SHIP Counseling: Free, Unbiased Medicare Help in Your State

Medicare decisions are full of details: enrollment windows, drug lists, networks, penalties and dozens of plans that change every year.

Many people end up getting advice from whoever calls them first, often someone who earns a commission for selling a plan.

There is a better option, and it is free in every state.

State Health Insurance Assistance Programs, known as SHIPs, offer free, unbiased, one-on-one counseling about Medicare.

This guide explains what SHIP counselors do, how they differ from insurance agents and how to get help from one.

What SHIP is

SHIPs are state programs supported by federal funding that help people with Medicare, their families and caregivers understand their options.

Each state runs its own program, sometimes under a different local name, but all share the same mission: free, objective help with Medicare questions.

Counselors are trained in Medicare rules and keep up with yearly changes.

Many are staff members; many others are trained volunteers from the community.

How SHIP differs from an insurance agent

Insurance agents and brokers can be helpful,

but they are usually paid by insurance companies when they enroll you in a plan,

and many work only with certain companies. SHIP counselors do not sell insurance and do not earn commissions.

Their job is to explain your options and help you choose what fits you, not to sell a particular plan.

That independence is the main reason to call a SHIP before making a big decision, especially if someone is pressuring you to switch.

It also helps when you have already talked to an agent.

A counselor can look at the plan an agent recommended and tell you, without any stake in the outcome,

whether it matches your drugs, doctors and budget, or whether another option would fit better.

Many people use both: an agent to learn about specific plans and a SHIP counselor for a neutral second opinion before signing.

Help beyond enrollment

SHIP help does not end once you are enrolled. Counselors can help when a pharmacy charges more than you expected,

when a claim is denied,

when you receive a bill you do not understand or when you need to appeal a decision.

They know which office to contact and what documents to gather, which saves hours of phone calls.

What SHIP counselors can help with

• Enrollment timing: when to sign up for Medicare and how to avoid late penalties.
• Comparing plans: drug plans and Medicare Advantage plans, using your actual prescriptions and doctors.
• Original Medicare and Medigap: how supplemental policies work and when you can buy one.
• Help with costs: Extra Help, Medicare Savings Programs and Medicaid.
• Problems and appeals: denied claims, billing questions and how to appeal a decision.
• Reading plan letters: such as the Annual Notice of Change.

How to reach your SHIP

The national SHIP website has a locator where you choose your state and find the phone number and website of your local program.

Many SHIPs offer help by phone, in person at community locations and, increasingly, by video.

Some hold group sessions and events during the fall enrollment period.

You can also ask Medicare how to reach your state's SHIP when you call with a question.

How to prepare for your appointment

A little preparation makes the session far more useful:

1. Bring your Medicare card and the card for any plan you have now.
2. Make a list of your prescriptions with exact names, doses and how often you take them.
3. List your doctors, hospitals and pharmacy.
4. Bring recent plan letters, such as the Annual Notice of Change or any denial letters.
5. Write your questions down, starting with the one that worries you most.

When to call

Good moments to contact a SHIP include the months before you turn 65, every fall before the December 7 deadline,

when your income changes, when you move,

when a doctor leaves your network and whenever a letter from Medicare or a plan confuses you.

The fall is the busiest time, so call early in the enrollment period if you can.

What a typical session looks like

A counseling session usually starts with your situation: your current coverage, your health needs, your doctors and your budget.

The counselor then walks through your options, often using the official Medicare Plan Finder with your actual prescriptions and pharmacy.

Together you look at estimated yearly costs, networks and any rules that could affect your care.

At the end, you leave with a clear picture of the choices and the deadlines that apply to you.

If you decide to make a change, the counselor can explain how to enroll, and some can help you complete the steps.

If you decide to stay where you are, you will know why that makes sense.

Questions worth asking a counselor

• Is my current plan still a good fit for next year, given my drugs and doctors?
• Do I qualify for any program that lowers my costs?
• If I switch, what could I lose that is hard to get back?
• What deadlines apply to me this year?
• What should I do if a claim is denied?

Bring a family member if it helps

Many people bring a son, daughter or friend to SHIP appointments.

Two people remember more of the conversation, and the family member can help keep track of documents and deadlines afterward.

Counselors are used to working with families and caregivers.

What SHIP will not do

SHIP counselors give you information and guidance, but the decision is yours.

They will not sell you a plan, will not pressure you and will not charge you.

If anyone claiming to be from a "Medicare help program" asks for payment or your Medicare Number out of the blue,

it is not a SHIP.

Frequently Asked Questions

Does SHIP cost anything?

No. SHIP counseling is free.

Can SHIP help my parent if I call for them?

Counselors can talk with family members and caregivers.

For questions about a specific person's coverage, the counselor may need that person's permission.

Is SHIP part of Medicare?

SHIPs are state programs supported by federal funds. They work independently of insurance companies.

This guide is general information and is not affiliated with Medicare or any SHIP.

Sources and Further Reading

• SHIP — State Health Insurance Assistance Programs: find your state's program and how to reach a counselor.
• Medicare.gov — Talk to someone: ways to get help with Medicare questions.
• USAGov — Medicare: an overview of Medicare and where to get help.