Unbiased, Confidential Assistance
Understanding benefits and programs can be complex, but you don’t have to do it alone.
The ADRC’s benefit specialists are here to provide unbiased and confidential assistance to older adults and adults with disabilities.
They can help navigate programs like Medicare, Medicaid, Social Security, and other public and private benefits.
Whether you need help applying, understanding your options, or resolving issues, our specialists are ready to assist you.
Explore Available Programs
What is Medicare?
Medicare is health insurance for people 65 or older, people under 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD).
The ABCDs of Medicare
Medicare Part A (Hospital Insurance) covers:
- Inpatient care in hospitals
- Skilled nursing facility care
- Hospice care
- Home health care
Medicare Part B (Medical Insurance) covers:
- Services from doctors and other health care providers
- Outpatient care
- Home health care
- Durable medical equipment (wheelchairs, walkers, hospital beds, etc.)
- Preventive services (screenings, vaccines, annual wellness visits)
Medicare Part C (Medicare Advantage) is a private plan alternative to Original Medicare that bundles Part A and Part B, often including Part D and extra benefits.
Medicare Part D covers:
- Prescription drugs
- Recommended vaccines
What are my Medicare coverage options?
When you enroll in Medicare, there are two main options:
- Original Medicare
- Includes Part A and Part B
- Option to add Part D (drug coverage)
- Use any provider that accepts Medicare nationwide
- Optional Medigap or other supplemental coverage
- Medicare Advantage (Part C)
- Bundled plan including A, B, and usually D
- Typically requires in-network providers
- May require prior authorization
- Variable out-of-pocket costs and premiums
- May include extra benefits (vision, dental, hearing)
How do I compare and choose the right Medicare options?
ADRC Benefit Specialists are certified SHIP counselors who provide free, unbiased guidance. Contact the ADRC to request an appointment.
You can also learn to compare plans using these resources:
What is Medicaid?
Medicaid is Wisconsin’s program for health care assistance.
There are a variety of Medicaid programs, each with different rules for eligibility, both financial and non-financial. Waupaca County Economic Support, a.k.a. East Central Consortium determines eligibility.
How to Apply for Medicaid Health Care
Medicaid applications require many forms. You can apply for most programs in a variety of ways such as:
- Online at access.wisconsin.gov
- Call East Central Consortium 1-888-794-5747
- In-Person or via Paper Application with the Waupaca County Economic Support Office
- Or with help from an ADRC Benefit Specialist: 715-258-6400
How to Apply for Medicaid Long-Term Care
Long-term care is for persons who are no longer able to complete day-to-day activities such as bathing, dressing, meal preparation, etc. without assistance.
The ADRC is the place to start to learn about and apply for Medicaid long-term care programs. The application process is extensive and requires applicants to meet both functional and financial criteria. We are here to guide you through it! For more information, contact the ADRC.
Programs and Benefits through Social Security
Retirement Benefits – Monthly income for eligible workers starting as early as age 62.
Disability Insurance (SSDI) – Support for people unable to work due to a qualifying disability.
Supplemental Security Income (SSI) – Needs-based assistance for individuals with limited income and resources, including older adults and people with disabilities.
Survivors Benefits – Financial support for family members of a deceased worker, such as spouses or children.
Spousal Benefits – Benefits for spouses or ex-spouses based on a worker’s earnings record.
Medicare Enrollment – Social Security handles enrollment for Medicare Parts A and B.
Support with Navigating Social Security Benefits
ADRC Benefit Specialists are here to help you navigate the often confusing world of Social Security. Whether you have questions about retirement, disability (SSDI), Supplemental Security Income (SSI), or spousal benefits, we can provide clear information and personalized support to help you understand your options and apply with confidence. Contact the ADRC to request an appointment with a benefit specialist!
How do I apply for Social Security benefits?
All applications for benefits are processed first at your local SSA office
Social Security Administration
607 W Northland Ave, Appleton, WI 54911
Call 800-772-1213 to request a phone or office appointment. You can also file the application online.
ADRC Benefit Specialists can assist with the application process!
ADRC Benefit Specialists may be able to help with other private or government benefits such as those listed below. Contact the ADRC to inquire more about your specific question or situation!
- Prescription Drug Coverage Assistance or Reduced Costs
- Wisconsin FoodShare Program
- Housing and Utility Issues
- Financial Assistance Programs