Community Superstars

Resources toHelp You Discover LIS Eligible Beneficiaries

SHIP Directors’ ConferenceMay 28, 2008

Diana Weber, Regional Manager, North Carolina SHIIPWanda J. Moore, Mid-East Commission

It’s 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 haven’t 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 leaders”—the 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 #1Create 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 #2Devise 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 SuperstarsSuggested 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 SuperstarsSuggested 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 SuperstarsSuggested Club and Organization Leaders

Women’s and Men’s 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 SuperstarsSuggested 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 #3Plan 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 #4The 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 #5Present 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. Don’t overwhelm with

details.

Step #6Ask 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 can’t afford their prescription drugs?”

Step #7Tools 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”

Business Card Template

Step #8Optional Computer Instruction

Some of your Community Superstars may be interested in learning how to use Medicare’s 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 Medicare’s Part D Plan Finder.

Step #9Arrange for the Next Meeting

Set date for next meeting. Ask Community Superstars to attend. Encourage them to recruit more volunteers for your program!

Appendix

Teaching materials LIS Basics LIS Charts Templates for Agency Booklet Additional Resources

LIS BasicsSpecial 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 SubsidyBeneficiary Group Income

Eligibility Requirement

Asset Eligibility Requirement

Need toapply forLIS?

Monthly Premium

Annual Deductible

Co-pay/Co-insurance for drugson plan formulary

Duals (people with Medicare & full Medicaid) who reside in long-term care facilities

Meet State Medicaid financial eligibility rules

Meet State Medicaidfinancial eligibilityrules

No, receive it automatically

No No None

Other people withMedicare andMedicaid, including those enrolled in aMedicare SavingsProgram (MSP)

Meet State Medicaid financial eligibility rules

Meet State Medicaidfinancial eligibility rules

No, receive itautomatically

No No Co-pay: $1.05 generic/$3.10brand name if income < 100%FPL ($866.67/month single or$1,166.67 married) Co-pay: $2.25 generic/$5.60brand name if income > 100%FPL or if MSP-Only No co-pay after $5,726.25limit

Non-duals withincome < 135% FPL

$1,170/month or less if single; $1,575/month ifmarried

$7,790 or less if single; $12,440 or less if married *

No if on SSI;Otherwise yes

No No Co-pay: $2.25 generic/$5.60brand name.No co-pay after $5,726.25 limit

* All asset eligibility limits include $1,500/person burial allowance

Partial Subsidy

Beneficiary Group Income Eligibility Requirement

Asset Eligibility Requirement

Need toapply forLIS?

Monthly Premium

Annual Deductible

Co-pay/Co-insurance for drugson plan formulary

Non duals withincome < 135%FPL AND assetsbetween $7,790and $11,990 ifsingle, 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 *

Yes No $56 Co-insurance: 15% (up to $5.726.25) Co-pay: $2.25 generic/ $5.60 brand name after $5,726.25 limit

Non duals withincome between135% and 150% FPL

$1,300/month or less if single;$1,750/month ifmarried

$12,440 or less if single; $23,970 orless if married *

Yes Sliding scale

$56 Co-insurance: 15% (up to $5,726.25 limit)Co-pay: $2.25 generic/ $5.60 brand name after $5,726.25 limit

Services & Products Provided

Service/Product Age Requirement

Income Level Requirement

Documentation Required

Seasonal Program?

Office Contact Person & Ext.

Additional Resources

Medicare Part D Plan Finder Tool: www.Medicare.gov

Social Security website: www.SSA.gov NCOA website: www.NCOA.org