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Dane County Department of Human Services

Elder Benefit Specialist Program

A Legal Services Program of the Area Agency on Aging of Dane County

The Dane County Elder Benefit Specialist (EBS) Program is administered by the Area Agency on Aging (AAA) of Dane County and is co-located and operated in partnership with the Dane County Aging and Disability Resource Center (ADRC). The EBS Program provides legal advice/representation for senior adults (age 60+) residing in Dane County that are faced with benefit, housing and other disputes or denials, complications, changes in benefits, claims not paid, and other similar issue groups that have an economic or socially isolating effect on the older adult.

Elder Benefit Specialists receive in-depth, on-going legal training. EBS, along with their program attorneys at the Greater Wisconsin Agency on Aging Resources (GWAAR) and AAA management, prioritize legal casework based on client needs.

Below are non-exhaustive lists of case examples.

EBS High Priority List
  •   Appeal or reduction of benefits with approaching deadline (60 days or less), or past deadline (no SSDI or SSI Disability-related appeals unless consumer provides rejection letters from 2 attorneys, per DHS guidance.)
  • Medicare Advantage appeal
  • Medicaid appeal
  • Eviction notice or pressing housing issue that is unable to be addressed by another community resource (Note: The EBS Program does not have access to rental assistance funds and is unable to assist clients with locating new housing.)
  • Social Security or SSI overpayment
  • Pharmacy/drug coverage issue – immediate need for medication
  • Other
EBS Normal Priority List
  • Original Medicare appeal
  • Original Medicare or Medicare Advantage plan billing issue
  • FoodShare appeal
  • Private insurance appeal or billing problem
  • Pharmacy or drug coverage issue – no immediate need for medication
  • Initial application for Social Security or SSI-Disability benefits. Assistance is not guaranteed – referrals screened for merit.
  • Medicaid Disability Application (MADA)
  • Debt collection issue
  • Other

Elder Benefit Specialist Program Referral Process

Potential EBS clients who present with issues on the priority lists above should first contact the ADRC Information & Assistance Helpline by calling (608) 240-7400. An I & A Specialist will discern their particular issue and, in many cases, assist the client to resolve the issue or they will escalate it to an EBS through an internal referral to the program, if necessary.

Benefit Resources

Free 'Welcome to Medicare' Seminars 

Presented by AAA Elder Benefit Specialists

If you are turning age 64 this year, the Dane County Area Agency on Aging wants to help you make informed choices about your Medicare options! Do you understand what Medicare is and isn’t... how to avoid penalties for late enrollment in Medicare... and how to get the most out of your health and prescription benefit plans? Some decisions and actions about Medicare can take place 3-6 months before you turn 65, so don’t wait until you are turning 65 to understand all you need to know about this important benefit.

Want easy to understand answers to all of these complex questions? Sign up to attend one of the Free Welcome to Medicare Seminars. By attending a seminar, you’ll walk away with the accurate and detailed information you need from unbiased experts in benefit programs.

2024 Schedule of Welcome to Medicare Seminars

PowerPoint & Handouts

Medicare Videos

Listed below are educational resources to help you learn about Medicare. They are presented by the Wisconsin Dept. of Health Services State Health Insurance Program (SHIP), the Greater Wisconsin Agency on Aging Resources (GWAAR), and the Centers for Medicare and Medicaid Services (CMS).


Wisconsin SHIP Information for Beneficiaries: Provides basic information about Medicare State Health Insurance Assistance Program (SHIP) counseling services; produced by SHIP TA Center. Wisconsin-specific contact information is provided at the end of the video.

CMS Medicare & You: Understanding Your Medicare Choices: Provides basic information about Medicare options; produced by the Centers for Medicare & Medicaid Services.

Medicare Advantage (Part C) & Prescription Drug Plan (Part D) Review & Enrollment

Due to the high volume of legal cases handled by the Elder Benefit Specialists, Medicare Advantage (Part C) and Medicare Part D plan review and enrollment using the Medicare Plan Finder Tool should be referred to the local Senior Focal Point case manager. This information can be learned by contacting the ADRC. If clients do not want to utilize a Focal Point case manager, they can also call the Wisconsin Medigap Helpline which is a free, confidential counseling service for all Medicare beneficiaries:

Toll-free: 1-800-242-1060
Medigap Part D and Prescription Drug Helpline: 1-855-677-2783
Website:
http://longtermcare.wi.gov/category.asp?linkcatid=1958&linkid=1014&locid=123 

Other

Aging and Disability Resource Center (ADRC) of Dane County:

Covering Wisconsin:

Capital Consortium:

Dane County Veterans Service Office:

Health Insurance Marketplace:

Medicaid in Wisconsin:

Medicare:

Medicare Counseling for Wisconsin Residents

Social Security Administration:

State of Wisconsin Board on Aging and Long Term Care:

Wisconsin Office of the Commissioner of Insurance – Health Insurance: