Navigating healthcare costs, especially with Medicare, can be challenging for seniors on a limited budget. The Senior Partners Care (SPC) program is designed to ease this burden. This community service initiative, offered by the Seven County Senior Federation in partnership with local healthcare providers, aims to make healthcare more affordable for those with modest incomes by assisting with Medicare’s out-of-pocket expenses.
What is the Senior Partners Care Program?
Senior Partners Care is a helping hand for Medicare beneficiaries. It’s a community-focused program from the Seven County Senior Federation, working closely with clinics and hospitals in Aitkin, Carlton, Chisago, Isanti, Kanabec, Mille Lacs, and Pine counties in Minnesota. The core mission of the SPC program is to improve healthcare accessibility by addressing a significant financial hurdle: Medicare’s 20% copayments and deductibles.
The Seven County Senior Federation plays a crucial role in verifying who can join Senior Partners Care. Once approved, individuals receive an SPC card, which is valid for one year. Participating healthcare providers in the listed Minnesota counties then agree to consider waiving these out-of-pocket Medicare costs for SPC members.
Who is Eligible for the Senior Partners Care Program?
Eligibility for Senior Partners Care is based on specific criteria to ensure the program benefits those who need it most. To qualify for SPC, individuals must:
- Be enrolled in both Medicare Part A and Part B (Original Medicare).
- Not have additional Medicare coverage for hospital or doctor services, such as a Medicare Advantage plan or Medigap policy.
- Meet established income and asset limits.
For example, in 2017, the income limit was $2,010 per month for an individual and $2,707 for a married couple. The asset limit, applicable to both individuals and couples, was $49,200 (excluding your primary residence, one vehicle, and personal household belongings). It’s important to note that these guidelines are updated annually to reflect 200% of the federal poverty guidelines, so current limits may vary. Always check the latest guidelines when applying.
Important Considerations and Limitations of SPC
While Senior Partners Care offers valuable assistance, it’s important to understand its scope and limitations:
- Participating Providers Only: SPC benefits are only applicable when you receive care from healthcare providers who are part of the Senior Partners Care network. Not all doctors, clinics, and hospitals in the area participate, and their involvement is voluntary. Always verify provider participation beforehand.
- Not a Payment Guarantee: SPC is not an insurance plan and does not guarantee payment of medical bills. It’s an agreement with participating providers to consider waiving Medicare coinsurance and deductibles. The final decision rests with the provider.
- Medicare-Covered Services: SPC applies only to services covered by Medicare. If Medicare does not cover a particular treatment or item, SPC will not cover it either, and you will be responsible for the full cost. Examples of services typically not covered by Medicare include routine dental care, eyeglasses, eye refraction, and hearing aids.
Costs Associated with Senior Partners Care
There are nominal fees associated with the Senior Partners Care Program:
- Seven County Senior Federation Membership: Annual membership is $20 for individuals and $35 for households of two. Becoming a member supports the Federation’s work.
- SPC Administrative Fee: There is an additional annual administrative fee of $15 per person for SPC enrollment.
- Non-Federation Member SPC Fee: Individuals who choose not to join the Seven County Senior Federation pay a higher annual SPC administrative fee of $40 per person.
Joining the Seven County Senior Federation often provides the most cost-effective access to the Senior Partners Care program, while also supporting a valuable community organization.
How to Enroll in Senior Partners Care
Enrolling in Senior Partners Care is a straightforward process managed by the Seven County Senior Federation. To begin your application:
- Contact the Seven County Senior Federation: Call during office hours, Monday to Friday, 8:00 am to 4:30 pm, at 1-866-679-4700.
- Request an Application Packet: Ask for a packet containing both the Senior Partners Care application form and a Federation membership application if you are interested in becoming a member.
- Gather Required Documents: To complete your SPC application, you will need to provide:
- Your annual Social Security statement (showing benefit amounts).
- Current financial information to verify income and asset eligibility. This includes recent copies of savings and checking account statements, pension statements, pay stubs (if applicable), and life insurance cash value statements. These documents should be dated within the last thirty (30) days.
- Indicate Preferred Providers: The SPC application will ask you to list the Seven County area hospitals and clinics you typically use for your healthcare.
An SPC card signifies enrollment in the Senior Partners Care program, helping eligible seniors access affordable healthcare by potentially waiving Medicare out-of-pocket costs at participating providers within the Seven County Senior Federation network.
Remember: Senior Partners Care is NOT Health Insurance
It is crucial to understand that Senior Partners Care is not a health insurance plan. It is a program designed to work in conjunction with your Original Medicare coverage to reduce your out-of-pocket expenses at participating providers.
Should You Replace Your Existing Insurance with SPC?
Generally, no, you should not drop existing private health insurance to rely solely on Senior Partners Care. Before making such a significant decision, consider these important factors:
- Limited Coverage Compared to Private Insurance: Your current private insurance plan likely offers broader coverage. It may include services not covered or guaranteed by SPC, such as ambulance services, vision care, dental care, medical supplies, or Medicare Part D prescription drug coverage.
- Travel Limitations: SPC is specific to Minnesota and the participating providers within the Seven County region. If you travel outside of this area, SPC benefits will not apply, and you would be responsible for all standard Medicare copayments and deductibles. Private insurance, especially Medicare Supplement plans, often offer broader coverage networks and travel benefits.
- Limited Provider Network: The Senior Partners Care provider network is smaller than most HMO networks or universal Medicare supplement policies. Your choice of doctors and hospitals may be more restricted with SPC compared to a broader insurance plan.
- Potential Difficulty Re-enrolling in Private Insurance: Be aware that if you cancel a private Medicare Supplement policy or retiree group insurance to enroll in SPC, it may be difficult or impossible to re-enroll in those plans later if you change your mind. These plans may have “one-way door” policies.
If you can comfortably afford your current private insurance and are satisfied with its coverage and your healthcare access, it is generally advisable to maintain your existing plan.
Can You Have Senior Partners Care with Medicare Part D?
Yes, you can enroll in a stand-alone Medicare Part D prescription drug plan in addition to participating in Senior Partners Care. This combination can provide more comprehensive coverage, especially for prescription medications. Furthermore, depending on your income and asset levels, you may also qualify for Extra Help (also known as the Low-Income Subsidy or LIS) with your Medicare Part D costs, further reducing your expenses.
Is Senior Partners Care Right for You?
If you are a Medicare beneficiary in Aitkin, Carlton, Chisago, Isanti, Kanabec, Mille Lacs, or Pine counties in Minnesota, have limited income and assets, and struggle with Medicare’s out-of-pocket costs, the Senior Partners Care program could be a valuable resource.
To find out if you qualify and to apply, call the Seven County Senior Federation office at 1-866-679-4700 today. Gather the necessary financial documents listed below and take the first step towards accessing more affordable healthcare.
| Documents Needed for SPC Application |
|---|
| – Annual Social Security statements (showing New Benefit Amounts) |
| – Savings/checking account statements* |
| – Pension statements* |
| – Pay stubs, if any* |
| – Life insurance (cash value)* |
| *Statements dated within the last thirty (30) days |
