Open Enrollment - How to navigate the Medicare maze

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 is a conversation with our guest, Crystal Strong, from the South Carolina Department on Aging.

Crystal is the Program Director for the State Health Insurance Assistance Program (SHIP), the Medicare Improvements for Patients and Providers Act (MIPPA) program, and the Senior Medicare Patrol (SMP) program within the South Carolina Department on Aging (SCDOA). She provides oversight and direction to the state grantees to support their work assisting Medicare beneficiaries, their families, and caregivers through outreach, counseling, and education. In this role, she is also responsible for the education and certification of the counselors/volunteers statewide 

In this podcast, Crystal will share information about how the SHIP program can help Medicare beneficiaries with their Open Enrollment choices. Medicare has many options that can be confusing, so this podcast helps provide Medicare beneficiaries with where they can go to get assistance while making these choices.

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

KEY TOPICS
00:29: Overview, introduction of guest, Crystal Strong
02:38: Introduction of SHIPs
03:24: What is Open Enrollment?
04:20: How do SHIPs help with Open Enrollment?
06:15: Tips for Open Enrollment
07:38: Final thoughts

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RESOURCES

 BFCC-QIO Information for stakeholders: www.keproqio.com/partners

 BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene

 SHIP information: www.shiphelp.org

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. 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.

Kia Weaver
Hello everyone and welcome to another edition of Kepro’s podcast, Aging Health Matters. This is Kia Weaver, Outreach Specialist with Kepro, here to introduce today's topic. Just as a reminder, being the QIO for 29 states, we do have three key services for people who have Medicare. We assist with appeals, quality of care complaints, and Immediate Advocacy. More information on these topics is available on our website, which is www.keproqio.com.

We also work with many outstanding partners to help spread information about the Medicare programs and its benefits. While we greatly appreciate their partnerships, we also want to be clear that the opinions and guidance expressed by them in this podcast are solely theirs or their agencies and not necessarily those of Kepro, CMS, or the Medicare program. Please keep in mind that state-by-state guidance may differ as well.

So today, with Open Enrollment coming soon, we'll be talking about this with our guest who is Crystal Strong, and Crystal is from the State Health Assistance Program. also known as SHIP. Crystal is the Program Manager for SHIP and the Senior Medicare Patrol programs at the South Carolina Department on Aging. Welcome Crystal. Thank you for being here today. Can you please provide a bit more information about your background?

Crystal S.
Sure. Thank you for having me. Like you said, I work at the South Carolina Department on Aging. I've been there a little over 23 years, and right now, I serve as the program manager for the SHIP, which is the State Health Insurance Assistance Program. And I'm also SMP, which is the Senior Medicare Patrol program or the other arm of SHIP, which is the Medicare fraud program. I serve as the program manager for both programs here in the state of South Carolina.

Kia Weaver
Perfect. Thank you.

Crystal S.
You're welcome.

Kia Weaver
Can you please tell our listeners a little bit about what your organization does, and how they help the community?

Crystal S.
Absolutely. Well with the programs that I manage and what we're talking about today, the SHIP program, which is the State Health Insurance Assistance Program, is a local program that provides in depth and objective insurance counseling and assistance for Medicare-eligible individuals, their family members, and caregivers. It's available for Medicare beneficiaries. We have one of each one of these programs in every state and will therefore basically help beneficiaries navigate through the Medicare maze.

Kia Weaver
OK. Thank you. And because we're talking about Open Enrollment, can you talk a little bit about what Open Enrollment means with respect to Medicare?

Crystal S.
Sure. Open Enrollment begins October 15 through December 7 of every year, and it's when all Medicare beneficiaries can make changes to their Medicare health plans and their prescription drug coverage for the following year to better, I guess you’d say, to better meet their needs, so if it's something that's changing or maybe something in a new plan that's available for them, then this is the opportunity that they have to make those changes. We provide information about original Medicare and Medicare Advantage plans that are available for the upcoming year.

Kia Weaver
Great. Thank you for sharing that. And in addition, how do SHIPs help Medicare beneficiaries with the Open Enrollment process?

Crystal S.
SHIPs are able to meet with beneficiaries to help them go over their choices that they have for their Medicare benefits. There is a SHIP representative for every region in our state, and in that region, they have particular counties, so that individuals are able to meet with them one-on-one, either in person and/or via Zoom or any other platform and help them go over their choices.

We use the Medicare Plan Finder, that's on medicare.gov, to help individuals make the choices for the different plans that are available. There are several plans, or should say many plans available, and so meeting with that counselor will help them navigate through that maze in order to find the best product for them.

And also you can find your local SHIP at shiphelp.org. But I'm also going to tell you since I represent the SHIP here in South Carolina, you can find us at, I'll give you our phone number, which is 1-800-868-9095.

You can call the state office, ask for the SHIP in your particular region, and they will give you to that particular counselor as well. In addition to that, you can also go on our website, which is www.aging.sc.gov, and you can also find your local SHIP counselor there as well.

Kia Weaver
Great. Thank you. I'm sure that's really helpful for our listeners. And do you have any tips for our listeners who may be on Medicare or who are community organizers who provide services to seniors?

Crystal S.

I do. We always tell people during this particular time, especially during Open Enrollment, even if you're not wanting to change, it is a good thing to have someone go over what it is that you currently have and what may be upcoming. Always open up your mail when you get it because things change. Your plan may not be offering the same prescriptions that they have. The formulary may have changed.

If you're in Advantage plan, the doctors that you use may no longer be in that network. So just be on the lookout, especially during this time, and check your mail even if you don't want to change. It's just a good idea just to get with someone, go over what it is that you have, and see if maybe we could save you some money possibly for the upcoming year.

So just the just like any other insurance, when it's that Open Enrollment season, we just want you to be proactive, see if there is anything that needs to change, if you need to go to another plan, and/or if what you have is perfect for you.

Kia Weaver
Thanks Crystal. You provided such great information. Is there anything else that you'd like to share?

Crystal S.
The only thing that I want to say again or give you again, your listeners, is our 1-800 number. It's 1-800-868-9095. And we ask that during that Open Enrollment period or anytime during the year, please give our office a call and ask for a Medicare counselor or SHIP counselor, whichever you remember, and they will get you to that person that services your area, so that we can answer or address any questions, concerns that you may have not just during Open Enrollment, but anytime during the year. If you have Medicare questions, we are the ones here that will provide you some assistance.

Kia Weaver
Thanks so much, Crystal, and thank you for being our guest today and taking the time out to share all that great information with our listeners. If you would like more information about our services, please feel free to sign up for our newsletter as well as subscribe to our YouTube channel. Our helpline phone number, as well as the link to sign up for our newsletter, will be available in the Show Notes.

We also have several resources on our website, which again is www.keproqio.com. Thanks again Crystal. Thanks so much for taking this time out and thank you to our listeners. Please stay tuned for our next episode.