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Updated March 18, 2021
Connecting Older Adults and Individuals with Disabilities to
Health Services: Resources for Constituents
Overview
Connect to Health Programs
Navigating the U.S. health and long-term care systems can
and Benefits
be confusing and complex for some constituents. Older
ACL funds and administers grants to states for the
adults and individuals with disabilities may face additional
following activities, which facilitate connections to
challenges in identifying and accessing needed health care
programs and benefits:
and long-term services and supports (LTSS), such as home
and community-based services that can assist individuals in
Aging and Disability Resource Centers
maintaining their quality of life and living independently.
Local Aging and Disability Resource Centers (ADRCs)
Decisions about rehabilitative services or LTSS may be
provide one-on-one options counseling and assistance with
made in response to an emergency or crisis. Older adults
accessing a wide range of publicly and privately financed
and individuals with disabilities, as well as their family
LTSS and caregiver supports. Examples of ADRC services
members, may have limited understanding of available
include application assistance, screenings and needs
options for home care versus institutional care, either for
assessments, care coordination, support services for
short-term rehabilitation or extended care needs. Moreover,
individuals transitioning from hospital-to-home and nursing
public programs may be financed through different funding
home-to-home, and services to mitigate social isolation.
streams (e.g., Medicare, Medicaid, Older Americans Act
ADRCs are part of the NWD system, which aims to
[OAA]), and some are state or locally administered. As a
streamline and make seamless the navigation of LTSS.
result, eligibility for certain public programs can vary by
state or local entity and may be limited only to individuals
State Health Insurance Assistance Programs
with low-incomes or high levels of care need. Private
State Health Insurance Assistance Programs (SHIPs) offer
funding, such as long-term care insurance, for example,
one-on-one health insurance counseling to Medicare
may be one option for individuals to offset the potential
beneficiaries. SHIPs assist constituents with joining,
high costs associated with needed long-term care.
leaving, or switching their Medicare Advantage health
plans and/or Medicare Part D Prescription Drug Plans.
In an effort to simplify access to information about health
SHIPs assist Medicare beneficiaries with issues related to
care and LTSS options for older adults and individuals with
their other health coverage, such as retiree health benefits,
disabilities, many states have developed No Wrong Door
Medicaid, long-term care insurance, and Medigap
(NWD) systems, which are collaborations between the
(Medicare supplemental insurance). SHIPs answer
Administration for Community Living (ACL), the Centers
constituents’ questions about covered benefits, premiums,
for Medicare & Medicaid Services (CMS) within the
cost-sharing (such as deductibles and coinsurance), and
Department of Health and Human Services (HHS), and the
complaints and appeals (e.g., about denials of coverage).
Veterans Health Administration (VHA) within the
Department of Veterans Affairs. State-administered NWD
Benefits Enrollment Centers
systems assist individuals and families needing information
Benefits Enrollment Centers (BECs) assist Medicare
about public programs or private resources and can assist
beneficiaries, including older adults and younger
with counseling and future planning for LTSS options.
individuals with disabilities, to identify and apply for
NWD systems also serve as the entry point to publicly
programs for which they may be eligible. Such programs
financed LTSS, including programs and services funded
may include Medicaid, the Supplemental Nutrition
under Medicaid, OAA, and VHA, as well as other state or
Assistance Program (SNAP), the Low-Income Home
locally funded programs.
Energy Assistance Program, Supplemental Security
Income, and pharmaceutical assistance programs. BECs are
This In Focus describes federally funded resources that
supported in part by the National Council on Aging’s
provide information, outreach, and assistance for
Center for Benefits Access.
constituents to find, navigate, and access available public
and private health care and LTSS. It is organized into three
BenefitsCheckUp
groups of resources: (1) health programs and benefits, (2)
BenefitsCheckUp is an online tool and hotline that assists
home and community-based services, and (3) health care
older adults in identifying benefit programs for which they
providers and facilities. Table 1 lists the websites and
may be eligible for. Constituents answer a confidential
contact information for the various resources described.
questionnaire, then they receive a contact list for potential
programs. These programs may address issues such as tax
relief, food, housing, utilities, discounts, employment,
prescription drugs, and health care. The site is operated by
National Council on Aging.
https://crsreports.congress.gov