Benefits Counselors
Who are they and do I need one?

By Sandra Fusion, Staff Writer

 

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 concerning benefits.

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):

  • Insurance benefits

  • Social Security benefits

  • Social Security Disability benefits

  • Medicare, including the new prescription benefit section (Part D)

  • Prescription Assistance programs (for individuals not eligible for Medicare)

  • Income tax benefits and credits

  • Retirement benefits

  • Veterans benefits

  • Community-based benefits

  • State program benefits, including home care alternatives

  • Advocacy with agencies, if needed

  • 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 insurance company

  • Recent bank account statements (although they may not need them)

  • Medications that you are currently taking (for Medicare Rx or other prescription benefit programs)

  • Retirement statements concerning benefits you are already receiving

  • Social Security statements and card (if available)

  • Disability benefits currently receiving

  • 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 and/or disabled.

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 investigating.

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