide to Health Insurance for People with Medicare.” A copy may be obtained at local Social Security offices, or by calling:

1-800-633-4227

TTY/TDD 1-877-486-2048

LONG TERM CARE INSURANCE

Insurance covering long term care services is sold by a number of private insurance companies in New York State. It is available both on an individual and a group basis. Before purchasing Long Term Care insurance it is very important to determine exactly what services are covered, including skilled and/or custodial care both in a nursing home and at home. Policies should be carefully read and compared.

The New York State Partnership for Long Term Care Program offers policies which guarantee full or partial asset protection. The New York State Department of Financial Services – Insurance Division has published a book “The Basics of Long Term Care Insurance in New York State.” To obtain a copy, contact:

FAMILY HEALTH PLUS

This public health insurance program covers adults between the ages of 19 and 64 who do not have health insurance and have incomes too high to qualify for Medicaid. Family Health Plus provides comprehensive coverage, including prevention, primary care, hospitalization and prescription drugs. There are minimal co-payments for some services and care is provided through participating managed care plans. The application is the same one used for Medicaid. Contact:

PUBLIC HEALTH INSURANCE SCREENING TOOL
Access New York
A simple online screening tool is available to assist in determining potential eligibility for a public health insurance program such as Medicaid, Family Health Plus, and Child Health Plus.
Visit: https://apps.nyhealth.gov/doh2/applinks/accessny/elgibility/gettingstarted.jsp

HEALTH INSURANCE COUNSELING

HIICAP (Health Insurance Information, Counseling and Assistance Program) provides information and guidance to Nassau County seniors who request assistance with health insurance selection and/or problems. It serves as the Long Term Care Insurance Resource Center for Nassau County and provides information, assistance, and counseling relating to long term care insurance policies, including the NYS Partnership for Long Term Care Insurance. It is funded by the Nassau County Office for the Aging and operated by Family and Children’s Association. Call:

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LIMITED INCOME ASSISTANCE PROGRAMS

MEDICAID - MEDICAL ASSISTANCE

Medicaid pays for medical care and services for individuals and families with very limited assets and income who cannot afford to pay all of their medical bills. It is especially valuable to older people with serious, recurring health problems because they usually cannot meet all of their medical expenses from Medicare alone.

A person may be eligible for partial assistance or for complete medical coverage depending upon his/her monthly income and assets. Some Medicaid recipients pay a co-payment for some services.

When seeking services, it is important to find out if the agency accepts Medicaid payments. If not, the individual will be responsible for the bill. Payment is made directly to the doctor or other health care provider. At the present time Medicaid may pay for the following:

• Hospital inpatient and outpatient services
• Laboratory and X-ray services
• Care in a residential health care facility
• Care through home health agencies
• Treatment by physicians, dentists, and podiatrists
• Eye care
• Hearing aids
• Treatment in psychiatric hospitals and mental health facilities
• Supplies, equipment, and some prescription medications
• Clinic services
• Physical, occupational, and speech therapy
• Private duty nursing
• Home health personal care services
• Transportation to Medicaid-covered services

As of April 1, 2010, there is no longer a personal interview requirement in New York State for Medicaid and Family Health Plus (FHPlus) applicants as a result of Chapter 58 of the Laws of 2009. Call the Nassau County Department of Social Services to determine eligibility, for a list of items needed to determine eligibility, and for an application.

Case Management Services

Assistance in completing Medicaid applications may be available for frail elderly persons. For information, call:

Nassau HELP-LINE (516) 227-8900

Medicaid Information
The New York State Department of Health provides answers to many questions relating to Medicaid eligibility. Contact:
www.nyhealth.gov/health_care/medicaid/index

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TITLE XX HOMEMAKER SERVICE

Under Title XX of the Social Services Law, part-time homemaker service (cooking, shopping, cleaning) may be provided to moderate income individuals who are above the Medicaid level and have limited resources.
Nassau County Department of Social Services
Information, Resource, and Referral Services Unit
60 Charles Lindbergh Boulevard
Uniondale, NY 11553
(516) 227-8395

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SUPPLEMENTAL SECURITY INCOME – SSI

The Social Security Administration administers a program of financial aid to persons 65 or over and to the blind or disabled of any age who need financial assistance. Income and resource eligibility levels must be met when a claim is filed. For detailed information regarding eligibility, allotments, and application, contact:

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DEPARTMENT OF SOCIAL SERVICES PUBLIC ASSISTANCE

The Department of Social Services provides financial assistance to persons under 65 who qualify by need and resources and are not eligible for SSI. Some SSI recipients without assets may receive limited additional allotments. SSI recipients may receive emergency funds if their check is lost, stolen or not received. Under special circumstances other emergency assistance may be available. For information contact:

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FOOD STAMPS

Families with low assets and income levels may be eligible for food stamps. When applying for food stamps, bring rent receipts, utility bills, proof of income, bankbooks, receipts for medical expenses and other items that can substantiate eligibility for this program. Since financial requirements change, to determine eligibility, call:

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SENIOR CITIZEN PROPERTY TAX EXEMPTION

Who is Eligible

In most communities, property owners 65 and over with yearly incomes of $37,399 or less are eligible under the following conditions:

• Applicants must be 65 years of age or over. If husband and wife own the property, only one must be 65 years of age.
• The combined income of all the owners cannot exceed $37,399. In case of husband and wife, if title is vested in one name only, the combined income of both must be considered. A few school districts and villages have set their eligibility at a lower income level.
• Income is figured for the calendar year immediately preceding the date of application. Income includes Social Security, retirement benefits, interest, net rental income, salary or earnings, and income from self-employment, but does not include gifts or inheritances.

Unreimbursed medical expenses and unreimbursed prescription drug expenses may now be deducted from income.

• The applicant must have owned the property or another residential property in the State of New York for at least two years prior to making the application.
• The property must be used exclusively for residential purposes.
• If a child attending school in the district lives with the applicant, the applicant cannot be granted exemption from the school tax.
• The property must be the legal residence of the applicant and be occupied in whole or in part by the owner or all the owners of the property.

Where to Apply

Apply anytime during the year, prior to December 31 for county, town and school taxes. Residents of an incorporated city or village must file a separate application. Consult village or city clerk for exact filing dates.

How to Apply

It is advisable to apply in person the first time. Bring original or copies of the following:

• Proof of age
• Deed to house
• Federal income tax report of the previous year
• Social Security payment record of the previous year

Once eligibility has been established, renewal applications will be sent automatically.

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STAR PROGRAM

STAR is the New York State School Tax Relief Program that provides an exemption from school property taxes for owneroccupied, primary residences. Qualified homeowners of all ages, regardless of income, may apply. Seniors over age 65 whose income is less than $79,050 may apply for the “enhanced” Star exemption. For further detailed information, contact:

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CIRCUIT BREAKER TAX REFUND/CREDIT - IT 214

The circuit breaker program provides tax credits to homeowners and renters with a maximum gross annual household income of $18,000. The amount of the tax credit available will depend on the amount of property taxes paid by homeowners, or the size of adjusted monthly rent payments paid by renters.

In addition to the household income limit, the full value of a homeowner’s property cannot exceed $85,000. A renter’s “adjusted monthly rent” must be $450 or less. Households who do not have to file income tax returns, obtain the tax credit in the form of a direct check from New York State. For further information, contact:

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SENIOR CITIZENS RENT INCREASE EXEMPTION (SCRIE)

The SCRIE Program is offered in a limited number of municipalities in Nassau County to income-eligible persons, age 62 and over, who live in rent controlled or rent stabilized apartments. The program provides a full or partial exemption from future rent increases. Initial application must be made with the municipality. For further information, to renew an application or to file a complaint, apartment dwellers may contact:

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PROPERTY REASSESSMENT

Persons who want to have their property reassessed must apply between January 2 and March 1. For details and an application, contact:

To file online, use the AROW (Assessment Review on the Web) feature on this website.

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VETERANS’ BENEFITS

VETERANS SERVICE AGENCY

There are special veterans’ benefits available to people 65 and older who either served 90 days or more of honorable active wartime service or served less time but were discharged because of disabilities related to their service. Widows and widowers of such veterans may also be eligible for benefits regardless of their age. The Veterans Service Agency handles the processing of claims for compensation, pension benefits, educational entitlements, property tax exemptions, and burial benefits, and assists with the appeals process. In addition, it coordinates a volunteer transportation program for veterans to the VA Hospital in Northport and the VA Clinic in Plainview.

Transportation to Northport VA Hospital or Plainview Clinic is available by appointment.
Call: (516) 227-6560

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ENERGY/FUEL ASSISTANCE

HOME ENERGY ASSISTANCE PROGRAM (HEAP)

This program provides a once-a-year benefit to low income homeowners and renters to help pay for fuel or utility costs. Persons age 60 and over, and disabled and SSI recipients of all ages, can apply by mail. For information on income eligibility levels and application procedure, contact:

WEATHERIZATION ASSISTANCE PROGRAMS

For information about WRAP, click here.

RESIDENTIAL ENERGY AFFORDABILITY PARTNERSHIP (REAP)

REAP is a program for Long Island Power Authority (LIPA) customers that can help limited income households better control their energy use and thus save money on electric bills. If eligible, a REAP team will visit the home and provide information on practical ways to reduce energy costs. In addition, they may install certain energy saving devices at no cost to the homeowner. Contact:

PROJECT WARMTH

Project Warmth is a community-based partnership that provides financial assistance to enable eligible families to pay their heating bills. This program is administered by Long Island’s United Way. Depending on the availability of funds, one-time grants are awarded during the winter months. Contact:

Project Warmth

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FUEL EMERGENCIES

HEAP EMERGENCY ASSISTANCE

Persons who are out of heating oil or who are threatened with a utility termination, and who are eligible for SSI or HEAP, may apply for Emergency Assistance. For eligibility information:

UTILITY SHUT-OFFS

Between November 1 and April 15, utility companies may not shut off services for non-payment of bills unless customers have been contacted at least 72 hours in advance. Service may not be shut off on Friday, Saturday, Sunday, a holiday, or the day before a holiday.

SENIOR IDENTIFICATION PROGRAM

Senior citizens who qualify may apply to utility companies for special identification and consideration in emergency circumstance. For information, call: