At the ADRC we have two Benefits Specialists on staff. Our Benefits Specialists are available to disabled persons ages 18 to 59, and those over the age of 60 to appeal Social Security decisions and navigate the complex systems of public and private health insurance.
Disability Benefit Specialist Brochure (Ages 18-59)
Elderly Benefit Specialist Brochure (Ages 60+)
There are numerous programs such as Medicaid Purchase Plan (MAPP), Medicare Part A, B, D and Senior Care that can be overwhelming and our Benefits Specialists are available by appointment to assist in these matters. If you require this type of assistance please visit our contact page. If you are unsure if this is the person that can potentially assist you, our Information and Assistance Specialists will be able to connect you with the appropriate resource.
News from Our Benefits Specialists - Interesting Updates for 2010!
The Medicare Part A (Hospital) deductible will increase from $1,068 to $1,100 for days 1 to 60. This is the deductible that you pay when you are admitted into the hospital.
The Medicare Part B (Medical) premium will be $96.50 ($110.50 for some folks). This is the monthly premium that you pay for Medicare Part B medical insurance.
The Medicare Part B (Medical) deductible will increase from $135 to $155 per year. This is the amount that you owe out of pocket, before your Medicare Part B begins to cover medical bills.
The Medicare Premium Assistance Program (QMB, SLMB & SLMB+) increased the asset limit beginning 1/1/10. If you were ineligible due to assets in the past, you may want to consider re-applying. The asset limits for the program are $6,600 for a single person and $9,910 for a group of two. If eligible, the State of Wisconsin may pay your Medicare Part B premium and in some cases, your deductibles and coinsurance.
Medicare Part D Rebate Checks Coming Soon!
Medicare Part D beneficiaries who reach the coverage gap (sometimes called the donut hole) in 2010 will receive a $250 check directly from the U.S. Department of Health and Human Services. On June 15, the first batch of checks will be mailed out to beneficiaries. The rebates will go to anybody who enters the donut hole in 2010. This includes beneficiaries who already entered the donut hole, those currently in the donut hole, and those who will reach the donut hole this year. After the first batch is sent out, a new batch of checks will be sent out every 6 weeks.
The rebate checks will be sent out automatically. No action is required of beneficiaries. There is no form to fill out. No request needs to be made. Beneficiaries do not need to call Medicare or call their Part D plan. Beneficiaries who entered the donut hole in the first half of the year will receive a check in the first mailing. Those who enter the donut after the cutoff for the previous mailing will receive the rebate in the next mailing.
Beneficiaries who receive the low-income subsidy will not receive a $250 rebate. Further, beneficiaries enrolled in a qualified retiree drug plan are not eligible for the $250 rebate.
Beware of scams! Some unscrupulous individuals are attempting to obtain personal information about beneficiaries by telling beneficiaries that they need to apply for the rebate. They then offer to help the person apply and collect personal information. Medicare Part D beneficiaries should be on guard against this scam. Remember, no action is needed to get the rebate!
Questions? Contact the ADRC at 262-638-6800 or call the Disability Drug Benefit Helpline at 1-800-926-4862.
Help with Your Medicare Drug Plan?
In the Fall make plans to think about the changes to our Medicare Part D drug benefit for the upcoming year. The Annual Enrollment Period or AEP is from November 15th through December 31. Changes to your Medicare Part D plans, must be done during this time, except under limited circumstances.
It is important to reanalyze your coverage as plans change every year in the details of premiums, co-payments, and the formularies – which are the drugs the plan covers. With over 50 plans in Wisconsin to choose from it can be a challenge, but most of the time you can save on average between $200 and $800 a year by:
1. Considering the deductibles and co-payments in the total annual cost of a plan before making your final selection.
2. Knowing if the plan’s formulary will cover all or most of the drugs you take.
3. Knowing if the plan covers generics if you get to the coverage gap, also known as the “donut hole.”
There is help available. You can use the online drug plan comparison tools at www.medicare.gov, or you can find people who will help you use this tool and answer questions. Be cautious if you attend public programs about Part D Plans and check out who is sponsoring the information before attending.
Medigap Helpline
1-800-242-1060
The Medigap helpline is provided by the State of Wisconsin Board on Aging and Long-Term Care at no cost to you. There is no connection with any insurance company. The program is funded by the federal government Centers for Medicare & Medicaid Services and the Wisconsin Office of the Commissioner of Insurance.
Prescription Drug Helpline
1-866-456-8211
The Prescription Drug Helpline is a service operated by the Coalition of Wisconsin Aging Groups. Helpline counselors are available to provide assistance to Wisconsin Medicare beneficiaries and their families (including those who are under age 65 and receive Medicare coverage due to a disability) regarding prescription drug benefits.
Disability Drug Benefit Helpline
1-800-926-4862
Disability Rights Wisconsin (DRW) operates a statewide helpline to help people with disabilities and their families or guardians with the complicated Medicare prescription drug benefit, often referred to as “Medicare Part D.”
Your Pharmacy. Many local pharmacies will assist their consumers with plan selection. Check with the one you use.
Benefit Specialists. Your county benefit specialist is also available to answer questions and assist with your Medicare D Plan selection.Call 262-638-6800 or 1-866-219-1043 Toll Free.