The Medigap Helpline & Prescription Drug Helpline
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1 The Medigap Helpline & Prescription Drug Helpline Board on Aging and Long Term Care A Wisconsin SHIP (State Health Insurance & Assistance Program) 2018
2 The Medigap Helpline is a service of the State of Wisconsin Board on Aging and Long Term Care. There is no connection with nor any endorsement of any insurance company. The program is funded by a grant from the federal Administration for Community Living (ACL) and the Wisconsin Office of the Commissioner of Insurance (OCI). 2
3 Our number is listed on the back of the Medicare & You booklet 3
4 Where We Are Located Our main office is located near the Madison airport State of Wisconsin Agency: Board on Aging and Long Term Care Medigap Helpline Services 1402 Pankratz St., Suite 111 Madison, WI
5 Who We Are Staff at the Medigap Helpline Services includes both the: o Medigap Helpline o Medigap Part D and Prescription Drug Helpline. Medigap Helpline Services Supervisor Vicki Buchholz Vicki.Buchholz@Wisconsin.gov 5
6 Intake Advocate Melani Quarles Toll Free Direct Number (Call or to order publications) 6
7 Medigap Insurance Counselors Medigap Insurance Counselor Steve Shapiro gov Medigap Insurance Counselor Vacant Medigap Insurance Counselor - Lead Jill Helgeson Jill.Helgeson@Wisconsin.gov Medigap Insurance Counselor Mary Jane Ripp Maryjane.Ripp@Wisconsin.gov Medigap Insurance Counselor Cheryl Zautcke Cheryl.Zautcke@Wisconsin. gov 7
8 Medigap Part D & Prescription Drug Counselor Rodney Rodgers Rondey.Rodgers@Wisconsin.gov Medigap Part D & Prescription Drug Counselor Vacant 8
9 How We Can Assist You Call us directly for assistance. Refer clients if they need assistance in selecting a Medicare Supplement (Medigap), a Medicare Advantage plan or Prescription coverage to the toll-free lines. Call intake for publication requests. Arrange presentations in your county or agency. Use of Language Line for other languages. 9
10 Our Primary Customers Medicare beneficiaries of all ages Persons 60 & over for prescription help. Disabled individuals Low income individuals Pre-retirement individuals Retirees losing their employergroup coverage End Stage Renal Disease beneficiaries. Private long term care insurance shoppers 10
11 Other Customers Elder or disability benefit specialists I & A specialists at ADRC s Social workers/case managers Legislators or staffers Non-Medicare individuals without health insurance Medical or healthcare professionals Insurance Agents 11
12 Insurance Explained Medigap counselors provide information, education and counseling on many coverages and topics: Medicare o o o o o Part A Part B Eligibility Enrollment periods Coordination with other coverages 12
13 Medicare Supplements (Medigap) o Traditional insurer vs. Network policies o Open eligibility window o Guaranteed Issue Provisions o Pre-Existing conditions o Relocation/snowbirds o Premium issues 13
14 Medicare Advantage Plans o Enrollment periods: Initial, Annual, Special o Trial periods o Service area coverage options o Relocation/snowbirds o Out of pocket maximums o Copay costs o Provider networks o Prescription Part D Inclusion 14
15 Prescription Coverage o Medicare Prescription Drug Plan (Part D for persons 60 and over) o Wisconsin SeniorCare (65 and over) o Low Income Subsidy (extra help) o Other Creditable Drug Options: VA/Tricare for Life Employer sponsored o Pharmaceutical Programs o Discounted Programs for Gap coverage or for those with NO RX coverage. 15
16 Medicaid Programs o Medicare Savings Programs: QMB,SLMB o Medical Assistance Purchase Program (MAPP) o EBD Medicaid programs o Badgercare Plus Employer Group Health Coverage o Active Employer Coverage o Retiree Group Coverage o Cobra/Wisconsin Continuation 16
17 Military/Veterans Benefits o Tricare / Tricare for Life o ChampVA o Veterans Benefits Health Insurance Marketplace o Navigator referrals o Coordination with Medicare o Enrollment time periods 17
18 Long Term Care Insurance o Nursing Home coverage o Home Healthcare coverage o Assisted Living o Qualified Partnership Policies 18
19 We look forward to hearing from you! Call: (Medigap Helpline) Call: (Prescription Helpline - serving 60 and over) boaltc@wisconsin.gov Write: Board on Aging & Long Term Care 1402 Pankratz St Suite 111 Madison, WI Website: BOALTC 1/
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