State Health Insurance Program (SHIP)

Frequently asked questions about SHIP

On my birthday, I will be eligible for Medicare. Can you help me?

Yes. Both the Medicare and Social Security websites have a vast amount of information addressing this particular question. Check out www.Medicare.gov or www.SSA.gov. You may also obtain a copy of Medicare and You from Medicare or our office or call Medicare directly at 1-800-633-4227. If you prefer, contact our SHIP counselor who will be able to give you the timelines on when you need to enroll and various options available to you for insurance plans that include: Prescription Drugs, Supplemets and Medigap Plans.

Part D Plans, Supplements, Medigap Plans, Advantage Plans are very confusing, how can I figure out what is best for me?

You may refer to the Medicare website www.Medicare.gov, the Medicare and You booklet (which is also available for view on the site) that will list the Advantage and Part D plans available in your State or contact Medicare directly at 1-800-633-4227. If you prefer, our SHIP counselor, with your help and information, can give you the options for assistance programs and plans that you are eligible for in your area. They will answer any questions you might have.

What if I am having a problem with an Employee Plan or COBRA?

If your benefits associate at your former place of employment cannot assist you, the SHIP counselor may advocate and assist as a third party to interpret the information. There are specific Federal Guidelines for COBRA which the SHIP counselor can provide information.

My doctor just changed my medications and they are not on my Part D plan formulary.

Our SHIP counselor can assist in reviewing your current plan. S/he will check to see if you qualify for changing to a plan that will cover it or look into a prescription assistance program.

I retired with an employee benefit plan that is getting too expensive for me to keep, can you help?

You may wish to review plans in your zip code utilizing the Compare Medicare Prescription Drug Programs or Compare Health Plans under the search tools on www.Medicare.gov. We can also do a complete review of your plan and give you the options available through Medicare for your situation. You can then decide on what whether to keep it or not.

There was a layoff and I lost my job and insurance. Are there any programs out there for me?

There could be depending on your location, the medication needed and other personal information that the SHIP counselor can go over with you to determine what you qualify for.

I just received my Explanation of Benefits from Medicare from when I was in the hospital. I do not understand them and it looks like I owe $50,000. Is that true?

Medicare can be contacted directly at 1-800-633-4227 or the billing department at the facility where you were treated for further explanation. If that is not successful, you may contact our SHIP counselor. Until the counselor can go over them, s/he cannot say for sure. The counselor will get a copy of the Medicare Summary Notice (MSN) or bill, if there is one, and review it for clarification so s/he can better advise you.

What is the Senior Medicare Patrol (SMP)?

The SMP program empowers seniors through increased awareness and understanding of healthcare programs. This knowledge helps seniors to protect themselves from the economic and health-related consequences of Medicare and Medicaid fraud, error and abuse. SMP projects also work to resolve beneficiary complaints of potential fraud in partnership with state and national fraud control/consumer protection entities, including Medicare contractors, state Medicaid fraud control units, state attorneys general, the Office of Inspector General and CMS (Center for Medicare and Medicaid Services). For more information you may access www.acl.gov which is the Administration for Community Living website.

Last month I got my Jazzy chair from ABC Medical Equipment Company. They said I did not have to pay anything and now I have a bill for $2000. What is going on? Could it be fraud?

You may contact the Medicare/Medicaid Fraud Hotline at 1-800-447-8477 and they will assist you in evaluating your situation. Your local SHIP counselor may also assist you in investigating this bill and if it is thought to be a fraud case, they can assist you in taking the appropriate action through the Senior Medicare Patrol.