Save Money on Medicare With State Health Insurance Assistance Programs

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Editor's Note: This story originally appeared on The Penny Hoarder.

Contrary to popular belief, Medicare isn’t free.

Monthly premiums, copays and yearly deductibles add up quickly — not to mention out-of-pocket costs on prescription drugs.

Navigating Medicare’s complex system by yourself can be overwhelming. It feels easier to just stick with your current plan and hope for the best.

But staying put can mean losing out on huge savings — potentially thousands of dollars a year.

If you want to explore your Medicare options but don’t know where to start, a network of free federally-funded programs can help. Here’s how.

What Is the State Health Insurance Assistance Program?

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The State Health Insurance Assistance Program, or SHIP, is a national network of trained volunteers who provide one-on-one assistance, counseling and education to Medicare beneficiaries, their families and caregivers.

SHIP was created more than 30 years ago under the Omnibus Budget Reconciliation Act of 1990. Each state uses federal grant money to administer its own SHIP.

Your state’s program may go by a slightly different name, such as SHINE (Serving Health Insurance Needs of Everyone) in Massachusetts or SHIBA (Statewide Health Insurance Benefits Advisors) in Washington and Idaho.

SHIP by the Numbers

  • Nearly 2.7 million Medicare beneficiaries, their families and caregivers received one-on-one health insurance counseling in 2018, including 330,737 adults under 65 with disabilities.
  • SHIP provided outreach to more than 4.2 million people at public presentations, enrollment events, health fairs and other community events in 2018.
  • There are more than 2,200 local SHIP sites nationwide and over 12,500 team members.
  • SHIP received $65.1 million in federal funding in fiscal year 2020 to carry out its mission.

SHIP counselors are certified to provide free, in-depth and personalized health insurance counseling to Medicare beneficiaries.

And because counselors don’t work for an insurance company, their advice is truly unbiased.

A SHIP volunteer will never try to sell you anything. There are no income or wealth restrictions either. Anyone can use the program, free of charge.

How Can SHIP Counselors Help Me?

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SHIP counselors can assist with numerous Medicare-related needs, including:

  • Reviewing your health insurance coverage and prescription drug plan options
  • Assistance programs for people with low incomes
  • Open enrollment questions
  • Billing problems
  • Navigating late enrollment penalties
  • Filing an appeal or complaint
  • Medicare Supplement insurance (Medigap), long-term care insurance and managed care options

Both new and existing Medicare beneficiaries can utilize SHIP. Counselors also help adults under 65 who qualify for Medicare due to a disability, as well as dual-eligible beneficiaries enrolled in both Medicare and Medicaid.

Reviewing Your Medicare Coverage Can Save You Thousands

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Beneficiaries get an annual opportunity to review and change their Medicare coverage during open enrollment, which runs from Oct. 15 to Dec. 7 each year.

It’s a great time to compare plans and make sure you’re not overpaying for health care.

Yet 7 in 10 Medicare beneficiaries didn’t compare plans during the 2018 open enrollment period, according to a recent report by the Kaiser Family Foundation.

The rate was even higher among Black and Hispanic beneficiaries, those 85 and older and those with low incomes.

Not shopping around at least once a year can mean overspending on Medicare, experts say.

“In addition to potentially better meeting their health care needs, reviewing plans annually can help save money as plan costs fluctuate regularly,” said Rebecca Kinney, director of the Office of Healthcare Information and Counseling for the U.S. Department of Health and Human Services’ Administration for Community Living.

How much can you really save using SHIP?

Kinney told The Penny Hoarder about a married couple in Ohio who hadn’t compared their Part D plans in nine years.

“They will save almost $4,000 in 2022 by changing plans after researching their options with the Ohio SHIP,” Kinney said. “The wife was almost in tears, she was so happy.”

What Else Does SHIP Do?

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A SHIP counselor can assist you in many ways, whether that’s helping you compare drug plans, screening you for money-saving benefits or answering enrollment questions.

They can also offer guidance on navigating unique situations, like how Medicare interacts with Medicaid, or what happens to your TRICARE coverage when you turn 65.

SHIPs generally offer a mix of in-person and over-the-phone assistance.

Many SHIPs also give webinars and education fairs, like the SHIP in Indiana, which hosted four virtual Medicare events on its Facebook page in September. Members of the public could interact with experts and get their Medicare questions answered in real-time.

SHIPs rely heavily on the Medicare Plan Finder tool and other information on Medicare’s website to sort through available options for beneficiaries.

Or, with your permission, a counselor can log into your account, review your recent drug claims and determine your most affordable Part D plan option.

Get Extra Help Paying for Medicare With Savings Programs

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SHIP counselors can also help lower-income beneficiaries navigate Medicare Savings Programs, which can cover Part B premiums, deductibles and copayments.

There’s also the Extra Help program, which helps substantially lower prescription drug costs. In 2022, Extra Help enrollees spend no more than $3.95 for each generic prescription and $9.85 for each brand-name covered drug.

These savings programs are available to beneficiaries who may not qualify for full Medicaid benefits, but still meet certain income limits and struggle to cover health care costs.

Medicare Savings Programs are administered by the states, so SHIP counselors can give you the specific eligibility and enrollment requirements in your area.

They can even help you with the application process.

These tiny tweaks to your Medicare insurance can add up to hundreds — or even thousands — of dollars in out-of-pocket savings each year, experts say.

How to Find Your Local SHIP

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You can find your SHIP by using the online SHIP Regional Locator tool. Or you can call the national network hotline at 1-877-839-2675.

You can speak with a representative and book an appointment with a counselor.

Some states may offer in-person counseling while others offer only over-the-phone or online counseling, so check to see what’s available in your state.

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