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