I received a phone call in October of 2017 from a couple who had heard the Senior Community Center of Owensboro-Daviess County, could run Medicare Part D comparisons, and maybe get them a better deal on their premiums than the $900 per month they were currently paying.
I made no promises other than to run the comparisons and present them with the printouts of their results.
At the Senior Community Center, as a contracted provider through the Green River Area Development District, we are trained to run those comparisons using websites like www.Medicare.gov, as well as using software that also checks for other potential benefits and resources a client may be eligible for, then assisting the client with those applications as well.
I gathered the couple's information and entered it. In no time I had reports showing plans and prices along with several other programs they may be eligible for. The couple chose not to make any changes for that year, but in 2018 asked me to review it again.
2018 was a different story.
Once again, I entered their information. There were differences that changed some eligibilities, so we made some applications and held our breath and waited. After a few short weeks, they received a letter requesting more information and we were on our way!
More forms, more applications, more verifications, and at least 25 minutes on hold with every call. Worth every precious minute. In March 2019, the couple received notice they were eligible to receive reduced Medicare Part D premiums as well as reduced prescription co-pays. A savings of what I'm told was immediately almost $150/month!
When they received the notice about the eligibility on the reduced premiums, it also suggested they apply for Kentucky Medicaid. We helped them apply. Shortly after, they received a letter that needed further clarification, so I reached out to the Department for Community Based Services in Frankfort.
Both our hearts sank when the calculations determined the family was just $50 over eligibility. She didn't have to, I'm sure, but she went an extra step and asked me questions about the family which indicated at least one of them may be eligible for another type of Medicaid -- the Home and Community Based Waiver Program.
According to the Cabinet for Families and Children, the (HCB) waiver program provides Medicaid-paid services and supports to the elderly or to adults and children with physical disabilities to help them to live at home rather than in an institutional setting.
What I didn't realize when she made this suggestion, was that although it was not traditional Medicaid, it was a different way to qualify for full Medicaid based on need, expenses, and income rather than solely on income, and one member of the household could qualify.
We made the application by contacting the Area Development District's ADRC, 800-928-9094, and they worked with the family to process the rest of the application. In May, the family received a letter informing them that the client was eligible for Medicaid through the Home and Community Based Waiver Program.
As a result, the family is now saving over $500 per month in Medicare premiums, supplements, prescriptions and will also have someone coming to the home three days each week for six hours each day to assist with laundry, meal preparation, bathing and light housekeeping! They get help and money in their pockets! They feel they've hit the lottery all because they wanted to compare premiums.
I asked the client what she was going to do with someone coming to help with housekeeping. She laughed and she was looking forward to finding out!
Is it all about money, though?
No. It's about independence. It's about keeping seniors healthy by doing all we can to ensure they stay safely in their homes for as long as they choose.
That means providing safe transportation, bringing in a hot meal and keeping an eye on them during the day, making a phone call now and then to check in, giving them something fun to do with other seniors, offering them classes that keep them engaged and fulfilling goals of life-long learning. All these things contribute to independence and if an extra $500 a month helps -- well, hallelujah!
Dana Peveler is executive director of the Senior Community Center of Owensboro-Daviess County, firstname.lastname@example.org or 270-687-4640.