By Cate Kortzeborn
When someone with Medicare finds his or her way to my office phone, it's often because of a complicated and snarly issue that's going to take time to fix.
However, it's sometimes a Medicare beneficiary who found my number somewhere and called for some basic help in understanding their coverage. I love those calls because I have a quick and easy answer for folks like that.
I refer them to the State Health Insurance Assistance Program, or SHIP. There's a SHIP in every state in the country. I have phone numbers for the ones in my Medicare region written on a card right next to my phone, and I refer to it often.
SHIPs are nonprofit organizations that help people with Medicare understand their benefits better. The counseling is personalized and it's absolutely free.
SHIPs aren't connected to any insurance company or health plan, so they're not trying to sell you any kind of product. If you're eligible for Medicare, you're eligible for assistance from your local SHIP. You can talk to a SHIP counselor over the phone, or go to your local SHIP office for face-to-face assistance.
The quality of the counseling is terrific. Many SHIP counselors have Medicare themselves, and they're well-trained to answer your questions. They know all the ins and outs of the program, whether you have Original Medicare (where you choose the doctor or hospital you want and the government pays your providers directly) or Medicare Advantage (in which private insurers offer healthcare services through a specific network of doctors, hospitals and other providers). SHIPs also can help with Part D prescription drug insurance.
And did I mention that SHIP counseling is free?
Here are some of the issues that a SHIP counselor can help you with:
- Billing problems.
- Complaints about your medical care or treatment.
- How to shop for a Medicare Advantage health plan or Part D prescription drug plan that meets your needs.
- How to appeal if you disagree with coverage or payment decisions by Medicare or your Medicare plan.
- How Medicare works with other insurance.
How do you get in touch with the SHIP nearest you? You can get phone numbers and other information for SHIP offices in all 50 states, the District of Columbia, Puerto Rico, Virgin Islands and the Pacific Territories at www.medicare.gov/Contacts.
Of course, there are other ways besides SHIP to get information about Medicare. One excellent resource is the "Medicare & You" handbook, which is mailed to Medicare beneficiaries every fall. "Medicare & You" is a goldmine of easy-to-understand information about how Medicare works, how to enroll, what services are covered and many other topics. The handbook also lists all Medicare Advantage and Part D plans available in your area, their costs and contact information for each one. You can find the latest edition of "Medicare & You" online at www.medicare.gov/medicare-and-you.
Help is also available through the Medicare customer service center at 1-800-MEDICARE (1-800-633-4227; TTY users call 1-877-486-2048). The call center is open 24 hours a day, including weekends.
Another helpful resource is the official Medicare website at www.Medicare.gov. The website has a wide variety of information about Medicare health and prescription drug plans in your area, including what they cost and what services they provide. Medicare also rates the plans based on its five-star rating system.
At www.Medicare.gov, you also can:
- Look for doctors or other healthcare providers and suppliers who participate in Medicare, and see what Medicare covers, including preventive care services like cancer screenings and vaccinations.
- Get Medicare appeals information and forms.
- Get information about the quality of care provided by plans, nursing homes, hospitals, home health agencies and dialysis facilities.
- Look up helpful websites and phone numbers.
Reprinted with permission byJack Cheevers, Public Information Officer, U.S. Centers for Medicare & Medicaid Services, Region 9, San Francisco.