Arleen Goodwin and Joan Kloehn founded the small Berkeley nonprofit Senior Medi-Benefits in the mid-eighties hoping to assist seniors with the paperwork generated by illness, so that people whose medical bills and insurance claims were piling up would get some help. People assumed that such nightmares would slowly recede as health providers joined networks with interconnected billing, and more claims would be submitted electronically.
Most people know what happened next. Hospitals, clinics and insurance companies merged, changed names, disappeared or issued ever-changing plans every year. Premiums doubled, then tripled, deductibles and “out of pocket” minimums skyrocketed. Seniors would be sent a letter saying their insurance companies no longer offered coverage, and the scramble would begin anew for ever more expensive health insurance.
One elderly couple who bought supplemental insurance from a friendly salesperson, thinking to find a way to cover the gap between Medicare’s coverage and their actual costs, had the friendly young man call a month later explaining with apologies that his company’s plan was no longer offered.
In the meantime, the sizeable bulge in the population of elderly citizens grew as inexorably as insurance premiums, and more and more families now face the difficulties of trying to plan for long-term care.
Enter Arleen and Joan, joined by their new associate Matt Olesen, who work as a team to help with Medi-Cal eligibility on behalf of families whose savings have dwindled as medical and nursing home costs rise. Senior Medi-Benefits’ work on behalf of California families is making a difference family by family as well as reforming systemic county-wide mistakes.
“Many families have had their applications wrongly denied,” states Arleen. “We battle for an individual application, but we also work cooperatively with the state to make sure the eligibility workers at the county level understand people’s rights.”
Discharge planners sometimes help with long-term care applications, as lawyers sometimes do. The discharge workers are overworked and underpaid; lawyers are overworked and ... expensive. Berkeley’s own Senior Medi-Benefits is the only nonprofit working with families on a case-by-case basis, step by step, until an application is finally approved.
“Many families don’t know whether they have to sell the house, how much money is too much, and they’re afraid to ask,” says Joan. “We’re not the government, not the state. We’re the place you can call to get the facts when you need them.”
Two commendations from the city hang on Senior Medi-Benefits’ walls. But the real thanks are from the families who’ve saved thousands of dollars by getting appropriate counseling before their assets are gone.
Health issues may never simplify, as co-founders Arleen and Joan once hoped, but it is certain their 17-year-old nonprofit will battle on, family by family and issue by issue, to make sure seniors get the assistance they need.
Senior Medi-Benefits’ number is (510) 420-0550, and online at www.seniormedi-benefits.org.
Carol Denney, a Berkeley resident, is the coordinator of medical claims for Senior Medi-Benefits.