There are so many benefits, both
financial and assistance-oriented to which individuals are entitled.
These include community-based programs, state or federal assistance
programs (such as Social Security, Medicare, and food stamps), as
well as retirement and insurance programs to name a few. One of the
issues with having so many benefits available to elderly and
disabled individuals is that it is difficult to track them and find
out which ones are appropriate for the situation. This is where a
benefits counselor can help.
The term benefits counselor can
be applied to either a paid staff person for an agency or a trained
volunteer. In simple terms, a benefits counselor is someone who
reviews existing information about your financial situation and
makes suggestions about benefits for which someone may be eligible
or changes in existing benefits you may already be receiving.
The Older American Act
authorizes benefits counselors to provide information to elderly
individuals concerning benefits for which they may be eligible. In
addition, individuals can receive advocacy assistance and referrals
to appropriate agencies that may be able to assist them. In
particular, the act emphasizes individuals who may not have the
capacity to assist themselves in cases where there may be disputes
Who are Benefits Counselors?
Generally, benefits counselors
work with individuals who are aged 60 and older. If someone has a
disability, they are also entitled to receive benefits counseling
information. Many of them work with or volunteer for agencies like
the Area Agencies on Aging (AAA). With the AAA, there are stringent
criteria for benefits counselors and certification levels are
available. The various certification levels designate the types of
cases for which someone can receive assistance.
Individuals receive free
assistance from a benefits counselor. It is not attorney
representation, however. Individuals who need legal representation
may still receive a benefits counselor; however, the benefits
counselor will not be able to represent them in court.
Not only paid staff can work as
benefits counselors. Many states have training programs for
volunteers who will work in conjunction with paid staff to assist
people with benefit information. The training program often includes
the examination process to certify volunteers at a particular
benefit level. Volunteers are trained to recognize cases which they
are not certified to assist and will refer these individuals to paid
staff members within the agency who can help them.
How Can They Help?
There are many different
organizations that provide benefits to individuals, depending on
their situation. It can be confusing to figure out what the
eligibility requirements are, how to apply, what types of
documentation are needed when applying, and many other issues that
arise when looking at benefit programs. Throw in supplemental
insurance policies and you have a recipe for confusion.
Trained benefits counselors can
step into the situation and sort through the “confusion” to help
develop a cohesive benefits plan for someone. Just because the
counselor helps sort through the benefits available doesn’t mean
that you’ll automatically be eligible. Each organization still has
specific criteria and cases need to be examined separately. Still,
the benefits counselor serves a valuable role in discovering
possible avenues for benefits that give families alternatives that
may not have been known before.
The types of information that
benefits counselors can examine include (but may not be limited to):
Social Security benefits
Social Security Disability
Medicare, including the new
prescription benefit section (Part D)
programs (for individuals not eligible for Medicare)
Income tax benefits and
State program benefits,
including home care alternatives
Advocacy with agencies, if
Referrals to community based
organizations or government agencies.
Make sure you have your
documentation available when you speak to a benefits counselor.
Things to consider taking with you to an appointment include:
Recent statements from your
Recent bank account
statements (although they may not need them)
Medications that you are
currently taking (for Medicare Rx or other prescription benefit
concerning benefits you are already receiving
Social Security statements
and card (if available)
Any other state, federal, or
community program where you are currently enrolled.
What if you’ve applied for
services and have been denied, yet you still feel that you qualify?
A benefits counselor can examine your case individually and try to
advocate on your behalf. Advocacy does not guarantee services,
however. Advocacy gives a voice where you may not have the words
needed to explain your situation. Indeed, advocates for individuals
may be able to sort through the requirements and find out if there
has been miscommunication, missing documentation, or other
communication barriers that prevent you from receiving specific
benefits. If you are still denied benefits, at least you will feel
like you have received the total attention of the “system.”
Where do they work?
Benefits counselors do not
always work for the AAA. Because the AAAs were empowered by the
Older Americans Act, you can search for a certified benefits
counselor through these agencies. However, there are other
organizations that employ benefits counselors. Some of these
examples include your local human service offices, county welfare
offices, and community-based organizations that serve the elderly
Another method you can use to
find a benefits counselor is by calling an information and referral
helpline. In more than 46 percent of the United States, you can dial
2-1-1 and reach a trained professional who can identify
organizations in your community where benefits counselors work. If
your area does not have access to 2-1-1, usually there is one point
of entry into the human service system. Some places call it a
helpline while others call it information and referral. To find out
if your community has access to 2-1-1, you can look online at
www.211.org. The nationwide status map can also give insight into
where to call if your area is not served by 2-1-1.
Learning about available
benefits for yourself or someone else can be challenging. For this
reason alone, it is important to have a trained professional review
your situation and point out avenues you may not have considered
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