Presentation on theme: "Community Superstars Resources to Help You Discover LIS Eligible Beneficiaries SHIP Directors Conference May 28, 2008 Diana Weber, Regional Manager, North."— Presentation transcript:
Community Superstars Resources to Help You Discover LIS Eligible Beneficiaries SHIP Directors Conference May 28, 2008 Diana Weber, Regional Manager, North Carolina SHIIP Wanda J. Moore, Mid-East Commission
Its all about Partnerships! We are already working with the same established partners to serve the same established clients. How do we discover the underserved clients? How can we most effectively spread the word about the LIS benefit? We need to create NEW partners! Our goal is to form NEW partnerships with groups and individuals that we havent dealt with before groups and individuals that we have overlooked in the past. New partners can help us find the underserved clients.
How do we reach the underserved? Minorities Disabled Faith Based Isolated Low Income
Challenge: LIS Eligible Beneficiaries are out there, but they are very difficult to find! How do we locate them?
Solution: Community Superstars!!! The natural-born leaders in the community who beneficiaries trust for information. Community Superstars may be professionals, trade groups, group leaders or just everyday people.
Our Mission: Locate natural community leadersthe everyday people who beneficiaries trust for information. Form a Community Superstar Coalition. Educate your Superstars about the LIS subsidy. Encourage Community Superstars to spread information about the LIS benefit to the people they see everyday, throughout the community.
Our Goal Locate hard to find LIS eligible beneficiaries. Enroll them in the LIS benefit.
Step #1 Create Your Core Team Create your Core Team. This team will be the decision makers, the think tank. Core Team members are people already on- board with LIS enrollment.
Suggested Core Team Members SHIP Area Agency on Aging Social Security Manager Social Services Director Senior Center Director
Step #2 Devise List of Community Superstars Meet with Core Team to devise list of Community Superstars. Community Superstars can be professionals or non-professionals, working or retired. Community Superstars are respected, well regarded people in the community, who other people seek out for information and advice. Use optional survey to gather information.
Community Superstars Suggested Professional List Cooperative Extension Agent Medical Office Managers Pastors Law Enforcement Officers EMS staff, Fire fighters Bankers Librarians Electric Utility Meals on Wheels Food Bank Leaders from Disabled Support Groups such as Alzheimer's, Hearing and Sight Impaired. Leaders from Disease- specific support groups such as Diabetes, ESRD, etc. Group leaders from Minority- centered groups Adult Educators Health Department
Community Superstars Suggested Trade Group List Hairdressers and Barbers Neighborhood Grocer Bingo game manager Bowling Alley Manager Goodwill or Second-Hand Store Manager Highway Mart Manager Store managers from hardware store, Dollar Store, craft store, variety store. Managers from fast food restaurants and local eateries.
Community Superstars Suggested Club and Organization Leaders Womens and Mens Club Presidents Bible Study Group Leaders American Legion and VFW Leaders Bingo, Bunco, Entertainment Leaders Senior Fitness/Exercise Group Leaders Garden Club President Retired Teachers
Community Superstars Suggested Retired Members Joe Smith, your neighbor who belongs to all the local Veterans organizations Maggie Barnes who loves to visit people in the hospital Martha Williams who always takes food to neighbors going through difficult times Bob Adams, the retired mayor who seems to know everyone in town
Step #3 Plan Your Event Core Team decides date, time and location to bring the Community Superstars together. If budget permits, make it a luncheon. Offer food, and they will come! Create your invitation; mail to the Community Superstars guest list. Make it FESTIVE! Have a THEME!
Step #4 The Event: Introductions Room Setting: Form a big square with tables so that attendees face one another. Start by asking each attendee to introduce himself or herself. Allow each person time to give a brief description of their agency, profession, club, or interest in the community.
Step #5 Present a brief program SHIP and Area Agency on Aging Staffs start with a short introduction about SHIP and AAA and the services they offer. Present brief explanation about Medicare Part D. Discuss the LIS Benefit. Keep it SIMPLE. Dont overwhelm with details.
Step #6 Ask for HELP Ask your Community Superstars to SPREAD the WORD about the LIS Benefit. Teach acceptable, comfortable approaches to open the discussion with friends and neighbors… Do you know someone on Medicare who cant afford their prescription drugs?
Step #7 Tools your Superstars can use Give your Community Superstars the tools they need to spread the word: – LIS flyers to post in public places – LIS business cards
Step #8 Optional Computer Instruction Some of your Community Superstars may be interested in learning how to use Medicares Part D Plan Finder tool so they can actively enroll beneficiaries. Secure a computer classroom to offer an optional class to teach them how to use Medicares Part D Plan Finder.
Step #9 Arrange for the Next Meeting Set date for next meeting. Ask Community Superstars to attend. Encourage them to recruit more volunteers for your program!
LIS Basics Special Enrollment Period All beneficiaries who receive the LIS benefit have a continuous SEP to join or change plans at any time – as often as once per month. All beneficiaries newly qualified for LIS have an SEP allowing them to join a Part D plan outside of open enrollment, and the Late Enrollment Penalty will be waived.
* All asset eligibility limits include $1,500/person burial allowance Full Subsidy Beneficiary GroupIncome Eligibility Requirement Asset Eligibility Requirement Need to apply for LIS? Monthly Premium Annual Deductible Co-pay/Co-insurance for drugs on plan formulary Duals (people with Medicare & full Medicaid) who reside in long-term care facilities Meet State Medicaid financial eligibility rules Meet State Medicaid financial eligibility rules No, receive it automatically No None Other people with Medicare and Medicaid, including those enrolled in a Medicare Savings Program (MSP) Meet State Medicaid financial eligibility rules Meet State Medicaid financial eligibility rules No, receive it automatically No Co-pay: $1.05 generic/$3.10 brand name if income < 100% FPL ($866.67/month single or $1,166.67 married) Co-pay: $2.25 generic/$5.60 brand name if income > 100% FPL or if MSP-Only No co-pay after $5,726.25 limit Non-duals with income < 135% FPL $1,170/month or less if single; $1,575/month if married $7,790 or less if single; $12,440 or less if married * No if on SSI; Otherwise yes No Co-pay: $2.25 generic/$5.60 brand name. No co-pay after $5,726.25 limit
* All asset eligibility limits include $1,500/person burial allowance Partial Subsidy Beneficiary GroupIncome Eligibility Requirement Asset Eligibility Requirement Need to apply for LIS? Monthly Premium Annual Deductible Co-pay/Co-insurance for drugs on plan formulary Non duals with income < 135% FPL AND assets between $7,790 and $11,990 if single, or between $12,440 and $23,970 if married * $1,170/month or less if single; $1,575/month if married Between $7,790 and $11,990 if single; between $12,440 and $23,970 if married * YesNo$56Co-insurance: 15% (up to $5.726.25) Co-pay: $2.25 generic/ $5.60 brand name after $5,726.25 limit Non duals with income between 135% and 150% FPL $1,300/month or less if single; $1,750/month if married $12,440 or less if single; $23,970 or less if married * YesSliding scale $56Co-insurance: 15% (up to $5,726.25 limit) Co-pay: $2.25 generic/ $5.60 brand name after $5,726.25 limit