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Cancer News You Need: Changes to Social Security, Medicare, & Other Benefits

Here is the latest news you need about laws and programs that may impact the cancer community, including health insurance options, Social Security benefits, and paid sick leave.

National Updates

Do you receive Social Security benefits?

  • Social Security payments will be increased in 2023 by 8.7%. This means that the maximum benefit for those who retired at full retirement age, or for anyone receiving SSDI, will be $3,627.
  • The maximum Supplemental Security Income (SSI) amount will be $914 for an individual who is not blind, and $1,371 for an eligible couple.
  • For more information, read SSA’s Fact Sheet 2023 Social Security Changes

Do you have Medicare and want dental coverage?

  • Currently, Medicare pays for dental care only when it is medically necessary to safely treat another covered medical condition. Unfortunately, Congress did not approve expanding dental coverage for all people with Medicare.
  • The Centers for Medicare & Medicaid Services proposed adding additional ways that Medicare will provide dental coverage. If changes are approved, they may be announced as soon as November 2022.
  • It is currently open enrollment for Medicare. For more information on Medicare, read Triage Cancer’s Extended Quick Guide to Medicare.
  • If you would like tips on how to compare options to pick the plan that is best for you, watch Triage Cancer’s animated video, How to Pick a Medicare Plan.
  • Need some help tracking your options? Use our Medicare Plan Comparison Worksheet.

Does your employer-sponsored health insurance plan meet your needs?

  • If your employer offers health insurance, you can still buy a plan through the state health insurance marketplace. But, you may not get financial help to buy a marketplace plan if your employer plan is considered “affordable.”
  • This year, a plan is affordable if it does not cost more than 9.83% of your household income to purchase the plan for the employee. This is termed the “family glitch” because “affordable” does not include the cost to cover your family, just yourself. What this means is that if your employer-sponsored plan is less than 9.83% for you, but higher than 9.83% to include your family members, the plan is considered “affordable” and you would not be eligible for financial assistance to purchase a plan through the marketplace.
  • But, starting in 2023, the “family glitch” will be eliminated. The cost of covering a family will be included in determining if an employer-sponsored plan is affordable.
  • Thinking of reviewing your options for next year? Open enrollment in most states begins November 1, 2022.
  • For more information, read Triage Cancer’s Quick Guide to State Health Insurance Marketplaces. If you would like tips on how to compare your health insurance options, watch Triage Cancer’s animated video, Picking a Health Insurance Plan.

State Updates

Virginia

  • Virginian employees may have access to paid family and medical leave beginning January 1, 2025. The benefit may provide coverage for up to 80% of an employee’s weekly wage for up to 12 weeks, per year. The law will allow, but not require, employers to purchase private paid family leave insurance for their employees. Paid family leave will include things such as time off for birth, adoption or placement of a child, a serious personal health condition, or caring for a family member.

South Dakota

  • South Dakota voters will vote on whether or not to expand Medicaid on the November ballot. If the proposal receives 50% of the vote, Governor Noem indicated she may approve expansion. This measure would provide at least 40,000 people with access to health insurance coverage. For more information on Medicaid, check out Triage Cancer’s Quick Guide to Medicaid.

New York

  • Insurers in New York are now required to cover chest wall reconstruction after a mastectomy. Prior to this, many insurance companies were denying coverage because they classified the procedure as “cosmetic.” For more information, read New York State’s press release explaining the bill.

Ohio

  • The “Breast Cancer Bill” now requires insurers in Ohio to cover yearly mammograms for all women, regardless of their age or other risk factors. Additionally, those who are at high risk because of history, genetics, or dense breast tissue, must be covered for additional screenings. The additional screening may be a 3-D mammogram (tomosynthesis), MRI, ultrasound, or molecular breast imaging. For more information, see House Bill 371.

Stay tuned for more news at the national and state level that may impact the cancer community.

About Triage Cancer

Triage Cancer is a national, nonprofit providing free education to people diagnosed with cancer, caregivers, and health care professionals on cancer-related legal and practical issues. Through eventsmaterials, and resources, Triage Cancer is dedicated to helping people move beyond diagnosis.

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Kaylee Place
kp@triagecancer.org