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From my own
personal perspective there just isn't much
that's more fun than trying to make heads or
tails out of medical bills, health insurance
statements, new drug programs and the like. I've
been trained by experience in deciphering who
paid who what, and what's covered and what
isn't, and I still get a headache. Caregivers
haven't been trained, don't have the time or the
desire to get trained, and to a man/woman all
complain that dealing with medical and insurance
providers is more than they can cope with. There
is help. You just have to know where to look for
it.
The State
Health Insurance Assistance Program, or SHIP,
is a state-based program that uses federal
grants to provide free counseling and assistance
by telephone or face-to-face to anyone 60 plus
years of age, and to Medicare beneficiaries
regardless of age. There are SHIPs in all 50
states plus Washington, D.C., Guam, Puerto Rico
and the Virgin Islands.
Trained SHIP counselors offer information,
counseling and assistance to Medicare
beneficiaries on a wide range of Medicare and
Medicaid, and Medigap matters. SHIP counselors
are commonly consulted about:
•
Information about Medicare benefits and
limitations, Fee-for-Service Plans, and
Coordinated Care Plans/Health Maintenance
Organizations (HMOs);
•
Special
Medicare/Medicaid benefit programs for those
with limited income and assets such as Qualified
Medicare Beneficiary (QMB) and Specified
Low-Income Medicare Beneficiary (SLMB) programs;
•
Assistance with
claims, requests for reconsiderations, and
appeal processes for Medicare and Supplemental
Insurance (Medigap) plans;
•
Assistance with
Medicare prescription drug plans;
•
Determining health
insurance needs and providing unbiased
information to assist consumers in making
informed decisions about health and long-term
care insurance (SHIP counselors do not sell or
solicit any type of insurance).
SHIP counselors are thoroughly trained to answer
questions and provide assistance with healthcare
insurance issues. Because benefits and
entitlements for older people and people with
disabilities are written into many so different
laws, SHIP counselors must be knowledgeable
about legal services in general. The Older
Americans Act (OAA) defines "legal services" to
include the work of a non-lawyer. SHIP
counselors are trained to help the elderly with
basic legal problems, but they are not under the
direction of a lawyer. Representation by an
attorney is not included as part of SHIP
services.
To find a SHIP counselor, start with the
SHIP National Directory and ask for a
referral to the most qualified counselor near
you.
If you're
under 60 and don't have Medicare you can contact
your
State Department of Insurance for assistance
with most questions or problems.
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