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Louisiana

THOUSANDS IN SAVINGS FOR LOCAL RESIDENTS

Nita Ford, a benefits counselor with the Lafourche Council on Aging, shared a couple of successes regarding seniors she has helped.

The first client is a female diabetic who is new to Medicare. Ford helped her enroll in a plan which is giving her a savings of $2,011.86 on her medication for the year. Without this help she would not be able to afford all the medications to keep her diabetes under control.

The second success is also an elderly female who always used her local pharmacy. She called the Council to assist her with her plan because she could not afford her medications after prices went up. Ford worked with the woman to find a plan which would be better for her and gave her a price from her local pharmacy and another pharmacy in her area. By switching to the other pharmacy, the woman will save $1,383.60 for the year.

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Kansas

Success Story: Gaining Hope After Losing Everything

Mr. Peterson came to SHICK (Senior Health Insurance Counseling for Kansas) after he lost everything. He worked for an oil company in Kansas City, KS that had been bought out by a larger one, and not only did Mr. Peterson lose his job, his employer-provided health insurance was gone too.

SHICK was able to help Mr. Peterson transition to Medicare, and he qualified for the Medicare Savings Program to pay his Part B premium and the Extra Help program to help cover his prescription drugs, saving him several thousand dollars annually. Additionally, Mr. Peterson was able to get assistance with his energy bills from the Low Income Home Energy Assistance Program, which will keep him and his family warm this winter.

Mr. Peterson, expressing his gratitude for the assistance SHICK provided him, reflected on the irony of his once having been earning big money at an oil company and now receiving crucial help to pay to keep his family comfortable. “I don’t know what we would have done if we hadn’t found the kind folks at SHICK. Thank you for stepping in when everything else was gone.”

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Oklahoma

SUCCESS STORY: SAVING THOUSANDS EACH YEAR

A 76-year-old gentleman with a serious heart condition, diabetes, and other chronic conditions had been reluctant to make any changes to his insurance because of his compromised health condition.

The Oklahoma SHIP educated him about how changing his Part D plan would not impact his other coverage. Afterward, he agreed to come in to the SHIP office to get help to compare plans.

While the gentleman doesn’t qualify for Extra Help at this time, the counselor told him to contact SHIP if anything about his financial situation changes. In the meantime, the SHIP was able to find a plan for him that covered all of his prescriptions and saved him over $6,000 a year.

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Arkansas

SUCCESS STORY: HELP WITH MEDICINES AND MORE

The daughter of a Medicare beneficiary contacted the Arkansas SHIIP, concerned that her mother could hardly afford to pay for food, much less her co-payments and deductibles for drug insurance or medical visits. Her mother's monthly gross Social Security income is $772.

The SHIIP counselor helped them to submit an application to the state for help with Medicare Part B (Medicare Savings Programs) and to submit an application to Social Security for help with her medications (Low Income Subsidy). The mother was born in 1920 and only now was able to receive help.

Her daughter cried with relief while on the phone with the SHIIP. Her mother also needed to apply for food assistance, and the SHIIP able to help her with that application as well.

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Missouri

SUCCESS STORY: “A REAL RELIEF” NOT TO WORRY ABOUT MEDICAL COSTS

Ms. E is a widow who lives on $809 per month. She never wanted to get involved with what she refers to as “welfare.” Like many seniors, she also felt like she made too much money to qualify for any support.

When she came into the local CLAIM office, the counselor explained the Medicare Savings & Extra Help Programs, and how they could benefit her. Ms. E was so excited; with winter coming on, she was already worrying about high utility bills and how she was going to make her monthly check stretch. She filled out the applications and the counselor made a home visit to help her organize her proof of income and other paperwork for Family Support [the determining agency].

Ms. E is now receiving the MSP benefit and LIS. She says it is a real relief to not have to worry so much about the cost of her healthcare and medicines―two things that she greatly needs. She greatly appreciates the CLAIM office—especially the one-on-one time we dedicate to helping seniors navigate these programs.

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Wisconsin

SUCCESS STORY: COMPREHENSIVE CARE LEADS TO THOUSANDS IN SAVINGS

Mrs. H came in to see the SHIP for the first time during the autumn Open Enrollment Period, seeking more affordable health insurance options. Her Medigap plan had just increased its premium, costing 25% of her income.

A thorough review of her situation—financial, health care needs, prescription coverage, housing costs—discovered that Mrs. H would be eligible for many programs that she had not known about previously. Not only was she eligible for LIS and MSP, but also for full-benefit Medicaid, Federal and State SSI payments, SNAP (Food Stamps) and a telephone discount.

Through the assistance of her Elder Benefit Specialist, Mrs. H’s out-of-pocket health care costs decreased by more than $2,000/year; her income increased by $2,500/year; and the value of the new benefits she receives, including LIS and MSP, exceeds $14,000/year. At age 79, Mrs. H will continue to receive these benefits for many years to come. Mrs. H now spreads the news about the local SHIP program by referring many of her friends and neighbors.

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Minnesota

SUCCESS STORY: NO LONGER FORCED TO MAKE TOUGH CHOICES

A couple came into a benefits evaluation site after passing signs promoting the site. While they didn’t feel they would be eligible for anything, they decided to stop in, as they were often skipping medications. As a result, the husband’s health had been getting worse.

While meeting with the Senior LinkAge Line® specialist, a variety of programs were explored to see what the couple would be eligible for. It turned out they seemed to be qualified for Extra Help (LIS). An application was completed for the couple online. They were pleased with how easy the application was and how helpful the Senior LinkAge Line® specialist was. The specialist told the couple that it would probably take about 6 weeks for the program to start, but to watch their mail for notices.

In about two weeks the couple went to the pharmacy to pick up some of the less expensive medications that they could afford. After the pharmacist told them the generic medications were only going to cost $1.30, they called the Senior LinkAge Line® specialist back, confused that their medications were so affordable. The specialist was able to confirm that LIS had begun for the couple and the couple could afford all of the medications that they needed. They no longer have to choose between medications and other living expenses.

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Illinois

SUCCESS STORY: A STEP TOWARD MORE INDEPENDENCE

Martha is 83 years old, has COPD, and lives alone in Fairview Heights. She has no family nearby and relies on her friends, who are also in their 80s, for trips to doctors and grocery shopping. Occasionally, if she feels up to it, she will drive herself places in a limited radius from her home.

A SHIP counselor met Martha because the township office is five minutes from her home. She never felt comfortable driving to the office in Lebanon, although she had heard about SHIP.

SHIP helped sign her up for Extra Help and LIHEAP. When Martha isn’t feeling well, the SHIP also does home visits for her. The other day Martha called the office because she was having a problem with her Medical card. She hadn’t received a new card yet, and was just overwhelmed by the call system the local Medicaid office has in place. SHIP answered her questions and offered to call the Medicaid office for her and leave a message. After being on the phone for 20 minutes, she felt confident enough to try it again and do it for herself. She called back a few days later to say that because we were willing to listen to her and help her figure out the situation for herself, she felt that next time she would be able to handle it on her own. Martha felt more independent than she had in a while, she said, and she knew she could call the SHIP and it would be there to listen.

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Indiana

SUCCESS STORY: HUGE SAVINGS IN THE DONUT HOLE

In July, a 70-year-old man, drawing $1,415 a month in Social Security walked into his local SHIP in tears. He had just come from his pharmacy, where he went to pick up his insulin medications, and was told that instead of $90 (or $45 each), his drugs would cost $1,032.41 because he was in the Part D donut hole. After reaching the coverage gap, the cost for his insulin was now $643.41 a month for one prescription, and $389.09 for the other.

The man had no idea what a donut hole was or anything about LIS. He was also paying a premium of $68.60 a month for his prescription drug plan. The SHIP counselor went online and submitted an LIS application on his behalf. In August, the gentleman came back in with his award letter of 100% LIS. He now has a monthly premium of $0.00 and pays $13.00 a month for both insulin prescriptions, plus his other four prescriptions. The yearly savings of $3,569.61 represents 21% of his annual income. Without the SHIP’s assistance he would have went without his insulin.

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Mississippi

NOT A MIPPA GRANTEE

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Iowa

SUCCESS STORY: HELP WITH FOOD AND MEDICAL COSTS

Beverly, 73 years old, visited the Aging and Disability Resource Center (ADRC) to apply for the Farmer’s Market coupons. Beverly thought if she could get assistance with Farmer’s Market coupons it would help her, as her insurance and medication costs were increasing.

The ADRC staff talked with her about the LIS, Part D and MSP programs. Beverly’s monthly income was below LIS guidelines, so the ADRC staff person completed and submitted an application for LIS. Beverly was approved for LIS and we also completed a Part D comparison and she was able to save $60 a month by also switching her Part D plan.

She was so grateful for the savings and sent a special thank you note saying how much the money she saved helped her to live better.

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Nebraska

SUCCESS STORY: NO LONGER STRUGGLING TO PAY FOR INSULIN

Sharon came to the Nebraska SHIIP seeking assistance through our foundation to purchase Lantus Solo-star pens. After some conversation, her local counselor found out that Sharon had Medicare A & B but did not have Medicare Part D. They enrolled her into a 5-star, $39.70 plan with Medicare Blue. Sharon elected to enroll in this plan even though she would have a premium penalty. She had been paying $225 per month for her insulin (not to mention her other medications) for the past two years. Her premium was going to be around $45/month and her co-pay after the deductible was $35. She couldn't stop smiling.

Then the counselor talked to Sharon about LIS, and assisted her to apply online. Two weeks later, Sharon called and said she received papers that she didn't understand. She came in with the letters to the drug company and from Social Security showing that she was entitled to full LIS. When the counselor explained this, she couldn't believe it. Sharon went from paying $225 a month for her insulin to paying $6.50. The SHIIP changed her enrollment to a plan with zero premium and worked with the pharmacy to get a refund on what she paid for medications in April, as the LIS was approved as of March 1. When she left she was so happy. She said now she would have less stress in her life because she was struggling to make ends meet...and she felt better already.

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South Dakota

SUCCESS STORY: SAVING MONEY AND A LIFE

SHIINE conducted a joint outreach event with Adult Services and Aging (ASA) Ombudsman, Title III Nutrition, Title III Caregiver and Adult Day and Adult Protective Services (APS) programs in Mobridge SD, a rural area of South Dakota. When they were doing the meals, a woman pulled the nutrition specialist aside and said she wanted to talk to the group from ASA and SHIINE before they left.

The woman thanked SHIINE and the volunteers for saving her life. Because of the outreach and education efforts SHIINE counselors and volunteers have been doing regarding the Medicare wellness prevention information and the importance of using the preventive benefits, she went to her doctor and upon examination they found breast cancer in the early stages. They were able to remove the lump and she is now cancer free. The woman also shared with the group that she and her husband had moved to SD from another state to build their dream retirement home in the Mobridge area and are now able to do so and enjoy it together. She was very grateful to the SHIINE program and she told them she credits SHIINE for saving her life.

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North Dakota

NOT A MIPPA GRANTEE

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Oregon

SUCCESS STORY: THREE SUCCESSES IN SAVING MONEY

A 60-year-old, unmarried, childless man was contacted about applying for MSP. English is not his first language, and he has limited reading abilities. He lives 26 miles from the nearest branch office. After multiple contacts, the SHIBA local office was finally able to assist the man with his application. The man is now on an MSP and receives Supplemental Nutrition Assistance Program (SNAP) benefits, worth a total of $167.90 per month.

Another SHIBA client knew about the MSPs, yet did not apply because she did not believe she could be eligible for the program because she has two cars. After she spoke with the SHIBA partner, she found out that one car is excluded and that the value of the other is under the resource level. The woman is now receiving MSP and SNAP benefits worth $115.90 per month.

Another woman had not applied for benefits because she has an adult daughter living with her who is receiving SNAP. She only thought one person in the household could apply. She is now on an MSP and she and her partner receive SNAP benefits. Their total benefit = at least $281.90 per month.

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New Mexico

A NEW MEXICO SUCCESS STORY

Juliette Lund from Albuquerque contacted the ADRC concerned about being evicted and needing assistance at home. Ms. Lund had several medical conditions which left her homebound and unable to complete the legal assistance forms. She had previously been enrolled in and received MSP and SNAP benefits. Because of her condition, she was not able to complete the recertification for both programs and was no longer receiving the benefits.

The ADRC coordinator immediately worked with Ms. Lund’s physician to complete the necessary forms to assist with the eviction notice and made sure they were sent to the Senior Center Law Office. After a three-way call, the ADRC coordinator scheduled a home visit with Ms. Lund to assist with completing the MSP and SNAP application.

Through follow-up, the ADRC learned that Ms. Lund’s MSP benefit had been reinstated, resulting in an additional $99.90 back in her Social Security check. The benefit will also save her a significant amount regarding her co-pays and coinsurance, since Medicaid will pay the 20% not covered by Medicare. The SNAP benefit was also reinstated, resulting in $25 per month. Ms. Lund thanked the ADRC coordinator and expressed that she could not have handled all the necessary paperwork without assistance.

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Colorado

SUCCESS STORY: SAVING ON MEDICINES AND MORE

An elderly woman called the CO SHIP Information and Resource Center looking for utility assistance. The MIPPA Specialist Sandra Torres conducted an interview with the client and discovered that she was eligible for several other programs.

The elderly lady was very apprehensive and stated she did not trust the system. The SHIP staff was able to convince the client that it would be a way to save money, which in turn could help her pay her utility bills. An appointment was set and the elderly lady was signed up for the Part D Low Income Subsidy, Medicare Savings Program, and Food Stamps.

Approximately 30 days later, Ms. Torres made a follow-up call to the client. The woman had received all benefits, and she was saving about $170 dollars per month.

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Utah

SUCCESS STORY: SAVING ON PRESCRIPTIONS

Mr. Burnett visited his local HIIP office in January 2012. He became a Medicare recipient in February 2001 but did not join a Medicare Part D plan when the program became available, because at the time he was taking only generic medications. Recently, his physician had prescribed brand-name medications. Mr. Burnett had given up applying for Part D because it was outside of the annual open enrollment period. Moreover, he thought that he had to pay a late penalty and didn’t qualify for Extra Help because his combined monthly income (with his wife) was $1,970.

The counselor reviewed the couple’s income and assets. The counselor found that Mr. Burnett and his wife take care of a family relative living with them. HIIP supported Mr. Burnett to apply for LIS. At the same time, the counselor helped him to fill out the Johnson & Johnson Patient Assistant Program (PAP) application for discounts on his brand-name medications. Mr. Burnett was approved for both programs. Since the PAP cannot serve clients with LIS, Mr. Burnett declined it. The HIIP also helped him to enroll a Part D plan, which would be effective on March 1, 2012.

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Nevada

SUCCESS STORY: “A LIFE PRESERVER ON A LARGE, DANGEROUS OCEAN”

An 80-year-old consumer with an income of $923 a month panicked when she went to renew her prescriptions and was informed of an enormous amount owed, since she was no longer on the Home and Community Based Waiver program. She did not know her options, and became scared, which increased her blood pressure. She made many phone calls to try and help her “find the needle in the haystack” of help, and was finally referred to the local SHIP office in her rural town.

The consumer felt that at her age, and with no way to solve the problem on her own, she was asea in a large, dangerous ocean. She called the SHIP counselor her “lifesaver” and “lifeboat” as the person helped to identify, explain, and solve the problem so she could obtain her medication, at a cost affordable to her.

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Arizona

SUCCESS STORY: SAVINGS, PAST AND FUTURE

A client with English as a second language had cancer surgery in late 2011, and was prescribed expensive medications starting January 2012. The SHIP counselor identified her as MSP eligible, and possibly also eligible for LIS. Both applications were explained to her son, who speaks English, and mailed to the client, who completed them in late January. In July, the woman was finally approved for MSP retroactive to January 2012. That meant her Extra Help coverage through MSP was also retroactive to January. In the meantime, she had been filling her expensive prescription medications and gone into the coverage gap, with her children helping her to pay for her drugs.

The SHIP counselor called Medicare to find out if the client was entitled to receive Part D reimbursements retroactive to January 2012, and was advised that yes, as long as she qualifies for Extra Help retroactively and was in a plan during that time. The counselor advised the client, through her son, to contact the plan about submitting her 2012 prescription out-of-pocket costs for reimbursement of over-payments. The son called about a week later to say that his mother had received a reimbursement check for $1,900 from her Part D Plan, in compliance with Medicare rules. They were overjoyed.

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California

SUCCESS STORY: A WIDOW GETS A RANGE OF ASSISTANCE

Wilma is 90 years of age, a widow, and lives in her own apartment. Her monthly income is below the federal poverty level and she has Medicare: she was referred to HICAP for help with MSP and LIS.

When the HICAP counselor called Wilma, she starting crying and said she was very lonely and didn’t think anyone cared for her. After discussing the help available, Wilma agreed to apply for both the LIS and MSP programs. In the course of the conversation, the counselor also learned that Wilma’s husband was a WWII veteran, so she was referred to the Orange County Veterans Association for possible financial assistance.

Thanks to HICAP, Wilma was approved for both the LIS and MSP programs. This approval will allow Wilma full access to health care resources so that she can continue living independently—but with the knowledge there’s a community resource always available to help her.

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Texas

SUCCESS STORY: REDUCING COSTS, HELPING A FAMILY

A MIPPA counselor at the Area Agency on Aging of North Central Texas assisted a 102-year-old woman who was living in a retirement community. While the woman’s primary concern was replacing her hearing aid, the counselor learned the woman had significant expenses her family was helping to pay for:

  • Her rent was double her Social Security income.
  • Two prescriptions cost her $80 a month.
  • The family also helped pay her supplemental insurance ($300 a month), and food costs ($225 a month).

The counselor spoke with the family about the Medicare Savings Program, Extra Help, and Food Stamps, and helped them apply for these programs. In the end, the beneficiary’s son reported that the family would save over $500 a month with these benefits.

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Washington

SUCCESS STORIES: TWO CLIENTS, HUNDREDS IN SAVINGS

Two Washington SHIBA counselors provided stories about how they’ve helped clients save hundreds of dollars on their prescriptions:

“I worked with an 87-year-old, recently widowed man who has had the same Medicare Part D and Part C plans for several years. His prescription costs were $480/month in copays, and he was getting distressed as it was difficult to afford. We entered his medication information into the Medicare Plan Finder and found a plan that would save him $978 in medication costs without increasing his regular medical costs. We also found that he now was eligible for LIS, so we applied online and he was successful in getting a 50% discount in premiums.”

“I had a couple from Winlock; the husband is diabetic and his medications were putting him in the donut hole. The couple, like many seniors, is living on a fixed income. They get most of his medication at a local pharmacy. We entered his medication information into the Medicare Plan Finder and found a plan that would save him $1,900 a year if he were to switch his current plan and get all of his medication at Wal-Mart. The new plan covers all his medication with no out of pocket cost to him except for his monthly premium.”

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Idaho

SUCCESS STORY: HELP WITH MORE THAN MEDICATIONS

The local gas company referred Hal (71 years old) to the Energy Assistance office, co-located with the Area VI Agency on Aging, the local MIPPA partner. Hal was behind on his utility bill and was about to have his gas cut off. He stated that he was struggling with medical bills and unable to keep up with his utility bill.

The Area Agency received a referral from the Energy Assistance office, screened Hal, and found he was eligible for the Qualified Medicare Beneficiary (QMB) program and Low Income Subsidy (LIS). An application was done online by staff for the LIS, lowering his cost for Medicare Part D as well as his co-pay at the pharmacy. The Agency referred him to the Department of Health & Welfare to apply for QMB. He was eligible, which helped him with his other medical out-of-pocket costs. Hal was now eligible for us to help him change his Part D prescription plan (outside the regular open enrollment period) to a plan that covered his new medications better.

Hal was overwhelmed with his recent health issues and was not aware there was help. He was extremely appreciative and with some emergency utility help, his bills are current and he is better able to deal with his health issues.

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Montana

A MONTANA SUCCESS STORY

Last November an elderly woman named Marge came into the SHIP office for assistance in choosing a Part D plan. As usual, the conversation started with small talk. Her eyes twinkled when she relived the stories of her past, how she and her husband, Frank, had owned a gas station and worked hard all their life, been married 60 years, and raised 3 children. Marge explained that Frank gets his medications through the VA and she’d never had a Part D plan because she didn’t feel she could afford the extra monthly payment. This led to conversations about Social Security and retirement, which revealed that Marge and Frank’s combined monthly household income was only $1,048.

Marge talked about the household budget, costs of Medicare, utilities, and food. Quickly the debits began to outweigh the credits, to which Marge remarked, “We don’t eat steak very often.” The counselor discussed the various programs that she might be eligible for, including LIS, MSP, the Low Income Home Energy Assistance Program (LIHEAP), and SNAP. Marge was skeptical, all her life she and Frank had paid their own way and she wasn’t sure about accepting any type of financial assistance. She took a few weeks to think it over before calling to say she was ready.

The Medicare Savings Program is now paying both Marge and Frank’s Medicare Part B premium, which saves them a total of $199.80 each month ($99.90 each). In addition, this family is also benefiting from the Extra Help Program, LIHEAP, and SNAP benefits.

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Wyoming

SUCCESS STORY: THOUSANDS SAVED ON MEDICATIONS

In August 2010 a Medicare beneficiary came into the Riverton office to sign up for Part D and to discuss options for a Medigap policy. The gentleman was under the age of 65 and was approved for Social Security disability and eligible for Medicare Part A/B in October. The counselor explained that in Wyoming, Medigap plans are not mandated to sell to disabled individuals and that his options for coverage would be a Medicare advantage plan or the WY Health Insurance Pool (WHIP).

Using the Medicare Plan Finder, the counselor discovered that one of his medications, Copaxone, which was being supplied to him through his doctor’s office, had a monthly retail cost over $4,000. He needed the drug for his Multiple Sclerosis and similar medications were not effective; without the Copaxone he could not function outside of his home. The man was screened for LIS, but not eligible due to his income.

The SHIIP counselor was a former eligibility worker for Wyoming Medicaid and recognized he met eligibility factors for a Medicaid waiver. She assisted the man with the application process for the waiver program and in the application for WHIP.

In December the gentleman was notified that he was qualified for the Medicaid waiver which would make him categorically eligible for Extra Help as a full benefit dual eligible. Whereas before the retail cost of his medications was $5,695.28 per month, now as a dual eligible his co-pay is nothing, except for the $1 he pays for the Copaxone.

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Michigan

SUCCESS STORY: SAVING THOUSANDS ON PRESCRIPTIONS IN MICHIGAN

MMAP counselor Rebekah Dietsch relates this story of a man she helped to receive LIS:

Last month I assisted a new Medicare beneficiary. While discussing his monthly income, I noticed that he was $2 below the threshold to qualify for the Low Income Subsidy, which I helped him to apply for.

Two weeks after applying, I received a telephone call from the beneficiary with his support staff also present. The beneficiary was in tears because it not only lowered his monthly premium, but one of his seven medications has a retail cost of $1,600 per month. The most he will pay for his medications now is $245 a month.

The man told me that his prescriptions have never been that affordable. He was very grateful for the help he received.

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Ohio

SUCCESS STORY: SAVINGS HUNDREDS ON PRESCRIPTIONS

J.B. worked for 40 years in the steel industry, only to lose his pension. He was 62 years old and on disability. He received $1,800 a month from Social Security and his medicine cost him $1,300.

J.B. went to the Girard Multi-Generational Center, which is a partner for MIPPA with Area Agency on Aging 11, Inc. who has the MIPPA grant through the Ohio Department of Aging. The Center helped him sign up for the Part D Low-Income Subsidy (LIS) and other benefits.

J.B. is a diabetic and had numerous bypass surgeries. Last month, instead of paying his normal prescription bill of about $500, it was $18.

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Kentucky

SUCCESS STORY: SAVING HUNDREDS ON INSULIN AND MORE

Ms. Jones called the Kentcuky SHIP six weeks after her husband passed away. She had an older Medigap policy that covered her prescriptions at 50%. Her insulin alone was costing her $200 monthly, and her income was only $1020 a month. Her supplement cost $338 per month.

The SHIP helped Ms. Jones apply for LIS/Extra Help, and she was subsequently awarded the benefit. After receiving the benefit, she was able to enroll in a Part D plan, and her monthly insulin cost went from $200 to $6.50. She was also subsequently able to drop the drug coverage portion of her Medigap policy and reduce its premium by nearly $150 per month.

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Virginia

SUCCESS STORY: SAVING ON PRESCRIPTIONS AND HOUSING

Ralph, 75, lives alone and receives limited income. He has Medicare in addition to medical and prescription coverage though his former employer. Problems arose when he could no longer afford his monthly premiums or drug copayments. Ralph was paying several hundred dollars for coverage through his former employer along with a $10 copayment for each prescription. In addition, Ralph was informed that his rent was going up and he would have to leave if he could not come up with the extra money each month; he had nowhere to go. He reached out to Area Agency on Aging and was referred to VICAP.

After speaking to Ralph, the VICAP counselor realized that he met criteria to receive LIS. She contacted the benefits person at former employer to see whether Ralph could take medical coverage without the prescription portion of the employer plan at a reduced cost. Ralph was allowed to sign up for medical coverage only, freeing up approximately $130 each month. The VICAP counselor then helped him apply for LIS and sign up for a Medicare Part D prescription drug plan, which helped him save another $100 monthly. With a savings of $230 each month, Ralph was able to pay the increase in rent and remain in his apartment.

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West Virginia

SUCCESS STORY: HELPING PARENTS AGE IN PLACE

A woman who lived in Maryland called the WV SHIP to ask about assistance for her parents in Charleston, WV. The couple, aged 83 and 80, had never enrolled in a Medicare Part D drug plan, and their prescriptions were costing between $400-$500 a month.

The couple had a combined monthly income of about $1,900, but they also were supporting an adult daughter who was unable to work. The WV SHIP helped the couple to complete an LIS application; 10 days later, they were awarded the full benefit. The counselor helped the couple enroll into a prescription drug plan with zero premium and deductible. Now, the woman’s medication cost only $2.60 a month; her husband—who takes two brand name drugs for his gout—pays only $6.50 for each of these.

The daughter later told the WV SHIP that the day she called the office was the first time she had felt there was hope in getting assistance for her parents.

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Maryland

SUCCESS STORY: A LIFELINE FOR MISS MABLE

Miss Mable is 65 and has a mental disability. She is known in the community as a person who likes to visit the local Goodwill. She has a one-bedroom apartment that is filled with all her treasures and is unwilling to depart with anything.

Miss Mable’s rent was increased to market value for non-compliance; she now pays $555 a month in rent. Her monthly income is only $725.

The Maryland SHIP helped Miss Mable submit a Rental Tax application, after which she received a healthy amount in return. She was also enrolled in a Medicare drug plan, ans helped to submit an online application for the Part D Low Income Subsidy. She also receives food (SNAP), energy and medical assistance, and the local Adult Protective Services unit works with her from time to time. The MIPPA program has been a lifeline, enabling Miss Mable to stay independent in her own home.

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Delaware

SUCCESS STORY: SAVING HUNDREDS EACH MONTH ON MEDICARE

A woman recently separated from her husband contacted ElderInfo looking to get assistance paying for Medicare costs. The client was found eligible, and received application assistance for the Part D Low Income Subsidy (LIS), Medicare Savings Program, and the Supplemental Nutrition Assistance Program (SNAP).

With LIS, the client now receives the full 100% subsidy, therefore, she pays $0 for her monthly Medicare drug plan premium, $0 deductible, and no more than $2.60 (generic) or $6.50 (brand name) for her prescriptions. Previously, she was paying $37.50 for her Medicare drug plan premium. With the Qualified Medicare Beneficiary (QMB) program, she can save $200 per month, thus eliminating the need for her current Medigap plan, plus $99.90 a month for her monthly Medicare Part B premium deductibles, and 20% co-insurance expenses. Lastly, with SNAP, she was able to save on her grocery expenses. Since applying for the various benefits, this client now saves over $330 per month.

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Pennsylvania

SUCCESS STORY: HELP WITH MEDICINES AND MORE

Mrs. Haverson came to Benefits Data Trust in May 2011 to seek assistance for herself and her husband, who has leukemia. With medicine for her husband’s condition totaling $10,000 a month, the couple was desperately struggling to pay their medical and other bills.

BDT helped Mrs. Haverson to apply for the PACE pharmacy benefit, SNAP, and the Property Tax/Rent Rebate Program. Mrs. Haverson and her husband received their PACE cards within weeks, which will save them several thousand dollars each year on prescriptions. They also appear eligible to receive $367 per month in SNAP benefits and a $500 property tax rebate. In a conversation with BDT, Mrs. Haverson expressed her gratitude:

I’ve never had to ask for help from anybody and this was just magical. Jaymee [the benefits counselor who assisted Mrs. Haverson] was so detailed, humane, and polite. She was empathetic, precise, and efficient. BDT is such a wonderful resource…It’s brought some optimism back into a dark situation. I would be lost and overwhelmed without you.

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New Jersey

HUNGRY NO MORE: A NJ SUCCESS STORY

A 58-year old woman from Southampton contacted the MIPPA subgrantee in Burlington County, crying on the phone about her financial situation. Since a car accident two years earlier left her permanently disabled, she has been paying more than $700 a month for private medical insurance. She was unaware that she now qualified for Supplemental Security Disability Income (SSDI) and Medicare.

MIPPA staff counseled her to contact Social Security, which she did. She applied for SSDI in February and by April 1 was receiving Medicare benefits and qualified under Plan C for those under age 65 and disabled. For that coverage, she now pays a monthly premium of $148, which covers more services than her original private insurance did! This was a savings of $552/month.

The woman contacted the MIPPA staff to thank them for their help and reported that she has stopped worrying if she has enough money for cat food. She said she used to go hungry sometimes so the cat could eat.

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New York

SUCCESS STORY: LOWERING THE COSTS OF CARE

A 73-year-old man from New York City called HIICAP to inquire about programs that could lower his prescription costs. He had a number of chronic health problems, including COPD, asthma, and heart disease. He was also a caregiver for an aging relative, and regularly volunteered at the local senior center.

The gentleman initially did not qualify for Extra Help, due to having resources slightly above the annual limits. The HIICAP interviewed him for a Medicare Savings Program which, once approved, would also deem him qualified for LIS.

A few months later, this client called to thank us for helping him to get MSP and LIS, and while on the phone he asked about a local program announcement for air conditioners provided by the HEAP Program. Given his chronic conditions and the summer heat, he thought that an air conditioner (which he could not afford) would be beneficial to his health. After receiving a local referral, he was able to qualify for the no-cost air conditioner. He called the State HIICAP office overjoyed that he was able to obtain the air conditioner and assistance paying for his medications. Each year he faxes a holiday greeting to the HIICAP office to let us know that he is well.

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Vermont

SUCCESS STORY: FINALLY ABLE TO MAKE ENDS MEET

A Vermont SHIP coordinator met with an elderly woman, Mrs. B, a farmer’s widow who rarely left her rural farm. She had no children or any other close family members. Mrs. B made contact with SHIP through a suggestion of a church friend to see if she could get some financial help. Her monthly income was about $900, however, her resources were over the limit for Medicaid. The SHIP counselor helped her apply online for Extra Help, the MSP program, and the lowest available level of State Pharmaceutical Assistance Program here in VT; she qualified for all of the programs.

This visit saved Mrs. B approximately $665.90 a month because she no longer had to pay her:

  • Part D premium of $37;
  • The Part D deductible of $325;
  • Her drug co-pays that totaled approximately $57 a month (after the deductible was met);
  • Part B premium of $99.90; and
  • She was able to lapse her Medigap insurance, thus save that monthly premium of $147.

Mrs. B. left the office in tears…tears of relief and joy because she could finally make ends meet with all of her savings. She left saying she would make sure all of her friends heard about his and encourage them to come and find out if they too could save as much money as she.

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New Hampshire

SUCCESS STORY: HELP WITH COSTLY MEDICAL BILLS

Mr. S is a 75-year-old East Indian gentleman who has been living and working here in the US for 24 years. He is still working and collecting his social security and sends money to support his family in India.

Mr. S never signed up for Medicare Part B because he could not afford it. He came to ServiceLink with a bill for over $1,200 from doctor's services for a hospital admission.

ServiceLink was determined that Mr. S was eligible for one of the Medicare Savings Programs, so the counselor did a 3-month retroactive buy-in. Mr. S now has medical insurance with assistance to pay the monthly premium, and can now submit the $1200 bill to Medicare.

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Maine

SUCCESS STORY: LIFE-SAVING HELP FOR A TRANSPLANT PATIENT

A man approached the Maine SHIP on July 16, after having just received a kidney transplant in June. His current health insurance was terminating on July 31, and he needed to urgently get enrolled into Medicare for assistance with medical expenses, especially medications to prevent organ rejection. (A kidney transplant automatically qualifies a person for Medicare, but he must apply.)

The man had called Social Security for assistance, but they had told him he couldn’t have an appointment until the end of July. Working with Margaret, a volunteer with the SHIP, and Lee at the Legal Services for the Elderly, the consumer was able to get an earlier appointment with Social Security and was put on Medicare retroactive to June 1. He was than able to get a Medicare prescription drug plan and supplemental insurance for an effective date of August 1.

Thanks to the SHIP and Legal Services for the Elderly, this consumer received the urgent, life-saving assistance he required!

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Massachusettes

SHINE COUNSELORS HELP CLIENTS SAVE THOUSANDS

Throughout Massachusetts, SHINE counselors have helped people with Medicare select plans and apply for programs that save them thousands of dollars. Here are just a few examples:

A woman in Mystic Valley was spending hundreds of dollars on health care and buying food with a credit card, because she had no money left over. The counselor helped her to qualify for Mass Health, which saved her over $300 a month.

In Boston, a counselor helped a senior sign up for LIS and within a week and a half, she said that her medications were significantly lower in cost. The counselor also signed her up for the Medicare Savings Program, thus saving her nearly $100 a month in Part B premiums. The woman also got a referral to a Benefits Specialist to get help applying for food stamps.

A Minuteman gentleman called SHINE saying he couldn't afford his generic gout medication, because it is now a brand name drug, and the generic is no longer available. After some research, the counselor found that he could probably qualify for help from the drug manufacturer, and helped him with the application. The man applied and got a year's supply of the medication totally free.

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Connecticut

SUCCESS STORY: INFORMATION AND BENEFITS AT THE LOCAL LIBRARY

Following a Medicare / Medicaid 101 presentation at the Fairfield Library, a woman approached the CHOICES counselor and said, "Thank you so much for your presentation, I learned so much and I know I'm eligible for the MSP you discussed." Ms. B said that she had the application for months but never filled it out.

The next day, Ms. B called and the counselor walked her through completing the MSP application over the phone since she was anxious to get it submitted. Two weeks later, Ms. B met to go over her health insurance coverage and also receive help to apply for other benefits. She was ecstatic because she had just received a letter from DSS notifying her that she was approved for Qualified Medicare Beneficiary program benefits.

Ms. B has been battling depression, which paralyzed her from taking action sooner. She said she was so glad she came to that presentation at the Fairfield library because, “You moved me to do something I’ve been meaning to do for months but couldn’t seem to do it.” The $100 that she will get in her Social Security check each month will help her tremendously. Ms. B confided that she had not seen her doctors in over three years because she could not afford the co-pays. Now she is able to schedule appointments to see all of her physicians, which she had avoided because of the costs.

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Rhode Island

SUCCESS STORY: GETTING ALL HER MEDICINES FOR LESS

 

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Tennessee

SUCCESS STORY: GETTING ALL HER MEDICINES FOR LESS

Recently, a woman who moved to Memphis following evacuation from New Orleans after Katrina called TN SHIP regarding assistance with receiving insulin after diagnosis of diabetes. The lady was extremely distraught and crying. She was on Medicare disability and had never enrolled in a Medicare drug plan because she felt she could not afford the premium.

After the SHIP Coordinator, Vickie Thompson, talked to her for several minutes, Vickie found the consumer was eligible for LIS (Extra Help). Vickie also found that the consumer was a breast cancer survivor and has been paying $69 (out of pocket) per month for her Tamoxifen that she could purchase for $10 for a 90-day supply at a different pharmacy. Needless to say, this revelation comforted her somewhat while upsetting her that she had spent so much for her Tamoxifen each month.

Vickie completed the LIS application, and enrolled the client in a drug program that allowed her to receive all of her medications for less than $10.00 per month, including her insulin. While for a SHIP Coordinator this may all be in a day’s work, it makes a big difference to the client, and allows her to keep a significant portion of her income.

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North Carolina

SUCCESS STORY: MS. TINGEN & MS. PHILLIPS SAVE LOTS OF MONEY

Ms. Tingen came to SHIIP in 2011 for assistance with her prescription drug costs. After applying for and receiving LIS, she saved $14,805 on her prescription drugs. At that time the SHIIP representative also applied for Medicare Saving Program assistance on her behalf. Ms. Tingen was approved and received an additional $1,326 with the return of her Medicare Part B premium.Unknowingly, she misunderstood documentation she received at the end of 2011 and failed to resubmit her MSP paperwork. When she realized she was no longer getting this assistance, she reached out to SHIIP once again, and they helped her re-enroll in the program, as well as receive back payment for her Part B premiums. Ms. Tingen feels blessed to know she has help from people who have her best interest at heart and are only a phone call or visit away.

Ms. Phillips has been coming to SHIIP for assistance since the inception of Part D. She has had to change her Part D plans each year, but doesn’t mind when it comes to saving her money. She will save $1,239 in 2013. Ms. Phillips has high praises for the assistance SHIIP provides. She says, “I don’t know what I’d do without the help I receive every year from Judy (her SHIIP counselor). Everything is so confusing, and she helps me understand my choices and how they affect my costs. She’s my life saver.”

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Alabama

SUCCESS STORY: EXTRA HELP WITH PRESCRIPTION SAVINGS

After seeing an article in the local newspaper about getting “Extra Help” to save money on Medicare, Ms. David called the local SHIP office at Marshal County Council on Aging to inquire if she qualified. On May 8 she completed an application for her and her husband for the Medicare Savings Program. The SHIP counselor asked Ms. Davis to let her know when/if they got approved, so she could set up a follow-up appointment to evaluate their Part D plans. Three weeks later, the couple was approved a Medicare Savings Program. Since they also are approved for the Low Income Subsidy, they could change their Part D plan outside of open enrollment. Both Ms. David and her husband were on a plan with a premium of $44.20 each a month. The counselor helped them to select a new plan that has no premium and deductible, with medications at $2.60/$6.50.

Before receiving these savings, they were paying Part B ($99.90 each) and Part D premiums ($44.20 each) and around $500 a month for medications, totaling $788 a month. Today they pay roughly $100 for medication only. That equals $688 a month in savings!

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Georgia

SUCCESS STORY: HELP FOR A SENIOR IN NEED

A counselor from GeorgiaCares shares this story of an elderly client she helped to receive benefits:

On October 17, 2012 I had the pleasure of speaking to a beneficiary who was born in 1919. The call was in regards to the Low Income Subsidy/Extra Help program. During my phone interview screening I learned that the beneficiary lived alone and her Social Security Disability amount was below the poverty level.

The beneficiary explained that she was not aware of any help that was available to her. I told her based on the information and income she provided, she would be eligible for the LIS and QMB programs. The beneficiary began to cry and stated “that no one has ever helped me before.” On that day I was happy that I made the call and I could assist someone in need of help.

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Florida

NOT A MIPPA GRANTEE

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Alaska

NOT AVAILABLE

 

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Hawaii

NOT AVAILABLE

 

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South Carolina

SUCCESS STORY: CHARLESTON, SOUTH CAROLINA

Ms. Burke called SHIP seeking assistance to reduce her Part D costs. After enrolling her in LIS and completing her plan comparison, she moved from $1,329 in annual cost to $82.80. In addition, she had been heating and cooling her home with a costly window HVAC unit. Through a referral, by MIPPA counselor Angela, to a human service agency, Ms. Burke received a new central heating and air unit. This will save her $1,200 yearly. In gratitude:

I’ve never knew the aging network provided services other than “Home Delivered Meals”. Mrs. Angela was a Godsend to help me stay warm and save money. She was patient, precise, and efficient. This program is such a wonderful resource… I would be worried and overwhelmed without their help.

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