The NAPCA Helpline: A Critical Lifeline for Limited English Proficient Seniors

Think about the last time you had to call your credit card company to dispute a charge: navigating complex menus, explaining the problem multiple times, answering the customer representative’s questions, providing information to the representative from your nearly indecipherable credit card statement . . . now imagine if the representative spoke a language you didn’t understand and the phone menus and credit card statement were both in that language.

Rita Pou-l Le, Chinese Helpline Staff

Rita Pou-l Le, Chinese Helpline Staff

This is the everyday reality for hundreds of thousands of Asian American and Pacific Islander (AAPI) seniors in the United States who are forced to conduct critical transactions in a foreign language. The U.S. Census Bureau reports that about 60% of Asian and Pacific Islanders are limited English proficient and one-third of AAPIs are linguistically isolated.

As important as financial health is, the stakes are higher and thus overcoming language barriers is even more critical when physical health is at stake.

The following are actual cases resolved by the NAPCA Helpline, only the names have been changed to protect their privacy.

Mr. Tran faced the loss of an important medication because his current Medicare Part D plan didn’t cover it and he couldn’t afford the monthly $88.51 cost. Furthermore, the online Part D Plan Finder on Medicare.gov is in English and thus not accessible to Mr. Tran who speaks only Vietnamese. Mr. Tran found the NAPCA Helpline phone number in the Seattle Vietnamese Times. To his surprise a man speaking Vietnamese answered and within a few days Mr. Tran was enrolled in a new plan and saw the cost of his medications go from $1,410 to $108 for the entire year.

For many seniors, these savings ensure they can get the medications they need without having to choose between medicine and food or rent. Having to cut pills in half or taking them every other day is an unfortunate reality for many seniors and can seriously jeopardize their health.

Mr. Qien realized even greater savings after reading an Ask NAPCA column in the Chinese language newspaper World Journal when he discovered that ten years of work history in the United States was not a requirement for Medicare eligibility. This came as a surprise to him because he believed, based on other newspapers, friends and insurance companies, that he and his wife were ineligible for Medicare since they hadn’t worked in the United States long enough. Armed with this information Mr. Qien and his wife successfully enrolled in Medicare. Linguistic barriers had previously prevented Mr. Qien from understanding that he was eligible for Medicare.

Mr. Qien again turned to the NAPCA Chinese Helpline after he encountered a problem with his Medicare Part D plan. An important drug prescribed by his doctor to treat his diabetes related anemia, was not covered and would cost Mr. Qien $375 per month. Since Mr. Qien couldn’t afford this cost, he felt his only option was to forego his treatment. As was the case with Mr. Tran, the Plan Finder on Medicare.gov was a resource he couldn’t access since he could only read Chinese.

NAPCA’s Chinese Helpline staff reviewed his plan and medications and identified a plan that would cover all of his medications for a total cost to Mr. Qien of $132 for the entire year. This is almost 1/3 of what he would have had to pay for one medication for one month.

Mrs. Oh also didn’t speak English very well and because most of the information on Medicare Part D’s Low Income Subsidy (LIS) or “Extra Help” was in English she was unaware that she could get assistance paying for her Medicare Part D. She chose not to enroll because she felt she couldn’t afford it. Mrs. Oh called the NAPCA Korean Helpline after learning about it from a friend. A Helpline staff member explained that LIS could help with her medication costs. Helpline staff helped her enroll in LIS and once approved, helped her choose a plan that would maximize her subsidy.

The cost of Mrs. Oh’s medications went from $1,298 to $175 a year.

A report published by NAPCA analyzing the cost savings of callers to the NAPCA Helpline who enrolled in plans recommended by Helpline counselors found the average cost saving during 2014 was projected to be $1,921 per person.

The NAPCA Helpline uniquely addresses limited English speaking AAPI seniors’ needs:

  • AAPI seniors can call the NAPCA Helpline from anywhere in the country toll-free
  • Staff answer calls in Cantonese, Mandarin, Korean, Vietnamese, and English and all staff are well trained in the subject matter of senior benefit programs and eligibility requirements including factors impacting immigrant and refugee seniors
  • Each language has a dedicated phone number to prevent limited English speaking seniors from having to speak to an operator in English or navigate an automated system in English
  • The Ask NAPCA column is published in several Asian language newspapers and Helpline staff regularly appear in Chinese, Korean and Vietnamese radio and television programs
  • NAPCA created a free online Medicare screening tool in several languages, linked to the Helpline for culturally and linguistically competent counseling and enrollment assistance
  • The NAPCA website provides language specific resources and information, also linked to the Helpline

With the complexity of benefit programs and the many changes in the healthcare system, the NAPCA Helpline remains an important lifeline for many AAPI seniors who have limited access to critical resources.
Angelo Locsin is the Special Projects Manager for the National Asian Pacific Center on Aging (NAPCA) and oversees Helpline operations and NAPCA’s information systems. The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.