medicare for all :: Article CreatorMedicare SHIP
Medicare SHIP (State Health Insurance Assistance Program) is a free, one-on-one counseling service that answers questions about Medicare coverage and plan options. The service is available to anyone who is eligible for Medicare.
Medicare's State Health Insurance Assistance Program (SHIP) utilized free counseling on all things Medicare. It is available in all 50 states and can help you to navigate the, at times, confusing Medicare system.
Medicare's SHIP is a free counseling service for all your Medicare questions. SHIP provides you or your caretaker with access to one-on-one, unbiased advice from a trained volunteer well-versed in Medicare.
Background and mission
SHIP is a government-funded, free Medicare counseling program that started in 1990 as part of the Omnibus Budget Reconciliation Act. SHIPs provide local, unbiased information to Medicare-eligible individuals and their families.
In addition to one-on-one meetings, SHIPs hold in-person and online workshops and enrollment events. These include "Medicare Mondays," which provide information to help you select coverage plans. Check with your local SHIP for a schedule of upcoming events.
Locations and other names
There are SHIPs in all 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands.
Some SHIPs go by different names. For example, Missouri's SHIP is known as CLAIM (Community Leaders Assisting the Insured of Missouri). In New York, SHIP is known as HIICAP (Health Insurance Information, Counseling and Assistance).
SHIP counselors are highly trained volunteers who live in your local community.
SHIP counselors are unbiased. They do not work for insurance companies, and they do not profit from your enrollment decision. Their goal is to provide you with personalized and up-to-date information about all aspects of Medicare.
Medicare can be confusing. Your healthcare needs can also change over time, and you may wonder if you can or should make changes to your coverage. SHIP counselors can provide information on many topics, including:
how and when to enroll in Medicare the different parts of Medicare and what each covers differences between Part D prescription drug plans and Medicare Advantage (Part C) plans, and how to choose the right one for you what to know if you need a Medigap (supplemental) plan how to join or leave a plan what to know if you choose a plan you do not like what out-of-pocket costs you might have with your current or future plan eligibility requirements for additional low-income benefits such as Medicare Savings Programs and Extra Help (Part D low-income subsidy) the process for filing an appeal or a complaint for denial of coverage Medicare coverage questions like length of stay at a skilled nursing facility or certain medical equipment you may need how to detect and avoid Medicare scams SHIP is available to all Medicare-eligible Americans and their caregivers. You're eligible for Medicare if:
you are age 65 or older you are a U.S. Citizen or legal resident who has lived in the United States for at least 5 years you are younger than age 65 but have a disability or end stage renal disease You can learn about local meetings and workshops, such as Medicare Monday, on each state's SHIP website.
Workshops often take place before the Medicare open enrollment period, which occurs annually from Oct. 15 through Dec. 7.
All SHIP services are free.
How to contact SHIP
Here are a few ways to discover information about your local SHIP:
Additional tips
It will also help to learn about the different parts of Medicare. For example, Medicare parts A and B are known as Original Medicare. Part C is also known as Medicare Advantage, while Part D is prescription drug coverage.
To best prepare for your appointment, have the following information handy:
your doctors' names and knowing whether they currently accept Medicare your current prescriptions your medical conditions any upcoming procedures any needed medical equipment or supportive devices (including eyeglasses) the type of dental care and services you'll need during a year your monthly and annual budget for healthcare spending Note that since the COVID-19 pandemic, you have the option to meet with a SHIP counselor virtually. Your counselor is obligated to provide the same service and maintain the same confidentiality as in person.
SHIP is a free counseling service for Medicare-eligible individuals and their caregivers. You can access SHIP at any time, including the months before you enroll in Medicare.
SHIP counselors are trained, compassionate volunteers from the local community. They know the ins and outs of Medicare and provide unbiased, personalized information.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. Jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
Dr. Oz's Impact On Medicare And Medicaid: Key Insights For Retirees
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Four Parts And Two Choices: Medicare Explained For The Approaching-65-and-older Crowd
My goal today: Give an overview of Medicare for the 65-plus crowd in 600 words or less.
Ready?
Medicare is a federal entitlement program. The government guarantees that eligible individuals will receive benefits.
There are several triggers for eligibility, but this column will focus only on age eligibility. Under that criterion, you must be 65 years old, have worked at least 40 quarters of covered employment and be either a U.S. Citizen or a holder of a green card for at least 5 years. You can sign up for Medicare starting 3 months before you turn age 65, or up to 3 months after the month you turn 65.
News Roundups
Catch up on the day's news you need to know.
There are four parts to Medicare: A, B, C and D. Parts A and B are considered Original Medicare, Part C is the Medicare Advantage Program and Part D is drug coverage.
When you first sign up for Medicare, you have two choices. The first choice is to sign up for Original Medicare, which is Parts A and B, join a separate Medicare drug plan known as Part D, and then purchase a Medicare supplemental policy that pays for additional coverage and helps with out-of-pocket costs. The second choice is to sign up with a private company for Part C, which is Medicare Advantage.
Now for the explanations. Part A primarily provides for hospital and very limited nursing home benefits. Part B provides coverage for physicians, tests, shots or vaccines, medical equipment, outpatient care and home health care. Part C is Medicare Advantage. Part D is coverage for drugs.
Let's compare and contrast your choice between Original Medicare and Medicare Advantage. Under Original Medicare, you can use any doctor or hospital that takes Medicare anywhere in the U.S. In most cases, you do not need a referral to see a specialist. Under Medicare Advantage, you can only use doctors and other providers who are in the plan's network and service area for non-emergency care, and you may need a referral to see a specialist.
Under Original Medicare, for Part B-covered services you pay a monthly premium. You also pay a coinsurance of 20% of the Medicare-approved amount after you meet your deductible. If you purchase a supplemental policy, it will help pay the coinsurance amount.
Under Medicare Advantage, you pay the Part B monthly premium, but you also may have to pay the plan's premium. Out-of-pocket costs vary, but you are not allowed to purchase supplemental insurance to cover them. You will have a yearly limit for what you pay for covered Part A and Part B services, but there will be different limits for in-network and out-of-network services.
There are also differences in coverage. Original Medicare covers most medically necessary services without prior authorization. Medicare Advantage must also cover all medically necessary services, but the plan can use its own criteria to determine medical necessity. You usually need to get prior authorization.
Most Medicare Advantage plans include Part D coverage and forbid you from joining a separate Medicare drug plan. For Part D coverage in Original Medicare, you will need to purchase a separate Medicare drug plan of your choice. Starting in 2025, the Inflation Reduction Act caps out-of-pocket prescription drug costs for Medicare Part D beneficiaries at $2,000 annually.
You need to pay attention when you reach 65. Timing is critical for benefits and to avoid a penalty for not signing up when you are first eligible.
My professional preference, shared by most attorneys who practice in this area, is Original Medicare with Part D and supplemental insurance, but I recommend hiring a Medicare broker who can shop coverage and explain your options to you.
Attorney Virginia Hammerle will present "Guardianship 101″ from 2 to 3 p.M. On May 23 at the Skillman Southwestern Branch Library, 5707 Skill-man St., Dallas. She will also present "Finances for Seniors" from 2 to 3 p.M. On June 4 at the Timberglen Branch Library, 18505 Midway Road, Dallas. Registration is required. To register, visit dallaslibrary2.Org, click on Events, choose the library branch and the date of the seminar. You can also call the branch at 214-670-6078 (Skillman) or 214-671-1365 (Timberglen).
Attorney Virginia Hammerle is board certified in civil trial law by the Texas Board of Legal Specialization and an accredited estate planner. To receive her monthly newsletter, contact her at legaltalktexas@hammerle.Com or visit hammerle.Com. This column does not constitute legal advice.
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