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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 program provides free advocacy and legal advice and/or 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, insurance 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, ongoing legal training. EBS staff, along with their program attorneys at the Greater Wisconsin Agency on Aging Resources (GWAAR) and AAA management, prioritize legal casework based on client needs and available resources in accordance with the Older Americans Act.

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
  • Medicare Advantage appeal (60-day appeal window)
  • Medicaid appeal (45-day appeal window)
  • Eviction notice or pressing housing issue
  • Social Security or SSI overpayment (60-day appeal window)
  • Pharmacy/drug coverage issue with an immediate need for medication
EBS Normal Priority List
  • Original Medicare appeal (120-day appeal window)
  • Original Medicare or Medicare Advantage Plan billing issue
  • Private insurance appeal or billing problem
  • Pharmacy/drug coverage issue with no immediate need for medication
  • FoodShare appeal (90-day appeal window)
  • Social Security or SSI Disability initial applications
  • Debt collection issue

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.

Additional Benefit Resources

Free Welcome to Medicare Seminars | What you need to know about enrolling in Medicare
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.

2021 Schedule of Welcome to Medicare Seminars

Medicare and Medicare D Enrollment

Due to the high volume of legal cases handled by the Elder Benefit Specialists, regular Medicare and Medicare D enrollment and annual re-enrollment using the Plan Finder 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 provides counseling on Original Medicare, Medicare supplement insurance, employer-based coverage, Medicare Advantage, and related topics. Toll-free: (800) 242-1060. For Medicare D related benefits, call toll-free: (855) 677-2783.

Educational Videos for Medicare Outreach

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.