Counselors offer help with Medicare, Medicaid

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The fall Medicare Annual Open Enrollment Period starts Oct. 15. You might be getting mail urging you to evaluate your Medicare plan. Maybe you could use some impartial guidance. This is where your State Health Insurance Assistance Program (SHIP) can help. SHIP counselors are available to you year-round to answer questions about Medicare, Medicaid, and even suspected insurance scams and billing issues.

SHIP counselors are funded and trained by the U.S. Department of Health and Human Services (HHS) and the Colorado Department of Regulatory Agencies (DORA). Unlike insurance agents or brokers, SHIP counselors are not paid to enroll you into Medicare plans. They are trained to teach you how Medicare insurance works and give you information so you can make informed choices.

Here are a few examples of how SHIP counselors can help:

 Provide personalized information on how you are currently enrolled in Medicare.

Jenny called SHIP because she’d received a lot of mail warning that if she didn’t enroll in prescription drug coverage she’d get a penalty. A SHIP counselor called Medicare with her. Jenny learned that she was already enrolled into a Medicare Advantage plan that included prescription drug coverage. Jenny also learned that her Medicare Advantage plan included some dental coverage. Since Jenny was happy with her medical care, she decided to keep her Medicare Advantage plan and to call member services to find a dentist.

 Evaluate your prescription drug coverage.

Ron called SHIP after receiving the “Annual Notice of Coverage” from his Humana Walmart prescription drug plan. The letter said his premium was going up sharply in 2020, and Ron didn’t even take prescription drugs. A SHIP counselor helped him find and enroll into the lowest premium prescription drug plan for 2020.

 Screen you for state benefits that pay the Part B or D premiums, copays, and deductibles.

Ted, under 65 years old and soon to receive Medicare due to disability, asked if he could stay on Medicaid because he couldn’t afford the premium for Part B. A counselor screened Ted for a Medicare Savings Program and determined that he might be eligible to have the Part B premium paid by the State of Colorado. Also Ted was eligible for “Extra Help,” a federal program that lowers the cost of Part D premiums, deductibles, and copays. A SHIP counselor helped Ted apply for the Medicare Savings Program over the phone and Ted then automatically received Extra Help for his prescription drug costs.

 Help you prevent, detect, and report suspected insurance errors, abuse, or fraud.

Janet called after discovering that her mother had both a Medicare Advantage plan and a Medigap supplemental plan from the same insurance company. Because this is not legal, SHIP reported it to the Colorado Division of Insurance which regulates Medigap plans sold in Colorado. The insurance company was required to reimburse Janet’s mother for several thousand dollars in Medigap premium payments.

As a bonus, the SHIP program for Douglas County is part of the Denver Metro Area Agency on Aging. Its counselors can connect you with the Community Resources Team to find resources like food and transportation. They can refer you to in-house programs like Veterans Assistance, Options Counseling, Case Management, the Elder Refugee Program, and the Transitions team that helps people move from a nursing facility back to their community.

You can find your national SHIP number on the back of your “Medicare and You” book: 1-888-696-7213. If you are a resident of Douglas County you call reach your local SHIP at 303-480-6835 or ship@drcog.org.

Jean Anhalt, SHIP/SMP Counselor, is with Area Agency on Aging at Denver Regional Council of Governments. This column is hosted by the Seniors’ Council of Douglas County. Please join us for our next virtual online presentation Nov. 5 at 10 a.m. Jean Anhalt will be our presenter about the SHIP program and what resources are available to help you with the annual Medicare open enrollment period. For more information, please visit www.MyDougCoSeniorLife.com, email DCSeniorLife@douglas.co.us or call 303-663-7681.

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