If you or someone in your family is approaching the age of 65, you’ve probably started to think about Medicare coverage — the federal health insurance for Americans aged 65 and older.
Medicare provides health insurance for about 60 million Americans. Individuals can sign up as they approach their 65th birthday. That’s the simple part.
But Medicare only covers about half of the health care expenses for those enrolled. Other expenses may be covered by additional private insurance or a Part C or Part D Medicare health plan — and those insurance programs can be confusing as you search for the best plan to fit your needs.
Free advice is available from volunteers at the Senior Health Insurance Information Program, or SHIIP, a government program that’s been around since 1990.
In the Corridor, several major health providers, including UnityPoint Health-St. Luke’s Hospital and Mercy Medical Center in Cedar Rapids, are sponsor sites for SHIIP. Trained SHIIP volunteers offer free, unbiased counseling about Medicare coverage to those 65 and over and to people who are younger but on Medicare due to a medical condition.
More than 2,400 people sought Medicare advice from SHIIP counselors at St. Luke’s in 2019, according to Angela Berns, St. Luke’s manager for volunteer services.
By helping people find the most cost-effective supplemental insurance, SHIIP counselors saved clients more than $1 million in prescription drug costs alone last year, Berns estimated.
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SHIIP counselors also can assist with claims issues, and they ease the stress created by the daunting piles of mail that begin arriving shortly before a person turns 65.
“Overwhelmed clients bring in boxes of unopened Medicare mail,” Berns said.
Learning how to interpret all of this information — not to mention spot fraud and keep up-to-date with Medicare plan changes — takes dedication.
SHIIP volunteers go through a rigorous process before they start working with clients. First, they must apply and be accepted at a sponsor site, then apply and be accepted by the Iowa Insurance Division and pass a background check. That all happens before any training begins. As part of their training, volunteers shadow an existing volunteer for at least a week.
“It’s a huge commitment,” Berns said. “Our volunteers have a fire inside of them to help others.”
Currently, St. Luke’s SHIIP program has 12 volunteers. The COVID-19 pandemic has impacted training and made job shadowing trickier. Appointments haven’t slowed down, though. They just take place over the phone instead of in person.
Realizing that clients may have additional questions over time, SHIIP volunteers keep track of who they’ve spoken with in a database, and clients can request to speak to the same counselor each time they call. In fact, counselors tend to work the same 4-hour shift each week, so clients know when they can get in touch.
WHEN TO CHECK PLANS
For those already on Medicare, the open enrollment period for Medicare supplemental insurance — Oct. 15 to Dec. 7 this year — is a busy time for SHIIP counselors. Berns said it’s particularly important to consult with a SHIIP counselor during open enrollment if your medications or your health has changed over the past year.
“People don’t necessarily realize they can make changes each year,” she said.
SHIIP volunteer Audrey Bradford said it’s crucial for Medicare enrollees to review their prescription drug plan each fall. Even if your medications haven’t changed, the Medicare Prescription Drug Plan you’re on might announce updates in October that will have a big impact on what you pay when they go into effect the following year.
Talking to a SHIIP counselor is free of charge, with no income restrictions, and no agenda.
“We don’t sell anything,” Bradford said. “Medicare is complicated enough without having to wonder if the person giving you information is going to gain from it.”
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Berns said many of the current SHIIP volunteers feel driven to help others because of the confusion they initially felt.
“It’s truly a passion,” she said. “They’re a good group of people who are concerned about the welfare of others.”
Learn more about Medicare, supplemental insurance and connect with a local SHIIP volunteer at shiip.iowa.gov.