Program bridges gap

FAIRMONT – A statewide program from Senior Community Services can help some seniors bridge the gap between what they owe on medical bills and what is covered by Medicare.

Senior Partners Care has been around since 1973, but only became part of the Senior Community Service in 2012.

“The Minnesota Senior Federation established the program,” said Deb Taylor, CEO of Senior Community Services. “But in 2009, the Senior Federation dissolved. It went to Volunteers of America, but they didn’t have the Medicare background that we have.”

The programs specifically target seniors who fall in between the 100 percent to 200 percent poverty level.

“When they’re under 100 percent poverty, they qualify for Medicaid,” Taylor said. “But that 100 to 200 percent area falls through the cracks. They usually can’t afford supplemental insurance, and those out-of-pocket expenses keep them from going and getting the health care they need … With SPC, seniors don’t have to lose everything to medical bills.”

Minnesota seniors who meet the program’s eligibility requirements must submit an application to Senior Community Services.

“They need to be in the 100 percent to 200 percent above poverty level,” Taylor said. “They also need to be on Medicare both A and B. They then need to apply and pay a $40 application fee on an annual basis.”

Upon acceptance, clients who use SPC healthcare partners for Medicare-approved services are eligible to have the balance on medical services and treatments after Medicare payment waived. The decision to waive a Medicare deductible, coinsurance or co-payment is made by the SPC partner based on a determination of the enrollee’s financial need.

“Currently, the facilities we are contracted with in the southern Minnesota area are the Madelia Hospital and the Mankato Clinic,” Taylor said. “We are working with more hospitals and clinics. They need to do charity too and this is a win-win, because they are providing services for seniors in need.

Taylor said bigger medical facilities, such as Mayo, have their own similar organizations, which SCS directs seniors to if they are in that service area.

“Many of them have their own charity programs,” she said.

Most of the treatments available at the SPC-partnered facilities are covered.

“Most treatments or services you receive from an SPC partner that are covered by Medicare should be covered by this program,” Taylor said. “But we are not insurance, HMO, PPO or a Medicare supplement.”

The program does not pay for medical bills. To receive support, SPC enrollees must use the SPC medical health care provider partners, and the service or care provided must be allowed by Medicare.

“What we’re trying to do is bridge that gap between what Medicare covers and the charge for the services,” Taylor said. “Health care equals quality of life; they go hand in hand … Our strategic vision is to mobilize the community to re-imagine aging and enhance the quality of life for older adults, and I think the SPC program compliments that.”

More information on the SPC program is available by calling Jodie Harmon at (888) 541-5488, or visiting the Website seniorcommunity.org