I would like to retire within a few months.  How do I sign up for social security?

You may go to Social Security’s website and actually do an on-line application.  You should do this about 3 months before you would like to retire.  The local social security office will call you after your online application is received and complete the form with you in a telephone interview.  If you do not have access to a computer, you may call the Social Security office at 683-0302 to set up a phone interview.

I am turning 65 soon.  How do I get signed up for Medicare and will I need other insurance with Medicare?

If you are already collecting social security, you will receive a Medicare card with an enrollment date for Medicare Part A and Part B that will be the first of the month in which you turn 65 about 2 months prior to turning 65.  If you have creditable coverage with your insurance at work or are covered by a spouse’s insurance, it may not be necessary to enroll in Part B.  You will need to contact the Social Security office to have Medicare Part B removed.  Medicare will only pay 80% of your medical costs, so it is important to look at either a Medigap policy to cover the remaining 20%, or privatize your Medicare with a HMO or other Advantage Plan.  The ADRC has information on all of the Medigap plans that have been approved by the Insurance Commissioner of Wisconsin.

I am turning 65.  Should I use the state’s prescription drug program (SeniorCare) or a federal Part D plan?

The state’s plan is $30 a year and drug co-payment costs are dependent upon yearly income.  SeniorCare is available only to people who are 65 and older, while a Part D plan is available to anyone receiving Medicare.  A part D plan has a monthly fee and can be a stand alone plan or can be built into an Advantage Plan.  Individuals with low income and low assets may qualify for extra help (Low Income Subsidy – LIS) with the plan and drug co-payments.  Most co-payments under the LIS are less costly than through SeniorCare.  For individuals who are taking expensive prescription drugs, SeniorCare can be taken along with a Part D plan and may help an individual pay for drugs when they reach the gap that requires 100% cost out of pocket.

I have been placed on a new medication that is not covered by my prescription drug plan.  May I change plans anytime?

People who are on LIS may choose a different plan anytime during the year.  Open enrollment is available from November 15 through December 31 of every year for everyone.  It is important to review your plan during open enrollment to determine whether you are still in the most cost effective plan for the next year.  Insurance companies do look at their bottom line each year and will raise monthly rates along with co-payments if their profit margin is not where they would like it to be.

I am having problems with my insurance covering some of my medical bills.  Where can I get help understanding Medicare claims and Part D coverage?

The Elderly Benefit Specialist at the ADRC has support from the Elder Law Center in Madison and can assist with straightening out most claims.

I do not have any health insurance.  What are my options?

BadgerCare Plus is available for adults, age 19 – 64, who do not have any dependent children.  Family income must be below 200% poverty level.  An individual cannot have had health insurance a least 12 months prior to enrolling in this program, nor can you have access to health insurance from your employer.  Application can be made online or by calling the Enrollment Center at 1-800-291-2002.  A $60 non-refundable application fee is required at the time of enrollment.  For those with higher incomes, independent agents may be able to find a high deductible policy at a reasonable premium.  High medical risk individuals may need to utilize the state’s health insurance risk sharing plan called HIRSP.  This plan can be contacted by calling 1-800-828-4777

My neighbors are elderly and seem to be neglecting their health and well-being.  Is there any help for them?

Information and Assistance Specialist at the ADRC are available to work with individuals and help them identify resources that could be brought into the home to help them maintain their health and well-being for as long as possible.  If the neglect is to the extreme and putting the person in danger of harming themselves, a referral will be made to Adult Protective Services for immediate assistance.

I don’t think my mother should be living by herself anymore. What options are available for her and how do I get started with finding a suitable living environment?

All persons age 18 and older, regardless of the disability, have the right to live in the least restrictive environment that will keep them safe.  The Information and Assistance Specialist at the ADRC are able to discuss different options, including home modifications to make the home safer, adaptive medical equipment, home-delivered meals, home care services brought into the home, assisted living facilities and nursing home care.

How does someone get durable medical equipment?

Individuals who need the equipment short term (3 months or less) may borrow the equipment from the ADRC or the Two Rivers Fire Department.  Both facilities have walkers, wheelchairs, commodes, crutches, bath benches, toilet risers, and a few other small items available.  A security deposit is requested.  Individuals needing the equipment long term, may be able to get the equipment through Medicare or their insurance.  A prescription from a physician is required for purchasing equipment from an agency that accepts assignment.

What is assisted living?

Assisted living is an alternative to living in your current home.  It includes adult family homes, residential care apartment complexes (RCAC), community based residential facility, and nursing homes.  An adult family home is a place where 3 or 4 adults who are not related to the operator reside and receive care, treatment or services that are above the level of room and board.  An RCAC is an apartment type setting that offers some independence and control over personal space.  Room and board, up to 28 hours per week of supportive care, personal care, and nursing services are generally offered in an RCAC.  A CBRF is a place where 5 or more unrelated people live together in a community setting.  Services provided include room and board, supervision, support services, and may include up to 3 hours of nursing care per week.  A nursing home is a facility in which a resident can receive care or treatment and, because of their mental or physical condition, require access to 24-hour nursing services, including limited nursing care, intermediate level nursing care, and skilled nursing services.  The ADRC can provide you with a list of facilities in the county.  The ADRC has a booklet that describes the different facilities “Answers about Elderly Housing” that is available to the public.  The state’s website and the federal website offer provider quality profiles and comparisons of most of the facilities.

I may need to give up driving within a few months?  What transportation options are available to me?

The city of Manitowoc has a taxi service as well as a bus that operates six days a week between and around the cities of Manitowoc and Two Rivers.  ADA transportation is available to those who cannot access the bus.  Aurora Medical Center and Holy Family Memorial may be able to assist with transportation of clients to their facility.  View a listing of the different transportation options and their contact numbers.  You may also contact Maritime Metro for transportation operations at 920-683-4560.

My special needs child will be turning 18 this year.  What do I need to put in place before the child turns 18?

If your child currently receives SSI MA, you will need to contact Social Security during the month of turning 18 to determine if you need to reapply, or if a review should be conducted.  If your child did not qualify for these benefits before age 18, you will need to apply at Social Security the month after his/her 18th birthday to determine eligibility for benefits.  If your child currently receives Katie Beckett MA, you will need to apply at the Social Security Office for SSI and/or Social Security Disability the month after he/she turns 18. If he/she receives MA through BadgerCare, this coverage can continue through age 19, as long as he/she continues to reside with you.  A parent’s legal responsibility ends at their child’s 18th birthday. Guardianship is set up when a person does not have the mental capacity to make decisions that meet their needs for physical health and safety.  The process of appointing a guardian includes: 1) The completion of a competency evaluation; 2) filing a petition with the court; and 3) A court hearing.   These steps are generally completed by a private attorney and started about six months prior to your son or daughter’s 18th birthday.

I have a disability that is preventing me from full-time employment.  How do I qualify for Disability Benefits?

The Social Security Act defines disability as the presence of a physical and/or mental condition that is severe enough to prevent any substantial work activity and is expected to last at least 12 months or result in death.  Applications for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are filed with your local Social Security office.  You will need to complete both an application for Social Security Benefits and an Adult Disability Report.  The later report collects information about your disabling condition.  The Disability Benefit Specialist at the ADRC office may be able to assist in gathering some of the necessary information.  An appeal may be filed if you are denied a disability determination.

What are Advance Directives and where can I get them?

An advance directive describes, in writing, your choices about the treatments you want or do not want or about how health care decisions should be made for you if you become incapacitated and cannot express your wishes. Any one age 18 and older and of “sound mind” can make an advance directive. Directives are available online or by sending a self-addressed, stamped business envelope to:

Living Will/Power of Attorney
Division of Public Health
PO box 2659
Madison, WI 53701-2659

They are also available at the ADRC.  The “Declaration to Physicians (Wisconsin Living Will)” informs your physical regarding your wishes about life-sustaining measures to be used when you are near death or in a persistent vegetative state.  It goes into effect when 2 physicians agree that your vegetative state cannot be reversed and you are unable to express your health care choices.  A “Power of Attorney for Health Care” is a document in which you appoint another person to make health care decisions for you in the event that you are not capable of making them yourself.  This, too, requires that 2 physicians agree in writing that you cannot express your treatment options to others.  You do not need an attorney to complete these two forms.  A “Power of Attorney for Finance and Property” designates power to an individual chosen by you to handle your finances and property.  Anyone with complex or special assets should ask an attorney for help with this paperwork.  “Authorization for Final Disposition” gives direction for funeral arrangements upon your death.

Are there volunteer opportunities available through the ADRC?

The ADRC utilizes volunteers to assist with running and maintaining the nutrition sites throughout the county.  Volunteers help with packing of home-delivered meals, delivery of these meals, serving of congregate meals, and clean-up.  Volunteers are available to take people to medical appointments, both in the county and to out-of-county medical appointments.  Volunteers also serve as friendly visitors to those who are shut-in or in nursing homes.