Senate Proposes Elimination of Crucial Medicare Counseling Program

Mitchell ClarkMedicare WatchLeave a Comment

The U.S. Senate Appropriations Committee recently approved a 2017 spending bill that completely eliminates funding for the Medicare State Health Insurance Assistance Program (SHIP).

Older adults, people with disabilities, and their families and caregivers need assistance understanding the A, B, C and Ds of Medicare. Operating in every state, SHIPs answer questions about Medicare and help people solve problems. Eliminating SHIPs would leave millions who need support comparing coverage options, appealing denials, applying for financial assistance, and navigating increasingly complex Medicare benefits stranded—with nowhere to turn.

Today’s Medicare beneficiary must choose among more than 20 prescription drug plans, an average of 19 Medicare Advantage plans, as well as various Medigap supplemental insurance policies—all with different premiums, cost sharing, provider networks, and coverage rules. For more than 24 years, SHIPs have advised, educated, and empowered individuals to navigate their state-specific Medicare choices. Specifically, SHIPs help beneficiaries resolve fraud and abuse issues, billing problems, appeals, and enrollment in low-income protection programs. In 2015, SHIPs provided assistance to more than 7 million people with Medicare.

Take Action

As 10,000 Baby Boomers age into Medicare each day, rather than defund SHIPs, Congress needs to increase SHIP funding. Join Medicare Rights and the National Association of Area Agencies on Aging (n4a) and write to your elected officials about why investing in unbiased, personalized Medicare counseling is important to you and your community.

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Why are the SHIPs so important?

  • The mission of the SHIPs is to empower, educate, and assist Medicare-eligible individuals, their families, and caregivers through objective outreach, counseling, and training, to make informed Medicare related health insurance decisions that optimize access to care and benefits. As such, SHIP counseling encompasses many issues, including: coverage options, fraud and abuse issues, billing problems, appeal rights, and enrollment in low-income protection programs.

  • SHIPs receive funding under the Administration for Community Living (ACL) for 54 grantees (all states, Puerto Rico, Guam, DC, and the US Virgin Islands), overseeing a network of more than 3,300 local SHIPs and over 14,500 counselors, 57 percent of whom are highly trained volunteers who donate almost 2 million hours of assistance.

  • In 2015, over 7 million people with Medicare received help from SHIPs. Since 1992, counseling services have been provided via telephone, one-on-one in-person sessions, interactive presentation events, health fairs, exhibits, and enrollment events. Individualized assistance provided by SHIPs almost tripled over the past 10 years.

  • SHIPs assisted nearly 1.1 million beneficiaries during the annual Medicare Open Enrollment Period in 2015, providing over 600,000 hours of work. Making informed decisions among an average of 20+ prescription drug plans and 19 Medicare Advantage (MA) plans, as well as various Medigap supplemental insurance policies, can save money and improve access to quality care.

  • SHIPs are a particularly critical resource for low-income older adults and people with disabilities and provided assistance to nearly 1.3 million individuals with incomes below 150 percent of the Federal Poverty Level (FPL) (amounting to less than $18,000 in annual income for a single household) in 2015.

  • SHIPs are pivotal to helping people with Medicare maximize their income and resources, such as by assisting with enrollment in low-income programs and by supporting individuals in selecting the Part D prescription drug plan or MA plan best suited to their health and financial needs. For example, in 2015, New York State’s Health Insurance Information, Counseling, and Assistance Program (HIICAP) saved people with Medicare an estimated $30 million through enrollment in low-income assistance programs, including Medicare Savings Programs and the Part D Low-Income Subsidy (LIS/Extra Help).

  • SHIPs offer increasingly critical services that cannot be supplied by 1-800 MEDICARE, on-line or written materials, or other outreach activities. On average, SHIP counselors spend 50 minutes with each client, and over 500,000 SHIP contacts in 2015 lasted more than one hour.

  • About one-third of all partner referrals to SHIPs originate from Medicare Advantage and Part D prescription drug plans, local and state agencies, the Centers for Medicare and Medicaid Services, the Social Security Administration, and members of Congress and their staff.

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