In late 2004 UNL Extension was chosen as one of five state universities nationwide to launch a pilot program in order to educate and enroll eligible Nebraskans in the first phase of the new Medicare benefit, the temporary prescription drug card program. Over 40 Extension staff responded and helped hundreds of Nebraskans. See EARS Report 3616.

Nationally, however, SHIIP enrollment still lagged behind. Only 13% of those eligible had enrolled. Yet nearly 75% reported difficulty paying the escalating costs of their prescription drugs. For those who took several medications daily, the struggle to pay for prescriptions could force them to choose between paying for medications or groceries.

Teamwork and collaboration among agencies, organizations and individuals - UNL Extension among them - enabled Nebraska to be a leader nationally in educating seniors and the public about changes in Medicare.

• Twelve UNL Extension professionals remain committed to Medicare education as a programming priority.
• Ten UNL Extension staff are trained Senior Health Insurance Information Program (SHIIP) counselors.
• During the third annual Medicare Prescription Drug Open Enrollment period, November 1 - December 31, 2007, Extension staff hosted 128 enrollment events. and since November 1, 2007, have assisted 1,083 clients at these events or in their office.
• Since November 1, 2007, staff enabled approximately 494 Medicare beneficiaries to enroll into a plan or change plans (58% increase over previous year,) with an approximate savings to the beneficiaries of more than $267,900.00.
• Through education, staff referred over 45 beneficiaries for low-income subsidy assistance.
• A grant was funded by Nebraska SHIIP to support UNL Extension's involvement in Medicare education and enrollment.
• According to statistics released by the Centers of Medicare and Medicaid Services (CMS,)Nebraska ranks 3rd in the nation with nearly 90% of Medicare beneficiaries having prescription drug coverage.
• Since UNL Extension's first involvement in 2004 with the initial phase of Medicare's Prescription Drug Program, Extension staff have counseled approximately 5247 beneficiaries or family members, enrolled or changed plans for 1924 individuals, with an approximate total savings in that time of $2,198,870.00.
• Since 2004, the Medicare Prescription Drug link on the UNL Extension website has been accessed 8,762 times.

In early 2005 a small group of Nebraska state and federal agencies, including UNL Extension, banded together to form the Nebraska Medicare Prescription Drug Coalition. A strong network of key stakeholders was built in order to use a consistent, accurate message and coordinated effort to implement the new prescription drug benefit scheduled to start January 1, 2006. Over 17 Extension staff across Nebraska continued to work with Medicare Prescription Drug education and enrollment. (See EARS report 3992.)

UNL Extension remains a key member of the Coalition and in late 2006 formed two unique grant-driven partnerships with Nebraska Senior Health Insurance Information Program (SHIIP) and AARP Nebraska, in order to provide educational sessions, individual counseling and enrollment assistance about the new benefit.

Four Extension Educators located in the southwest, northwest, east-central and southeast areas of the state have made long-term commitments to Medicare education. Eight additional staff from across the state have been trained by SHIIP and are working with Medicare education.

In September 2008, Extension staff shared their Medicare knowledge and educational techniques with those attending the National Extension Galaxy Conference in Indianapolis, Indiana.

In the last year, the focus of Medicare education has broadened. In addition to providing Medicare Prescription Drug assistance, staff have expanded their educational efforts regarding Medicare's Prevention Benefits and Online Tools. Another change in educational delivery was increasing one-on-one counseling and informational sessions rather than hosting large groups

UNL Extension continues as a key stakeholder in the Nebraska Medicare Coalition. Locally, Extension staff working with Medicare education collaborate with a large number of volunteers, agencies and organizations throughout the state.