Benefits Counselors: The Front Lines of MIPPA
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Benefits Counselors: The Front Lines of MIPPA

August 14, 2012 Get more info

Download the latest MIPPA quarterly report to see their progress.

Across the country, thousands of benefits counselors help people with Medicare find benefits that help them pay for prescriptions, health care, and other necessities.

Since 2009, these counselors—supported by the Medicare Improvements for Patients and Providers Act (MIPPA)—have helped more than half a million vulnerable seniors and adults with disabilities apply for over $1.6 billion in benefits, and learn about preventive services that can help them stay healthy.

Here are just a few of their stories.

“A Life Preserver on a Large, Dangerous Ocean”

In Nevada, an 80-year-old woman 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. After many phone calls, she 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.

Savings Hundreds Each Month in Maryland

A 70-year-old woman visited her local SHIP in Maryland after she lost her job and worried about how to pay her bills and Medigap premium. Her benefits counselor discussed the woman’s current monthly income, and determined she was likely eligible for the Part D Low Income Subsidy and one of the Medicare Savings Programs.  On Feb. 1, they completed the applications. The client returned to see her counselor two months later, and she had received a refund of her Part B premiums from Social Security, and her QMB card. She was also able to cancel her Medigap plan and save that money too. Her estimated monthly savings total $361.40.

“We don’t eat steak very often”

Last November an elderly woman named Marge came into the Montana SHIP office for assistance in choosing a Part D plan. 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 three 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. Marge and Frank’s combined monthly household income was only $1,048. Marge talked about the household budget, costs of Medicare, utilities, and food, to which Marge remarked, “We don’t eat steak very often.”

Marge’s 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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