Elder Benefit Specialist Program:
A Legal Services Program of the Area Agency on Aging of Dane County
The Dane County Elder Benefit Specialist Program is administered by the Area Agency on Aging (AAA) of Dane County and is co-located and operated in partnership with the Dane County Aging and Disability Resource Center (ADRC). The EBS Program provides legal advice/representation for senior adults (age 60+) residing in Dane County that are faced with benefit, housing and other disputes or denials, complications, changes in benefits, claims not paid, and other similar issue groups that have an economic or socially isolating effect on the older adult.
Elder Benefit Specialists receive in-depth, on-going legal training. Elder Benefit Specialists (EBS), along with their program attorneys at the Greater Wisconsin Area on Aging and Resources (GWAAR) and AAA management, prioritize legal case work based on client need.
EBS High Priority List:
- Appeal or reduction of benefits with approaching deadline (60 days or less), or past deadline
- Medicare Advantage appeal (60 day appeal window)
- Medicaid appeal (45 day appeal window – no late appeals)
- Eviction notice or pressing housing issue
- Social Security or SSI overpayment (60 day appeal window)
- Pharmacy/drug coverage issue – immediate need for medication
- Court proceedings
EBS Normal Priority List:
- Original Medicare appeal (120 day appeal window)
- Original Medicare or Medicare Advantage Plan billing issue
- FoodShare appeal (90 day appeal window)
- Private insurance appeal or billing problem
- Pharmacy/drug coverage issue – no immediate need for medication
- Social Security or SSI Disability initial application (Per DHS, EBS can only accept disability appeal cases if client has rejection letters from 2 attorneys who practice disability law within 100 mile radius of client’s home)
- Medicaid Disability Application (MADA)
- Debt collection issue
Elder Benefit Specialist Program Referral Process
Potential EBS clients that are new to the program should first contact the ADRC Information & Assistance helpline by calling (608) 240-7400. An I & A Specialist will discern their particular issue, in many cases assist the client to resolve the issue, or escalate their issue to an EBS through an internal referral to the program if necessary.