Submitted by Annette Morrison, M.S., CRS-A/D
As the leaves turn brilliant orange, red, and yellow all across Illinois, Senior Health Insurance Counselors (SHIP) are refreshing their knowledge of Medicare rules and regulations. They are rolling out the appointment books, stocking the brochure racks, and brushing up on their Plan Finder skills over the internet, all in preparation for Medicare Open Enrollment which starts October 15th and continues through December 7th. Fall in itself signals a transitional period—and the only time period during the year that a Medicare beneficiary can change their Prescription Drug Coverage or Medicare Advantage Plan, unless they have a special circumstance.
The advantage of coming to a SHIP Counselor for Medicare Insurance advice over signing up over the telephone based on a call, a TV advertisement, or a broker, is that the SHIP Counselor is not out to sell you a specific product. There are no kickbacks, no buy-ins, no bias. A SHIP Counselor will look at your needs, and what you are financially capable of handling, and then show you your options. They do this through Medicare.gov’s website, using the Plan Finder tool. If you are computer savvy, you can access it yourself, by going to www.medicare.gov.
Senior Health Insurance Program Counselors are trained through the Illinois Department on Aging. Not only must they go through an intense 4-day training to learn the ins and outs of Medicare, but they are also required to attend regular refresher trainings, conferences, and to report statistics about who they serve to their funding sources. SHIP programs are offered throughout the nation and are funded through the Older American’s Act. The Illinois SHIP office can be reached by calling 1-800-252-8966.
If you are on Medicare, you have the option to change to a new Prescription Drug Plan or a Medicare Advantage Plan that will begin on January 1, 2024. A new plan may offer better, more cost-effective coverage for your medications. How will you know this? That’s where the SHIP Counselor will become your new best friend. SHIP Counselors are trained to sit down with you to look at the new offerings, type in your exact medications and dosages, and then compare the available plans for 2024. They can help you compare new plans to your current coverage to see if you should make a change. A formulary is the term used to describe the list of medications that a drug company will cover on its plan. If your company has a change to their formulary that will affect you, they are required to notify you in writing in the month of September. This is a great reason to look to see if a new Prescription Drug Plan would work better for you. Also, you may find that a drug you were on suddenly has a generic version available which will save you $80 a month or that you can save money by going to a different pharmacy. You may find that a different company is offering a better plan and will cover all of your medications in 2024.
Another option during Open Enrollment is to switch to a Medicare Advantage Plan, sometimes referred to a Medicare “C” or “Medicare Replacement Plan.” Medicare Advantage Plans are offered by private insurance companies to manage all of your Medicare insurance needs in one convenient package. Their plans will cover Medicare A—Hospital, Medicare B—Doctors, and sometimes Medicare D—Medications. These plans are usually HMOs or PPOs and have a dedicated network of providers in a geographic region you must use to get coverage. It is important if you are considering these plans, to look up your doctor/provider to make sure they are in the network or you may be responsible for some or all of the cost. Medicare Advantage Plans are also attractive to those people looking for some dental, vision, over-the-counter medication allowances, health club membership payment, and hearing coverage. Most plans offer a minimal amount of these extra services, which original Medicare and Medicare Supplements generally do not offer. The amount of coverage varies by plan and your SHIP Counselor can help you find out if a Medicare Advantage plan is a good option for you.
CCSI Case Coordination has SHIP Counselors in McLean, Livingston, DeWitt, and Shelby Counties to assist you throughout the year. Schedule your appointment with a SHIP Counselor and make a well-educated decision during Open Enrollment. You may find that the plan you are already on continues to offer you the best coverage, in which case no action is required. But sometimes, like colorful trees in the fall, you need to drop the old so you can make room for the new. Your local SHIP Counselor is here to help you with the process.
To make your one-on-one appointment with a SHIP Counselor, contact CCSI Case Coordination LLC at 309-661-6400. We begin taking Open Enrollment appointments on October 1st, 2023. We are located at 3601 G.E. Road, Suite 2, Bloomington, IL 61704. Services have no fee, but donations are graciously accepted. No one is ever denied assistance based on the inability to pay. Funding is provided through ECIAAA and IDOA.