If you are turning 65 or helping an older family member explore their health care options, understanding the mysteries of Medicare can be a daunting task. Fortunately, there is a local organization offering free help. The State Health Insurance Assistance Program, also known as SHIP, is a free and impartial counseling program for Medicare beneficiaries in Indiana. SHIP’s volunteer counselors will answer any questions you have about Medicare coverage.
The Indianapolis Recorder recently spoke with Alex Peck, an Affordable Care Act specialist with the Indiana Department of Insurance, to learn more about Medicare and SHIP.
Indianapolis Recorder Newspaper: What are the public’s top questions or misconceptions about Medicare?
Peck: Help paying for their Medicare costs. In Indiana, income eligibility amounts for the Medicare Savings Program are higher than many other states, so there are many who are eligible who haven’t applied.
For a single person, the monthly income limit is $1,879 with an asset limit of $7,390. For a married couple, the monthly income is $2,524 with an asset limit of $11,090.
Can you talk about the process of enrolling in Medicare? For example, in what instances will a person be automatically enrolled, and when is the open enrollment window?
If they are already receiving a Social Security check before age 65, they will automatically be enrolled in Original Medicare and receive a Medicare card before the first day of their birthday month. If not, when someone is turning 65, they can go to their local Social Security office to enroll in Medicare as early as three months before their birthday month.
They will be given a choice of enrolling in Original Medicare Parts A and B with a Medicare supplement plan (private insurance) or a Medicare Advantage plan (managed care). They would also need to select a Part D drug plan. Their acceptance is guaranteed for their birthday month and six months after.
Only Medicare Advantage and Part D drug plans have an open enrollment each year. From Oct. 15 to Dec. 7, Medicare beneficiaries can change from Original Medicare to a Medicare Advantage plan or switch Medicare Advantage plans. These changes then go into effect on Jan. 1 of the new year.
Is there a penalty for not enrolling in time?
Unless you are actively working, there is a Part B and Part D late enrollment penalty. For Part B, the penalty is an additional 10 percent premium increase for each year of non-enrollment. For Part D, the penalty is an additional 1 percent premium increase for each month of non-enrollment.
For people who continue to work after age 65, there is no penalty, and they will have a special enrollment period when they are ready to stop working.
When SHIP provides free health insurance counseling to people with Medicare, do you counsel people in person, over the phone or online?
SHIP provides face-to-face counseling at 118 local SHIP sites, answers questions over the telephone at (800) 452-4800 and provides information and resources at medicare.in.gov.
Most people know that Medicare helps those over 65, but in what ways does it assist those with disabilities?
People with Social Security Disability qualify for Medicare after two years of receiving disability benefits. Other people under age 65 qualify sooner for Medicare because they have End Stage Renal Disease (ESRD) or Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease. However, their choices may be limited. People with ESRD cannot enroll in a Medicare Advantage plan, and in Indiana, Medicare supplements are not available for people under age 65. They are guaranteed Original Medicare Parts A and B and a Part D drug plan.
If someone is concerned about their Medicare coverage and needs help, what should their first step be?
They should call SHIP at 1-800-453-4800. Often their concerns and questions can be answered over the telephone. However, if they want to meet with a local SHIP counselor in their area, they can ask for that information also.
Is there anything else you would like our readers to know about SHIP?
It’s important that someone new to Medicare understand all of their options before they make a decision about Medicare. There’s a lot to consider. They might also have other coverage through a past employer, spouse or military service.
A SHIP counselor is specially trained to provide information on all their options and will remain impartial. They aren’t trying to sell you anything or influence your decision in any way. There’s also no charge for SHIP counseling. There’s little reason not to give SHIP a call just to make sure you understand all of your Medicare choices.