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December 3, 2020
Connecting Older Adults and Individuals with Disabilities to
Health Services: Resources for Constituents
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Navigating the U.S. health and long-term care systems can
be confusing and complex for some constituents. Older
adults and individuals with disabilities may face additional
challenges in identifying and accessing needed health care
and long-term services and supports (LTSS), such as home
and community-based services that can assist individuals in
maintaining their quality of life and living independently.
Decisions about rehabilitative services or LTSS may be
made in response to an emergency or crisis. Older adults
and individuals with disabilities, as well as their family
members, may have limited understanding of available
options for home care versus institutional care, either for
short-term rehabilitation or extended care needs. Moreover,
public programs may be financed through different funding
streams (e.g., Medicare, Medicaid, Older Americans Act
[OAA]), and some are state or locally administered. As a
result, eligibility for certain public programs can vary by
state or local entity and may be limited only to individuals
with low-incomes or high levels of care need. Private
funding, such as long-term care insurance, for example,
may be one option for individuals to offset the potential
high costs associated with needed long-term care.
In an effort to simplify access to information about health
care and LTSS options for older adults and individuals with
disabilities, many states have developed No Wrong Door
(NWD) systems, which are collaborations between the
Administration for Community Living (ACL), the Centers
for Medicare & Medicaid Services (CMS) within the
Department of Health and Human Services (HHS), and the
Veterans Health Administration (VHA) within the
Department of Veterans Affairs. State-administered NWD
systems assist individuals and families needing information
about public programs or private resources and can help
with counseling and future planning for LTSS options.
NWD systems also serve as the entry point to publicly
financed LTSS, including programs and services funded
under Medicaid, OAA, and VHA, as well as other state or
locally funded programs.
This In Focus describes federally funded resources that
provide information, outreach, and assistance to help
constituents find, navigate, and access available public and
private health care and LTSS. It is organized into three
groups of resources that can assist constituents connect to
(1) health programs and benefits, (2) home and community-
based services, and (3) health care providers and facilities.
Table 1 lists the websites and contact information for the
various resources described.
Connect to H ath Prgrm
ACL funds and administers grants to states for the
following activities that help individuals connect with
programs and benefits:
Aging and Disability Resource Centers(
Local Aging and Disability Resource Centers (ADRCs)
provide one-on-one options counseling and assistance with
accessing a wide range of publicly and privately financed
LTSS and caregiver supports. Examples of ADRC services
include providing application assistance, screenings and
needs assessments, care coordination, support services for
individuals transitioning from hospital-to-home and nursing
home-to-home, and services to mitigate social isolation.
ADRCs are part of the No Wrong Door system
(https://nwd.acl.gov/), which aims to streamline and make
seamless the navigation of LTSS.
Stat Heath asurnce ssitanc Prgram
State Health Insurance Assistance Programs (SHIPs) offer
one-on-one health insurance counseling to Medicare
beneficiaries. SHIPs assist constituents with joining,
leaving, or switching their Medicare Advantage health
plans and/or Medicare Part D Prescription Drug Plans.
SHIPs assist Medicare beneficiaries with issues related to
their other health coverage, such as retiree health benefits,
Medicaid, long-term care insurance, and Medigap
(Medicare supplemental insurance). SHIPs answer
constituents' questions about covered benefits, premiums,
cost-sharing (such as deductibles and coinsurance), and
complaints and appeals (e.g., about denials of coverage).
Benefits Enrollment Centers (BECs) help Medicare
beneficiaries, including older adults and younger
individuals with disabilities, identify and apply for other
programs for which they may be eligible. Such programs
may include Medicaid, the Supplemental Nutrition
Assistance Program (SNAP), the Low-Income Home
Energy Assistance Program, Supplemental Security
Income, and pharmaceutical assistance programs. BECs are
supported in part by the National Council on Aging's
(NCOA's) Center for Benefits Access.
BenefitsCheckUp is an online tool and phone helpline that
helps older adults find benefit programs they may be
eligible for. Constituents answer a confidential
questionnaire/screener, and they receive a contact list for
potential benefit programs they could investigate further.
Such programs can help with topics such as tax relief, food
and nutrition, housing, utilities, discounts, employment,
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