Senior Health Insurance Assistance Program Organizations (SHIPs) and Medicare Open Enrollment

SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro provides BFCC-QIO services in 29 states, the general information is relevant to everyone who has Medicare (including Medicare Advantage) and everyone who works with people who have Medicare. 

This episode focuses on Senior Health Insurance Assistance Program (SHIP) organizations. They offer free Medicare counseling information, unbiased, factual, to everyone on Medicare. This is especially helpful during Medicare open enrollment.

Kepro welcomes guest Janet Peterson Payne who works for Georgia Legal Services as a certified Georgia SHIP Medicare counselor. Georgia SHIP program for Georgia is administered through the Georgia Department of Human Services, Division of Aging. Georgia SHIP provides free, unbiased and factual personalized counseling to assist Medicare beneficiaries. The SHIP program is the only agency endorsed by Medicare to provide these services.

For more information about Kepro BFCC-QIO, please visit www.keproqio.com.

KEY TOPICS
00:55: Overview, introduction
04:00: How SHIPs help people who have Medicare
09:05: Medicare open enrollment
22:00: Resources

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RESOURCES

Information about Medicare Open Enrollment

• Find information about your local SHIP: www.shiphelp.org
• YouTube Video
  Medicare & You: Medicare Open Enrollment is a video that gives you important information about the Medicare Open Enrollment period
• Website
  Visit www.Medicare.gov/plan-compare to learn about and compare coverage options and shop for health and drug plans.
• Telephone
  Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

Information about Kepro’s free services for people who have Medicare

• Immediate Advocacy: www.keproqio.com/ImmediateAdvocacy
• Information for stakeholders: www.keproqio.com/partners
• Information for people who have Medicare: www.keproqio.com/bene

Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M

Transcript

Welcome to Aging Health Matters, a podcast from Kepro, a Beneficiary and Family Centered Care Quality Improvement Organization. We plan to cover healthcare topics for the Medicare population. The information in today’s show may help you or someone you know in their healthcare journey. Thanks for joining us; now let’s get started.

Scott Fortin
Hello and welcome to another edition of our podcast. This is Aging Health Matters from Kepro, a Beneficiary and Family Centered Care Quality Improvement Organization. Today we'll be covering a topic that is near to many of us, and that is Open Enrollment. I know that our guest and our Outreach Specialist today are going to have some great tips for our audience. But just as a reminder of a little bit about who we are and what we do. In some previous podcasts, things that we've covered have been around Immediate Advocacy, appeals, so hospital discharge appeals, and quality of care complaints that Kepro handles, and how you can reach us. That information will be available in the show notes as well as in the information that our cohost Kia Weaver will give you at the end of this podcast.

So without further ado, I'm going to turn it over to the co-host of this podcast, Kia Weaver, our Outreach Specialist, and Janet Payne. Kia.

Kia Weaver
Thanks, Scott. Hi everyone. My name is Kia Weaver. I'm one of the Outreach Specialists here at Kepro. I cover CMS Regions one and four, and today we have a guest from a SHIP in Region four in the state of Georgia. Janet, if you could please tell us a little bit about yourself and your role, that would be great.

Janet Payne
Yes. Good afternoon everyone, and thank you for the opportunity to spread good news. I am a SHIP counselor in the state of Georgia, and I say that with pride and excitement because we offer free Medicare counseling information, unbiased, factual, to everyone on Medicare in the state of Georgia.

I am retired from corporate America. I have a lot of background since retiring in the area of aging services, so certainly a great segue into the specific area of Medicare for the citizens of Georgia.

Kia Weaver
Thank you so much for taking the time out to speak with us today. You told us a little bit about what your organization does, but can you tell us a little bit more about what they do and how they help the community?

Janet Payne 
Oh certainly. SHIP offices are located in every state. It is a service that the Centers for Medicare & Medicaid Services offers every person on Medicare in this country. The SHIP offices are available in the community as well as via phone. We do a lot of Medicare outreach because we bring our services to the community. As I said before, we are a comprehensive Medicare resource and counseling service, and that means that we provide personalized counseling, education, and outreach to assist our Medicare beneficiaries in making the right decision with their Medicare options. And as was stated earlier, we are moving into our Open Enrollment period, October the 15th through December 7, where we use that opportunity to do a deep dive into the individual needs of our Medicare beneficiaries.

Kia Weaver
Perfect. Thank you so much. That was actually my next question. Just to talk a little bit more about Open Enrollment. So you said the dates were October 15 to December 7. And can you just talk a little bit more about what an Open Enrollment means with respect to Medicare?

Janet Payne

Yes, Medicare has the Open Enrollment period, comes at the same time every year, and we use it as an opportunity to do a deep dive into the Medicare needs of each of our Medicare beneficiaries, be it the ones over 65 or the ones under 65 with a disability. We also use this time to discuss the Medicare handbook that everybody receives that’s on Medicare, and most of the time it becomes the object to collect dust on the bookshelf. But we use this opportunity to discuss this wonderful resource that every Medicare beneficiary has, and it explains all of the different components of Medicare. And we also use this opportunity to stress to our Medicare beneficiaries that after talking with them that they review their current plan and also if they are retiree from a from their former employer, they may have a retiree medical plan from their former employer. And we emphasize the need for them to review their plans, so they remain compliant and not jeopardize any of these benefits that they have their medical retiree plan from their former employer. 

We also use this time to talk about what SHIP offices do because it's a case of each one teach one. We are a very mobile society. We have cousins and aunts and grandchildren and parents in other states. So we emphasize the resources available that they can share the information, not only for their respective state, but for others that live in other states. So it’s the case of each one teach one, but we certainly want to use this opportunity to do a deep dive into their Medicare needs. Now during the Medicare Open Enrollment period that comes every year, October the 15th through the December the 7th, we look at resources. We want to have a personal conversation with the beneficiaries about what their needs are. We take the time to talk to them very informally about what's going on with them in their lives and their medical lives. Do they have a situation now that did not exist for the previous enrollment period? So we engage and take the time to talk about their current situation. Now we ask them, do you like your current plan? Does it still fit your needs? Do you have any new medications that you are taking now that you were not taking last year? We also discuss with the beneficiary if they have received any type of notice of change in their current plan, and a lot of times, this information comes, and it again goes to the pile. Look at it later. It's just junk mail. But we talk to them about if their current plan has changed. By law, they should have received an annual notice of change because we try to eliminate the surprise element. 

So we ask these questions, and sometimes they haven't even considered the fact that their current plan that they've liked may be changing for the next enrollment period. We talk about the differences in the different types of Medicare, original traditional Medicare or the Medicare Part C, the Medicare Advantage plans. We talk to them about the differences. We ask specific questions about if they still want to remain with their current option in terms of the way they choose their Medicare. We answer a lot of questions about the Medicare Part C ads that we see on TV a lot. We get phone calls. We get advertisements in the mail. We answer a lot of questions, and we help the beneficiaries work through that information because so much of it is confusing. And we would like to get the beneficiary to the point that they understand exactly what their Medicare needs are, and also, we talk about the Medicare Advantage Open Enrollment period that occurs every year from January the 1st to March the 31st. This is their opportunity. If they have selected a Medicare Advantage plan for the next benefit year and now they're getting into that next year, and they find out maybe some things that did not understand, some benefits they thought they had, and they no longer have those benefits that they thought they had. This is the opportunity, January the 1st through March the 31st, to review their plan and to change if it does not meet their Medicare needs. Again, this is only if you have a Medicare Advantage plan already. You can take advantage of the Medicare Advantage Open Enrollment period, January the 1st through March the 31st, of that new plan year. During Open Enrollment, I like to tell my beneficiaries you can play in the same playground, or you can choose to play in a different playground. You can choose your Medicare benefits if you're already in a currently in the original traditional Medicare, you can change to Medicare Advantage Plan or change back to the original Medicare if you are in a Medicare Advantage plan. We try to cover as many bases as we can during this Open Enrollment period.

Kia Weaver
Thank you so much. That's such helpful information for our listeners. Thank you for going into detail about how SHIPs help Medicare beneficiaries during the Open Enrollment process, and I agree it can be very confusing and overwhelming just with the amount of information that's available. Can you talk a little bit about how beneficiaries can find their local SHIP offices?

Janet Payne

Absolutely. There are a number of ways. States make it easy to access the services of SHIP offices through a variety of ways. Certainly, they can access through the SHIP website, www.shiphelp.org, and you can click on that and then click on your respective state. You could access that way. We have community resources, the Area Agencies on Aging. They're called different things in different states, but basically your aging coalition for your respective states, the senior centers in the area. We have a relationship with them. You can contact them, and also, we tell them that they can use their community organizations and health fairs, all of the community resources. We are out there. Now also, we would like to tell our listeners that the information is layered in terms of how your Medicare options are processed. So we ask them to look at the information, process information that we've given them, and call back. Everything does not have to be answered in one call. We are very patient. The goal is to make sure that every Medicare beneficiary understands exactly what their options are, and we don't mind repeating that information.

We will repeat that information as often as we need to, to make sure the beneficiary understands their  options. We have many, many outlets. We have SHIP counseling offices. We call them off-site counseling locations that we set up in the respective areas because we want to bring the services to the community, to our seniors, because this is the time in their life that it might not be that easy to travel to a main central point. So we have various touch points in the community to provide the SHIP Medicare counseling.

Kia Weaver
That's great. Thank you. It's so great that there's many different avenues that beneficiaries can contact their local SHIPs and get different resources that they may need. So that's great. Thank you. Do you have any last tips for our listeners or anything else you like to add for those who might be on Medicare or listeners who are community organizations that also provide services to seniors?

Janet Payne

Yes, certainly. First of all, I want to emphasize that SHIP services are free. And I want to say free, free, free, which is a segue into my next comment, to watch out for fraudulent information. So SHIP offices will never charge you for any type of counseling or service. So watch out for the fraudulent information because you would never pay for a SHIP service and also that the beneficiary does not have to make any quick decisions.

There's no sense of urgency unless you are backed up to some type of deadline. But during the Open Enrollment period, you do not have to make any quick decisions. Ask as many questions because we are very, very passionate and very patient group, ask as many questions as it takes to get you to where you need to be with your Medicare options.

Kia Weaver
Perfect. Thank you so much, Janet. It was so great speaking with you, and I hope our listeners have found this information really helpful. I work with SHIPs all the time, and I've even learned new things from you. So thank you so much. If you've enjoyed this episode and would like to hear more about the services that Kepro offers, the partners that we work with, and so much more, please stay tuned for our next episode. Please also feel free to sign up for our newsletter and subscribe to our YouTube channel. Information about our newsletter and YouTube channel can be found on our website. We are constantly updating our website to reflect any changes or updates to inform our partners and the Medicare beneficiaries that we serve. And again, our website is www.keproqio.com, so please feel free to check out our website. And as Janet mentioned, a good way to find resources from local SHIP options and a good way to find the contact information from local SHIP options is their website, which is www.shiphelp.org. And thank you so much. Thank you again Janet for speaking with us today.

Janet Payne
Thank you.