Aging Well: Spotlight on SHIP

Navigating Medicare with the

State Health Insurance Assistance Program 

Rachel Schmidt has helped seniors navigate the Medicare system for many years during her career with the federal government. When she retired, she turned to Jewish Council for the Aging’s SHIP – State Health Insurance Assistance Program – to continue assisting.

She, along with 14 other SHIP volunteers, stands ready to help Montgomery County seniors and adults under 65 with long-term disabilities learn about Medicare benefits and health insurance issues.

Many callers have lots of Medicare questions and concerns. Some want reassurance that they are making the right decisions. Others have no idea where to start or what to do for themselves. Still others are calling for their parents and often have little idea what Medicare is all about.

The callers Rachel enjoys helping the most are those who have been on Social Security Disability Insurance (SSDI) and now need to transition to Medicare. She recently spoke with the sister of a woman about to turn 65. She needed information to help her sister, who suffers from schizophrenia. Her mother had always been there for assistance, but she recently died.

The younger sister needed Rachel’s help transitioning her older sister from the SSDI program. Rachel called the state Medicaid office and was able to determine what benefits the woman was eligible for and what drugs she uses.

“It’s those people that tug at my heartstrings so much,” she said. “They are disabled. They can lose benefits.” She added, “It’s not a smooth transition.” Some people lose benefits as they try to handle the transition themselves. 

Rachel worked for almost 20 years with the federal government’s Medicare Payment Advisory Commission, which deals with Medicare Part D, the prescription plan. If people don’t sign up for the right plan, the medication they have been taking – and which has been covered by their current health insurance – may not be included.

“That happens all the time,” she said. But SHIP volunteers carefully review what medications callers use and guide them to the correct plan. Rachel enjoys the work and how thankful the callers often are. “Just about everybody who calls is very grateful. It’s such a complicated system.”

Al Woodward has been volunteering with SHIP for about six years. He connected with the program after his retirement by searching through the Montgomery County volunteer page.

While he enjoys helping people, his favorite calls involve assisting those with limited income and who can’t afford many health care options. Few of his callers are aware of the Medicare Savings Program (MSP). There are state and federal Medicare plans to help people pay for Part B, their deductibles, and other out-of-pocket expenses, he said.

“I have talked to lots of people. They can’t afford to pay for their health care costs. It’s sad,” Woodward said. “They can’t go without the care they need.”

One caller he recently spoke with had worked for the federal government and wanted to keep her current health care insurance with Medicare programs, but was having difficulty affording it as she was paying for her child in graduate school. “I gave her some options. I think I helped. She was happy,” Woodward said.

Fifteen SHIP volunteers answer calls from JCA’s office in Rockville or their own homes. They are well trained and must take several courses and pass an examination before they can become certified. Then they shadow a current volunteer before handling calls on their own. Then, once a month for two hours, they receive additional training at JCA’s Rockville office.

Together, they handle about 200 calls each month, according to SHIP Director Rafael Espinoza.

“The calls vary,” he said. While some people want SHIP volunteers to tell them exactly what to do, “We are not insurance brokers. We are unbiased,” he explained.

Volunteers give callers a few options for Medicare Advantage plans, but do not recommend a particular one. They also offer comparison analysis for Part D drug plans.

SHIP volunteers are particularly busy during Medicare Open Enrollment season, which begins in October and runs through Dec. 7. During this time, many of the callers are people who aren’t comfortable working on a computer or don’t have internet services, so they can’t do the research on their own, according to Espinoza.

“Some others prefer the old-fashioned way – filling everything out on paper,” he said, noting that applications must be done online. “So, we help them with that.” Often, callers “don’t feel confident enough. They want reassurance,” he said.

While SHIP volunteers are handling calls, Espinoza spends some of his time making in-person presentations at county libraries and senior recreation centers or senior living facilities. He speaks at libraries twice a month, talking primarily with new enrollees. At senior residential homes, he helps those already enrolled in Medicare. His current talk is aimed at helping people avoid Medicare fraud and abuse.

To speak with a SHIP volunteer or learn more about Medicare, go to the SHIP website, call 301-255-4250, or email SHIP@AccessJCA.org

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