• Five-Star Nursing & Rehabilitation Facility awarded by the Centers for Medicare and Medicaid Services.
• Administrator member of American College of Health Administrators
• Administrator recipient of CMS Outstanding Achievement award for Reducing Hospitalizations
• Time to enroll in Medicare
• Preventing elder abuse
• Feds lowering drug costs
• Administrator is 2016 Recipient of Lily Leadership Award
by Kristen Guglielmo Editor
As the leaves start to turn and the air gets a little crisper, it’s also time to make some important healthcare decisions.
Medicare is the federal health insurance program for people 65 or older and for certain younger people with disabilities. Most people are first eligible to register three months before turning 65.
During Medicare’s Annual Enrollment Period, one can make some changes to their plan. The AEP is just a few days away, spanning from Oct. 15 to Dec. 7. During that window, people can make adjustments to their overall plan.
To know what changes can be made, it’s important to know about the different plans, which medicare.gov outlines.
Part A helps cover inpatient care in hospitals, skilled nursing facility care, hospice care and home health care. It’s often referred to as “hospital insurance.”
Part A is premium-free for most people, who qualify because they paid Medicare taxes for at least 10 years while working. People might be able to buy it if they do not qualify.
Part B, also commonly referred to as “medical insurance,” helps cover services from doctors and other healthcare providers, outpatient care, home healthcare, durable medical equipment such as wheelchairs or walkers, as well as many preventive services such as screenings or yearly wellness visits.
The Part B premium is currently $174.70 each month, or higher depending on income. The amount can change on a yearly basis, according to medicare.gov.
Medicare Advantage, also known as Part C, is a Medicare-approved plan from a private
company that offers an alternative to Orginal Medicare (Parts A and B). Part C plans usually include Parts A, B and D, and often have different out-of-pocket costs than Original Medicare or supplemental coverage.
Part D, also known as drug coverage, helps cover the cost of prescription medications, including many recommended shots and vaccines.
Plans that offer Medicare drug coverage are run by private insurance companies that follow rules set by Medicare, according to medicare.gov. And, new in 2025, out-of-pocket costs for covered drugs under Part D plans are capped at $2,000.
If people’s out-of-pocket spending on covered drugs reaches $2,000, they would automatically get “catastrophic coverage” — meaning they won’t have to pay out-of-pocket for covered Part D drugs for the rest of the calendar year.
And, according to AARP, while Medicare is prohibited from covering drugs prescribed specifically for weight loss, Part D plans can cover weight loss drugs when ordered for other purposes, such as Ozempic for type 2 diabetes.
Premiums for Part C and Part D plans vary.
During the AEP, one can switch from Original Medicare to a Part C Medicare Advantage Plan, which often includes extra benefits such as vision, dental or prescription drug coverage. One could also go back to Original Medicare from a Medicare Advantage Plan, or drop or change Medicare Part D plans.
Whichever choice is in place by
it is important to understand that the private plans replace Original Medicare, the agency said. All medical care must be received from providers in the plan’s network.
If you have health insurance through a former employer or union, the agency said it’s best to check with your benefits administrator before joining a plan to avoid jeopardizing retiree health benefits.
Susie Stewart, a licensed insurance specialized in Medicare and working with the Senior Citizens League, told the Chronicle in an email that people should be cautious about where they get their insurance advice from.
“I’ve seen clients take Medicare advice from the receptionist at the doctor’s office, a person at the SSA, their home healthcare aides, and their neighbors,” Stewart said.
She continued, “The advice I offer is to speak with a licensed insurance agent that specializes in Medicare. I’ve been in sales for decades, and Medicare is the most complicated and ever-changing of all. Beneficiaries need to use wisdom about where they take advice.”
Stewart added that the best place to go for information is medicare.gov.
Dec. 7 will carry into the new year starting Jan. 1. Typically, a new plan kicks in on the first day of the following month, according to the Senior Citizens League. However, that’s not the case during the AEP. Only in certain cases, such as if one has just moved or is new to Medicare, coverage might start as early as Nov. or Dec. 1.
The AEP is not the time to enroll in Medicare Parts A and B. That would occur during the initial enrollment period (when one is first eligible upon turning 65), or during the General Enrollment Period between Jan. 1 and March 31. Alternatively, if one is eligible due to certain situations such as losing employer coverage, one may apply outside of the GEP window.
EWhen deciding if changes to your plan are necessary, according to an article by Stewart on seniorsleague.org, people should read all information sent to them from their carrier. When visiting with an insurance agent, have a Medicare ID card and Medicaid card, if applicable, on hand.
It’s also important to think carefully about which plan is needed.
“Some people say, ‘I just want the best plan,’” Stewart wrote. “What you and someone else need is completely different, so there is no ‘best plan.’”
xperts say a trusted insurance agent and medicare.gov are the best sources for older adults who want to better understand Medicare coverage.
Asked about Medicare enrollment, a representative for the city Department for the Aging told the Chronicle in an email, “Comparison information for Medicare Advantage and Part D plans is available at medicare.gov.
“You can also enroll in a plan on this site or by calling 1-800-MEDICARE (available 24/7) during the Annual Election Period (October 15 – December 7) for coverage starting January 1.
“If you’re enrolled in a Medicare Advantage plan at the start of the year, you’ll have another opportunity to switch plans (or return to Original Medicare) during the Open Enrollment Period (January – March), with coverage starting the first of the following month.”
Before joining a Medicare Advantage plan,
Think about your doctors, dental needs, copay concerns and necessary medications, Stewart said. Have a list of those on hand, too, when meeting with an insurance agent so you can be sure they are covered under your plan.
Stewart also said it’s important to take down your insurance agent’s name and phone number, because a good agent will be available to you even after you pick a plan.
The Medicare and You handbook, a comprehensive guide, also be found at either medicare.gov or nyc.gov/site/dfta. Medicare beneficiaries in September should have received a copy in the mail, the DFTA said.
New Yorkers can visit the agency’s website, at nyc.gov/site/dfta, for help and more information on Medicare.
The agency also offers a Health Insurance Information, Counseling and Assistance Program, in which those with questions can speak with a trained expert to discuss Medicare. For more information, call Aging Connect at (212) 244-6469. Q
by Naeisha Rose Editor
An African proverb says, “Those who respect the elderly pave their own road toward success.”
Unfortunately, in New York City elder abuse led to 7,722 older adults having to reach out to the Department for the Aging’s Elderly Crime Victims Resource Center for support in 2023, and 35,741 having to access its Elder Justice Network in 2024.
Both the center and the network provide counseling and crisis intervention.
“Elder abuse is the most shameful form of ageism,” said Department for the Aging Commissioner Lorraine Cortés-Vázquez via email. “That is why our Elderly Crime Victims Resource Center and Elder Justice Network, in partnership with the NYPD, work tirelessly every day to support victims. To build an age-inclusive city, we are raising awareness about elder abuse so victims know they are not alone and how to get help.”
“Elder abuse is the most shameful form of ageism.”
—
Lorraine Cortés-Vázquez, Commissioner, NYC Department for the Aging
The ECVRC also provides criminal justice support. The justice network also provides shelter referrals, virtual or in-home assessments and assistance navigating the family, criminal and housing court system, and it helped train 37,481 police officers to recognize the signs of elder abuse during their patrols so they can make referrals to the justice network.
Two years ago, DFTA announced that a police older adult liaison officer had been assigned for every precinct and NYCHA service area in the city.
Elder abuse may be committed by a trusted family member or friend, and anyone experiencing it may reach out to the agency’s center or justice network by calling (212) 244-6469 or using its service finder at nyc.gov/aging, according to DFTA.
The office of Queens District Attorney Melinda Katz said elder abuse comes in different forms. There can be physical, sexual and emotional abuse, and the elderly may also become victims of fraud and financial exploitation.
People 60 or older, across all racial, ethnic and socioeconomic groups and sexual orientations, are victims of elder abuse,
By Donna Furey, Esq.
There is a lot of confusion around how to pass your assets to your beneficiaries and avoid going to Court. A beneficiary is the person or organization that you would like to receive your assets after you pass away. For most assets, you can fi ll out a form and add the beneficiaries’ names to the asset and avoid going to Court. If your assets do not have beneficiaries named, your Will would need to be fi led in Court to be probated. If you do not have a Will or beneficiaries on your assets, someone will have to be appointed as the Administrator of your estate and the laws of New York set forth who will receive your assets.
If you give assets to your beneficiaries while you are alive, there may be tax consequences when the beneficiary sells the asset. This mainly happens when you transfer stock or a house to someone or add them
as a co-owner. After you pass away, the beneficiary receives the asset at your tax basis or purchase price. For example, if you purchased stock for $10.00 a share and the stock is now worth $100.00 a share, the beneficiary would pay capital gains taxes on $90.00.
Beneficiaries can be added to most assets including bank accounts, IRAs, annuities, life insurance, stock and even houses by using a life estate deed or transfer on death deed. The beneficiary does not receive the asset until you pass away and they receive the asset at the date of death value and do not have to pay capital gains taxes. On July 19, 2024, the Transfer on Death Deed Law was adopted in New York.
Any day you and your beneficiaries can avoid Court, is a great day and saves money!
added the QDA’s Office.
To protect older adults, her office will hold a Senior Safety Summit at the Rochdale Village Community Center’s Grand Ballroom, at 169-65 137 Ave., on Oct. 22, from 12 to 2 p.m.
“My office is committed to ensuring that our elderly population enjoys their golden years in safety and in good health — free from abuse, scams and other types of criminal activity,” Katz said via email. “My Elder Fraud Unit and the Elder Abuse Project are staffed with representatives who can help.”
The summit will include presentations on elder abuse, fraud and scams, and representatives will provide resources on how to avoid becoming a victim.
If you or someone you know is seeking free supportive resources now, call (718) 286-6562.
Dr. Isabella Park, associate medical director at Northwell’s Long Island Jewish Forest Hills Hospital and its director of geriatrics and palliative medicine, as well as an assistant professor at the Zucker School of Medicine at Hofstra/Northwell, said elder abuse can also be an inappropriate or lack of appropriate action, such as psychological, medical abuse and neglect.
The hospital is located at 102-01 66th Road.
“It’s not just about incurring abuse, like physical abuse, where you are hitting, burning, or pushing around or being very rough,” said Park. “It’s also emotional and psychological abuse, like yelling, threatening and isolating type of scenarios.”
Park said the hospital has sometimes seen patients come in and they look like they have been uncared for and like they are not getting the medication they need for diabetes or heart disease.
“Sometimes there is self-abuse,” Park added. “They socially isolate ... it could be behavioral; there are people with personality disorders like schizophrenia, and they age. Family members and those in the community might not know what is going on behind closed doors.”
Park says the hospital utilizes standard screening questions conducted by nurses and doctors, along with social workers, to assess is there is any type of abuse.
“If we do suspect any type of abuse we try to ask more questions and have our social workers more involved.”
Park said that if you or a loved one needs help, reach out to Adult Protective Services at (718) 883-8254.
“If they need more help, and they do not know who to ask, they can always come to the [emergency room],” she said. Q
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by Michael Gannon Associate Editor
When the Inflation Reduction Act was signed into law in 2022, it authorized a number of initiatives aimed at reducing the cost of prescription drugs for senior citizens.
Back in August, the U.S. Department of Health and Human Service announced a negotiated agreement with pharmaceutical companies that will reduce the price of 10 widely prescribed and expensive medications for millions of Medicare recipients.
The reductions will go into effect in January 2026, with future negotiations for other drugs already planned.
That comes on top of a $2,000 annual cap on out-of pocket costs for drugs covered under Medicare Part D that will go into effect this coming January.
“HHS, for the first time ever, negotiated directly with pharmaceutical manufacturers to lower drug prices for Medicare,” U.S. Health and Human Services Secretary Xavier Becerra said Oct. 2 in a press release about the second cycle of negotiations.
“The new, lower prices for the first 10 drugs will save billions for the American people,” Becerra added. “Today, we lay the groundwork for the second round of negotiations. This is the latest action by the BidenHarris Administration to improve access to affordable, life-saving prescriptions.”
The drugs in the first round include Januvia, produced by Merck Sharp Dohme (diabetes); NovoLog and Fiasp insulin systems by Novo Nordisk (diabetes); Farxiga by AstraZeneca AB (diabetes, heart failure, chronic kidney disease); Enbrel by Immunex Corp. (rheumatoid arthritis, psoriasis, psoriatic arthritis); Jardiance by Boehringer Ingelheim (diabetes, heart failure, chronic kidney disease); Stelara by Janssen Biotech (psoriasis, psoriatic arthritis, Crohn’s disease, ulcer-
Beginning
ative colitis); Xarelto by Janssen Pharms (blood clots, coronary or peripheral artery disease); Eliquis by Bristol-Myers Squibb (blood clots), Entresto by Novartis Pharms Corp. (heart failure); and Imbruvica by Pharmacyclics LLC by Janssen Biotech (blood cancers).
HHS said about nine million people use at least one of the drugs that will be covered.
“These negotiated prices range from 38 to 79 percent discounts off of list prices,”
HHS said.
The federal Centers for Medicare and Medicaid Services estimates the negotiated prices will save people enrolled in Medicare prescription drug coverage $1.5 billion in out-of-pocket costs in 2026 when they go into effect.
A list provided by CMS states that at present, the list price for a 30-day supply of Januvia 2026 is $527, while the negotiated price come January will be $113. A 30-daysupply of Entresto is slated to go from $628 to $295.
At the other end of the spectrum, a 30-day supply of Imbruvica would fall from nearly $15,000 to $9,319.
The list prices do not include savings from insurance or services such as GoodRX.
The statement from HHS said up to 15 additional drugs covered by Medicare Part D that will be subject of the second round of negotiations are expected to be announced in February.
“While saving Medicare and taxpayers billions of dollars, the negotiated prices will also provide people with Medicare a better deal on some of Medicare’s costliest prescription drugs, promoting necessary competition in the market, and ensuring Medicare is strong today and into the future,” said CMS Administrator Chiquita Brooks-LaSure.
CMS said the drug companies, as part of the negotiations, are required to make sure the negotiated price is made available to pharmacies, mail-order drug services and “other entities that dispense the selected drug to such individuals.”
The law requires that all Medicare prescription drug plans including Part D and Medicare Advantage plans include the negotiated drugs; and they must have agreed to the negotiated price.
The new Medicare Prescription plan, which also starts in 2025, will allow those with Part D coverage the option of stretching their payments for out-of-pocket costs in monthly installments spread out over the year, rather than having to pay the entire amount at a pharmacy each time a prescription is filled.
“No one should have to choose between paying for medicine or putting food on the table,” Becerra said in statement last February. “Thanks to President Biden’s lower cost prescription law ... fewer seniors and people with disabilities are making that difficult decision.”
AARP, the prominent advocacy group for people over 50, applauded the drug negotiations back in a statement on Aug. 15.
“Today’s announcement marks a significant step forward in our long-standing efforts to lower prescription drug prices,” said Nancy LeaMond, AARP’s executive vice president and chief advocacy and engagement officer.
“AARP members from across the political spectrum overwhelmingly called for lowering prescription drug prices,” she added. “And this first round of Medicarenegotiated prices will bring financial relief to millions of older Americans.”
HHS this summer said the $2,000 annual cap will save seniors even more, and apply to everyone enrolled in Medicare Part D prescription drug coverage.
“By April 1, 2023, more than 1.7 million people had already reached $2,000 in outof-pocket cost on their prescription drugs,” the agency said in an Aug. 16 press release.
The government, for now, will subsidize recipients in order to offset expected premium increases. Multiple published reports have said many insurance carriers are considering hikes in rates and deductibles.
Some of those same reports state that Mutual of Omaha will end its standalone prescription coverage, while Humana is expected to pull out of several regional markets. Other companies are expected to consider reductions in their other Medicare offerings to offset increased costs.
New York City’s Office of Citywide Health Insurance Access which comes under the Human Resources Administration, has a number of tips and links for those seeking more information on all Medicare programs at tinyurl.com/8ncyvb7.
There also is information on how to apply for additional assistance to pay for medications for low-income residents who might need help.
The city Department for the Aging also offers free health insurance help, both in person and over the phone, for older adults.
The official website for Medicare is medicare.gov, while the Centers for Medicare and Medicaid Services can be found at
