These Free State Programs Help Millions of Seniors Navigate Medicare Open Enrollment Each Year
Each year from October 15 to December 7, current Medicare recipients get a chance to evaluate and make changes to their health care and drug coverage.
This annual opportunity is known as the open enrollment period.
But navigating this process without guidance can be complicated, even overwhelming.
Thankfully, a network of federally funded programs is available to help.
What Is SHIP?
The State Health Insurance Assistance Program, or SHIP, provides one-on-one counseling and assistance to millions of Medicare beneficiaries each year.
SHIP was formed by way of U.S. statute in 1990. Each SHIP receives federal grant money and is administered at the state level by either the Department on Aging or the Department of Insurance.
In 2019, states and U.S. territories received nearly $45 million in federal money to support SHIP services.
The programs have different names in different places, such as HIICAP (Health Insurance Information, Counseling and Assistance Program) in New York and SHINE (Serving Health Insurance Needs of Elders) in Florida.
There are about 16,000 SHIP counselors nationwide, and each one undergoes extensive screening, Medicare training and certification.
Counselors assist people who are new to Medicare as well as those who have been enrolled for some time.
They also work with adult children who are helping their parents navigate the system.
SHIP counselors are trained to help with various Medicare issues, including:
- Open enrollment
- First-time Medicare enrollment questions
- Assistance for lower-income people
- Medicare penalties and appeals
SHIP Makes Open Enrollment Easier
According to a recent Kaiser Family Foundation analysis, 45 percent of people on Medicare in 2017 said they rarely or never review or compare their Medicare options.
The rate was even higher among beneficiaries ages 85 and older.
While some people may be satisfied with their current plans, the analysis points out that “low switching rates could also indicate that many beneficiaries find the process of comparing plans too challenging, are unaware of the open enrollment period, or have limited confidence in their ability to choose a better plan.”
That may be due, in part, to the growing number of available plans to choose from.
In 2020, the average Medicare beneficiary had access to 28 Medicare Advantage plans and an additional 28 Part D plans.
“Medicare can be incredibly complicated to manage and confusing to sort through,” Rebecca Kinney, director of the Office of Healthcare Information and Counseling for the U.S. Department of Health and Human Services’ Administration for Community Living, told RetireGuide.
When it comes to open enrollment, Kinney said SHIP counselors can help people compare plan premiums, deductibles, provider networks, drug coverage and other factors simultaneously to maximize value and lower costs.
Even if you want to use the Medicare Plan Finder tool to explore options on your own, SHIP counselors are still available to answer any questions along the way, Kinney added.
“SHIP is unique in that it is the only national program available to provide this type of service to Medicare beneficiaries at the local level free of charge and with no commissions,” Kinney said.
Medicare Open Enrollment in the Era of COVID-19
Open enrollment is usually the busiest time of year for SHIP counselors, said Shannon Hohl, program supervisor for Idaho’s Senior Health Insurance Benefit Advisors, or SHIBA.
But this is the first year SHIBA is assisting people during a global pandemic.
“I know that nationally, SHIP is a little nervous about open enrollment this year,” Hohl told RetireGuide. “We don’t know if there’s going to be more people needing help, or less. We’re just committed to doing our best to serve everyone.”
Hohl said Idaho is uniquely positioned to accomplish this. Because the state is mostly rural, SHIBA counselors haven been working with beneficiaries over the phone for years.
In many other states, in-person seminars were the primary way counselors educated people about open enrollment.
A Medicare beneficiary could sit beside a counselor while he or she used the Medicare Plan Finder to help them pick the best Medicare Part D or Medicare Advantage plan.
While some states are still offering this, most have transitioned to phone and virtual counseling via Zoom, Skype or Webex.
States have implemented other creative solutions during the pandemic, including drive-through counseling and online webinars.
With a beneficiary’s permission, counselors can even log into a person’s MyMedicare.gov account and see their last 12 months of drug claims, which can help when comparing the cost of Part D plans.
But Hohl notes that each state is adapting to COVID-19 differently. It’s important to contact your local SHIP to see what’s available.
The best place to find the SHIP in your area is through the SHIP Technical Assistance Center locator.
How SHIP Can Help You
During open enrollment, SHIPs can help you navigate the Medicare Plan Finder, understand available enrollment options and walk you through picking the best plan.
These decisions can add up to hundreds — or even thousands — of dollars in out-of-pocket savings each year.
Delaware’s state government website boasts that its SHIP has provided more than 2,930 counseling sessions so far this year, reportedly saving beneficiaries more than $192,000 in premiums.
There’s also Medicare Savings Programs that can help cover premiums and, in some cases, deductibles, coinsurance and copayments.
People with low incomes often don’t realize they’re eligible for these extra help programs, Hohl said.
Since these savings programs are administered at the state level, local SHIP counselors are well-suited to help financially struggling seniors navigate the process.
Counseling sessions can get booked up fast, so it’s wise to contact your local SHIP early in the open enrollment period to make an appointment.
Go to https://www.shiphelp.org to find the SHIP in your area. Or, call the national network at 1-877-839-2675.