Get Help with Medicare Enrollment Through Your Local SHIP

Anyone who has shopped for health insurance plans knows that a plethora of options is available. Yet trying to find the plan that best fits your needs can be daunting. Not only do the plans have many features but what they cover and how much they will cover can also be hard to discern.

The federal government’s health insurance program, Medicare, can be as confusing as the open market. If you are eligible for Medicare and need help navigating the system, you can turn to your local State Health Insurance Assistance Program (SHIP).

What Is SHIP?

Congress established SHIP in 1990 to give free, unbiased guidance to help people understand their Medicare options. The SHIP network receives federal funding via the Administration for Community Living (ACL), which is part of the Department of Health and Human Services (HHS).

SHIP Services

SHIP provides valuable services to current Medicare recipients and those who are eligible for Medicare. Individuals who are new to Medicare, such as those who are turning 65 or who have a qualifying disability, can get help figuring out whether Original Medicare or Medicare Advantage is best for them. They can also obtain guidance on the various parts of Medicare, such as Part D and Medigap.

Medicare enrollees can get assistance from SHIP each year during open enrollment to review and switch plans if needed. SHIP also offers support with appeals and grievance processes, provides education on resources that help pay for Medicare, such as the Extra Help program, and may also hold local outreach events and share fraud prevention tips.

Complexity of Medicare

With multiple parts (A, B, C, D), plus supplemental (“Medigap”) coverage, private Medicare Advantage plans, and various savings program options, Medicare can be bewildering. SHIP provides guidance in the form of neutral, trustworthy help.

Unbiased Advice

SHIP counselors do not receive commissions or indirect incentives tied to plan enrollment. As a result, they are generally considered more trustworthy and less biased than brokers or agents who may have financial ties to insurers.

Access and Local Help

SHIP can be a valuable resource in many rural or underserved areas for personalized help. Local offices know the particulars regarding local providers and which plans may be effective in a specific area. This information can help enrollees avoid mistakes, like picking a plan that doesn’t include the local pharmacy or certain specialists.

Cost Savings and Preventing Harm

By preventing enrollment mistakes, helping people get needed coverage and benefits, and aiding with appeals or understanding rights, SHIP can help prevent higher downstream costs, such as unexpected out-of-pocket costs and uncovered services. SHIP also helps protect older adults from being steered into inadequate or expensive plans.

Recent Budget Cuts and Policy Changes

In recent several months, some proposals and actions have put SHIP at risk.

ACL’s Reorganization

The HHS is dissolving the ACL and moving its programs into a new division. ACL currently houses SHIP, among many other aging, disability, and elder care support programs. Roughly half of ACL’s staff has been laid off, affecting staff levels in leadership, policy, budget, and regional offices.

Policy and Political Status

Though current budget proposals include cutting discretionary funding for SHIP and dissolving ACL, Congress still controls appropriations. In some recent appropriations bills, discretionary funding remains intact.

The Older Americans Act (OAA), which authorizes many ACL programs, needs to be reauthorized by Congress. Continuing resolutions have provided funding for OAA programs through fiscal year 2025. However, SHIP’s future relies on timely reauthorization, adequate appropriation levels, and other statutory mandates.

However, the combination of flat funding, proposed discretionary budget cuts, staff cuts, and ACL’s dissolution and restructuring threatens SHIP in significant ways. Many local SHIP offices may be forced to cut back or close, reducing access at a time when more people are relying on them.

If you would like to speak with an experienced elder law attorney regarding your situation or have questions about something you have read, please do not hesitate to contact our office at 1 (800) 680-1717. We look forward to the opportunity to work with you.

Disclaimer: The information provided above is for general informational purposes only and is not legal advice.