Medicare options can be very confusing, especially for new retirees who are just qualifying for coverage.
Choosing the wrong options, or missing an important option, could have significant financial and medical care implications.
There is a free service available to help Medicare eligible individuals and their family members make an informed decision regarding their Medicare options.
What is SHIP?
SHIP stands for “State Health Insurance Assistance Program.” The mission of the SHIP Center is to provide helpful information for Medicare-eligible individuals. The Center is supported by a US Government grant. In other words, your hard earned tax dollars at work.
Why not utilize the service?
There is a SHIP program in every state to help individuals navigate Medicare, Medigap and Medicare Advantage options. These programs offer one-on-one counseling and assistance to help people understand their choices, including state specific options.
The Center touts offering unbiased help regarding Medicare coverage options. I see this as being similar to the Human Resources department at a company that helps employees make informed health insurance decisions during their annual open enrollment period.
SHIP services website
Their official website is SHIPtaCenter.org. There is a lot of good information on the site related to Medicare benefits.
Some of the information provided on the website includes:
- SHIP locator – found right on the main page – allows you to pick your state and then provides the contact information to receive one-on-one assistance
- The blog page contains articles written every month or so on Medicare relevant topics such as:
- Medicare’s Open Enrollment Period
- Protecting yourself from Marketing Violations when dealing with private companies selling Medicare Advantage Plans and Part D plans
- How to Lower your Part D drug costs
- The Success Stories page has videos of people helped by the SHIP Center as an example of how they can help you
- There is also a page for people interested in being a SHIP Volunteer
Health insurance counseling
After going to the SHIP state locator page, you will receive the contact information for your local SHIP office. You can then reach out and give them a call with your Medicare question. You could even call just to have a discussion to better understand your Medicare plan options.
SHIP representatives will provide one-on-one insurance counseling. They make it clear that their service is not just for people new to Medicare. Support is provided to any anyone facing Medicare decisions, including those just wanting a review of their annual options.
Their brochure and website break down the common areas of help they provide, including troubleshooting billing issues, enrollment assistance, discussing Medicare-related insurance options, coverage, understanding healthcare costs, and many others. Prescription drugs and the related plan choices are another area of counseling assistance provided.
Pitfalls of making the wrong Medicare related choices
When it comes to Medicare, making an uniformed choice can be quite costly, both financially and medically.
I recently read a Wall Street Journal article titled “The Big Mistakes People Make in Medicare – And How to Avoid Them.” The article featured one man, age 66, who stated ‘I was so stupid.’ By that he meant he did not do a thorough job of investigating his options when selecting his health plan.
He selected a Medicare Advantage plan instead of Traditional Medicare due to the perceived savings. He then turned out to have prostate cancer, and unfortunately, the Advantage plan did not have the specialists available for the treatment he wanted. Under the rules, he could not just switch back to Medicare and get Medigap coverage because he no longer had the protection of a “guaranteed issue right.” That means he could be denied coverage, as he was with Medigap.
Many of the other mistakes mentioned in the article also dealt with choosing Medicare Advantage Plans. These plans are network health plans, which limits the doctors and coverage areas. These plans tend to be attractive up front due to their premium pricing. The issue is that the cheap pricing likely pays off if you have minimal or basic utilization. If you have a significant medical issue needing specialty care or move outside of their coverage area, you could be in trouble.
The same applies for choosing a Part D drug benefit. You could pick a plan that is not the right one for the medications you take.
Finally, the article talked about the issue of biased advice. This means that the insurance company selling you the Advantage Plan might not tell you the whole story regarding their coverage.
After reading the article, it helped confirm that reaching out to the Certified Medicare Counselors at SHIP is a smart move to get some help selecting or confirming the right plans for you.
Counseling service reach
To get an idea as to how many people utilize the service, I pulled up the data for my local SHIP office and their stats provided the following for last year (2022):
- Last year over 54,000 people were helped in the state
- The average time spent on a counseling call was 40-50 minutes
- Some meetings were face to face at the counseling office and some were home visits
- Many people were helped over the phone, email or had a web based interaction
- Over 800 outreach events were performed, with over 20,000 attendees
The other important piece of information from the state were the number of options available. The number of health plan options is staggering. No wonder utilizing a local ship counselor makes so much sense. Even if you think you have it figured out, why not run your planned choices by an expert for validation?
For last year, the state stats mentioned that there were 24 Part D prescription drug plan options, 29 companies selling Medigap plans and 100 Medicare Advantage plans to choose from. That is a lot of information to sift through!
Executive Summary: Use the SHIP Center for Medicare insurance assistance
- SHIP stands for “State Health Insurance Assistance Program.” It is primary funded by government sponsorship.
- SHIP has a Center (HQ) with local area agencies in every state
- Their mission is to help people make informed decisions regarding their Medicare options
- Local area state agencies provide one-on-one assistance
- Their website, ShipTACenter.org contains a state assistance locator, a blog page with useful articles, and success stories helping people
- Their services are not just for those new to Medicare, but others who want to evaluate their Medicare options during open enrollment
- Making a wrong choice can be costly, both financially and medically. This is where SHIP can be a valuable resource to help you make the best choice