Elder Benefits

Welcome to the Sawyer County Elder Benefit Specialist (EBS) Webpage

Below, please find topic links to information and resources that you may find helpful.

This site was developed to put access to information and resources in one place in order to empower people to be as independent as they wish. Many programs have online applications/enrollments. The Sawyer County EBS is also available to provide information, assistance and support, and can also help with most applications/enrollments.


FEATURED TOPIC:  January 1 to March 31 Enrollment Periods

Medicare Advantage Open Enrollment Period (Special Enrollment Period- SEP)

Medicare's General Enrollment Period

January 1–March 31 annually
Coverage is effective the first of the month after the plan gets your request.

January 1 – March 31 annually
Coverage starts July 1
Late penalties may apply
If you’re in a Medicare Advantage Plan (with or without drug coverage),
You can:
  • Switch to another Medicare Advantage Plan (with or without drug coverage).
  • You can drop your Medicare Advantage Plan and return to Original Medicare. You’ll also be able to join a Medicare drug plan.
During this period, you can’t:
  • Switch from Original Medicare to a Medicare Advantage Plan.
  • Join a Medicare drug plan if you’re in Original Medicare.
  • Switch from one Medicare drug plan to another if you’re in Original Medicare.
You can only make one change during this period, and any changes you make will be effective the first of the month after the plan gets your request.

If you didn’t sign up for Part A (if you have to buy it) and/or Part B (for which you must pay premiums) during your Initial Enrollment Period, and you don’t qualify for a Special Enrollment Period, you can sign up during the General Enrollment Period between January 1–March 31 each year.

Your coverage won’t start until July 1 of that year, and you may have to pay a higher Part A and/or Part B premium for late enrollment.

For information about the late enrollment costs:
For additional information:For additional information:
If you would like assistance:
The EBS is able to assist with information, a comparison of plans from Medicare's PlanFinder and with enrollments. Just complete the below form and return it to the ADRC.

To switch plans Independently:

  • You can also contact 1-800-MEDICARE (1-800-633-4227); or 
  • Enroll Online through Medicare's Planfinder
If you would like assistance:
The EBS is able to help with information as well as with enrollments into Part B, and can assist with a joint call with you to the Social Security office for Part A enrollments.
To Enroll Independently:
  • By phone: You can contact the Social Security Administration office in Superior, WI: Contact info
  • Online: Application for Enrollment into Part B
  • Part B by mail or fax: If you are already enrolled in Medicare Part A and want to enroll in Part B, you can complete form CMS-40B, Application for Enrollment into Medicare- Part B (medical insurance). If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564.
Assistance is also available through:
  • 1-800-MEDICARE or www.medicare.gov
  • Medigap helpline: 1-800-242-1060
  • Disability Drug Helpline: 1-800-926-4862 (if under age 60)
  • Wisconsin Medigap Prescription Drug Helpline: 1-855-677-2783
Assistance is also available through:
  • Social Security Administration (SSA): https://www.ssa.gov/
  • Sawyer County residents are served by the Social Security Administration office in Superior, WI: Contact info

Four Reasons to Check Your Prescription Drug Plan:
  1. Each year, plans can make changes to their coverage such as: monthly premiums, yearly deductibles, covered medications, copays, coinsurance amounts, pharmacy networks, and areas of coverage.
  2. Your plan may no longer cover all your medications. Insurance companies change their formularies, so even if you are taking the same medications, the amount you pay for your medications may change in 2021.
  3. Your plan may have put restrictions on some of your medications such as preauthorization, quantity limits and step therapy.
  4. You may be taking different medications now.
What You Can Do:
  • Read important notices. Each Medicare Part D and Advantage plans is required to send an “Annual Notice of Change” postmarked by Sept. 30 to each of their members outlining the changes for the upcoming contract year.
  • Review your current Medicare health and drug coverage. If you are happy with your current plan, there is no need to do anything.
  • Shop around. If you are happy with your current plan, there is no need to do anything. If you are unhappy with your current plan, or just curious, and would like to compare plans yourself, you can do that by going to www.medicare.gov.
  • Watch out for misleading marketing or enrollment fraud.
Medicare beneficiaries can receive free, unbiased assistance with plan comparisons from the Elder Benefit Specialists at the Aging and Disability Resource Centers.

Additional Resources for Open Enrollment:


About the EBS Program

Elder benefit specialists (EBS) help answer questions and solve problems related to Social Security, Medicare, health insurance and other public and private benefits for older adults. They serve people ages 60 and over. Services are free of charge. Similar services are available to younger adults with disabilities through a Disability Benefit Specialist (DBS).
Benefit Specialists can provide you with the information you’re looking for and connect you to the resources you need.
  • Provide accurate information about a wide variety of programs that cover healthcare, food, and other household expenses
  • Help you identify and apply for programs that will best meet your needs
  • Help with an appeal when eligibility or coverage is denied
  • Advocate on your behalf
Additional EBS Program Information:


Sawyer County's EBS

Carol Martin
Aging and Disability Resource Center of the North
10610 Main., Ste. 224, Hayward, WI 54843
Email: cmartin@sawyerhs.hayward.wi.us
Phone: 1-866-663-3607 x205
Fax: 715-634-3580
Hours: Monday through Friday
8-11:30a and 12:30p-4p

Please note, although no face to face visits are being scheduled at this time due to the COVID-19 virus…
We are still here to help.
Please contact Carol for
information or assistance
with services/benefits.


Helpful Links to Information

Below, please find topic links to information and resources that you may find helpful. This site was developed to put access to commonly asked information in one place in order to empower people to be as independent as they wish. Many programs have online applications/enrollments. 
The Sawyer County EBS is also available to provide information, assistance and support and can help with most applications/enrollments.



COVID-19 Resources



What You Should Know Before You Turn 65 

GWAAR What to Know When You Turn 65 image Opens in new windowHelpful information from GWAAR.org- The Greater Wisconsin Agency on Aging:






 

Social Security Administration (SSA): https://www.ssa.gov/

Sawyer County residents are assigned to the Social Security Administration office in Superior, WI: Contact info

Disability Benefits

Information about Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI)

Applying for Medicare Benefits

It is recommended to apply 2-3 months prior to when you would like the benefit to begin. Contact EBS for more info.

Applying for Retirement Benefits

It is recommended to apply 2-3 months prior to when you would like the benefit to begin.

SSA Resources:

 


Medicare:  www.medicare.gov/

Medicare is the federal health insurance program for: People who are 65 or older; Certain younger people with disabilities and People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).  Note: Enrollment for Medicare Part A and Part B is completed through the Social Security Administration.

Commonly Requested Resources about Medicare

Medicare Basics

Learn About Your Options: Medicare Health Plans, Advantage Plans and Medigap/Supplemental Policy Options

Prescription Coverage

Part D Prescription Option

Wisconsin SeniorCare Option

Medicare Apps and Tools

  • Medicare’s Phone App: What’s Covered
  • Care Compare- Medicare’s online tool to help you find & compare doctors, hospitals & other providers near you that accept Medicare.

Medicare & You Handbook

  • The Medicare & You 2020 Handbookis the definitive guide to Medicare.  The Handbook is available online in different formats including:
    • Pdf;
    • Large Print;
    • Ebook;
    • Audiobook; 
    • Braille; and
    • Can be requested in book form.
    • Note: Books can also be picked up locally at the ADRC.

Additional Medicare Resources


Programs that Can Assist with Medicare Costs


 


Medicaid Resources






  • Medicare Savings Programs: 
    • Qualified Medicare Beneficiary (QMB)
    • Specified Low-Income Medicare Beneficiary (SLMB & SLMB+)
    • Qualified Disabled and Working Individual (QDWI) Program
Applications, renewals and changes can also be completed online at: www.access.wisconsin.gov



Housing Resources

For general information about rental assistance, tenant/landlord rights, and assistance with completing applications, please contact the Aging and Disability Resource Center of the North



Energy Assistance


Wisconsin Home Energy Assistance Program (WHEAP)
  • Sawyer County residents, please call 715-634-4806 to schedule an appointment;
  • Residents living on Lac Courte Oreilles tribal boundaries, please call 715-634-8934 x7474



FoodShare (SNAP)


For information about other nutritional programs and food resources, please contact the Aging and Disability Resource Center of the North

 


Transportation

For information about other transportation resources, please contact the Aging and Disability Resource Center of the North

 


Additional Links of Interest

 Local Links:


If you have feedback about this webpage, please contact Sawyer County's EBS