When the Medicare insurance, counseling, and assistance programs were established nationwide in the early 1990s, their primary focus was addressing the confusion caused by the increase in choices of Medicare supplemental insurance (Medigap). The role of a SHIP counselor today, however, is far more complex and covers topics from traditional Medicare to the recent prescription drug plans.
Specifically, SHIP counselors:
Provide information and answer questions about Medicare, Medicare Advantage (such as Health Maintenance Organizations) plans, Medigap plans, and long-term care insurance plans.
Give information about and advocate for preventive health benefits paid by Medicare.
Help beneficiaries and their families understand the Medicare prescription drugs coverage (Medicare Part D) and options available in West Virginia.
Answer questions and help resolve concerns about medical bills, insurance claims, and Medicare summary notices.
Meet by telephone or in person to review national and state-specific programs, including prescription drug discount programs and programs that help reduce out-of-pocket medical expenses.
Educate beneficiaries about their rights for quality care and options for appeals of Medicare decisions.
Educate beneficiaries about how to recognize Medicare fraud and abuse and how to report it.
Make presentations to groups in the community about all aspects of Medicare.
This project was supported, in part by grant number 90SAPG0081 and 90MPPG0012, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.