FAQs

If you are already collecting social security, you will receive a Medicare card with an enrollment date for Medicare Part A and Part B, about 2 months prior to turning 65.  The enrollment date is the first of the month in which you turn 65.  If you have creditable coverage with your insurance at work or are covered by a spouse’s active employer group insurance, it may not be necessary to enroll in Part B.  It is recommended to contact your employer to see how Medicare effects your benefits.  If you are waiving Part B follow the instruction on the back of the card and send it back to the assigned address.  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 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 higher out of pocket.

People who are on LIS may choose a different plan anytime during the year.  Open enrollment is available from October 15 through December 7 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.  Plans are subject to change based on the marketplace and coverage needs.

The Benefit Specialists at the ADRC of the Lakeshore may be able to assist with straightening out most claims.

If you are low income there may be some State assistance available.  Please contact the East Central IM Partnership at 1-888-256-4563.  For information regarding Marketplace Insurance please call Lakeshore Community Health Care at 920-686-2333.  You can also contact any insurance agent for private plan information.  *Penalties may apply if you are without creditable health insurance.

Information and Assistance Specialist at the ADRC of the Lakeshore 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 should be made to Adult Protective Services and for immediate assistance call 911.

All persons age 18 and older have the right to live in the least restrictive environment that will keep them safe.  The Information and Assistance Specialist at the ADRC of the Lakeshore 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.

Individuals who need the equipment for short term may borrow the equipment from the various loan programs.  Please see more information on our Community Resources section of the website.  Individuals needing the equipment long term, may be able to get the equipment through Medicare or their insurance.  A prescription from a physician may be required for insurance approval.

The ADRC can provide you with a list of facilities in the county.  The ADRC has a Senior Resource Directory of Northeast Wisconsin booklet that describes the different facilities that is available to the public.

Please see our Transportation page of our website for transportation options.

If your child currently receives SSI MA, you will need to contact your local Social Security office.  If unsure of the location of your local SSA office, you can enter your zip code here to find out:  SSA Locator.  This contact should be made during the month your child turns 18 to determine if a new application or a review needs to be completed.  If your child did not qualify for/was not receiving these benefits before age 18, he/she will need to apply the month after his/her 18^th birthday to determine eligibility for benefits.  This can be done either on-line or at the local Social Security office or with a Disability Benefit Specialist at the local ADRC.  This same process would need to be done if your child currently receives Katie Beckett MA.  If he/she receives MA through BadgerCare, this coverage may continue through age 19, as long as he/she continues to reside with you.  A parent’s legal responsibility ends at their child’s 18^th birthday.  This means the parent’s ability to speak for or make decisions on behalf of their child ends as well on their child’s 18^th birthday.  If it is felt that the child may not be able to act in his/her own best interest, then guardianship may be an option a parent wishes to pursue.  Guardianship is set up when a person does not have the mental capacity to made decisions that meet their needs for their own physical and financial 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 should be started about six months prior to the child’s 18^th birthday.

The Social Security Act defines disability as the presence of a physical and/or mental condition that is severe enough to prevent any substantial gainful activity (For the year 2017, that amount is $1,170 GROSS {before any deductions are taken off} per calendar month) and is expected to last at least 12 consecutive months or result in death.  Application for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) can be done either on-line or at the local Social Security office or with a Disability Benefit Specialist at the local ADRC.  A Disability Benefit Specialist at the local ADRC is also able to assist with gathering necessary information, completing paperwork, explaining benefits to you if your claim is approved, filing appeals if claim is denied, and much more.

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

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.

Please contact the ADRC of the Lakeshore for current volunteer opportunities at 1-877-416-7083.