Professional Guidance for Medicare Decisions

Whether you’re approaching eligibility for Medicare or have had Medicare for a while, it’s essential to make informed decisions about your healthcare coverage. With the complexity of Medicare, many find it beneficial to seek guidance from a SHIP counselor. Evergreen Commons has SHIP counselors who provide personalized, unbiased guidance that can help you or a loved one navigate Medicare decisions and find the plan that best fits your needs. Our counselors are well-versed in the Medicare process and understand the anxiety and frustration choosing a plan can bring. Here's what you need to know about meeting with a SHIP counselor to direct your Medicare decisions:

Preparing for Your Meeting 

1. Gather Necessary Documents:
   • Medicare Card: If you’re already enrolled, bring your Medicare card or documentation.
   • Health Insurance Information: Any current health insurance policies, including those from previous employers.
   • Prescription List: A list of medications you currently take, including dosage and frequency.
   • Income and Asset Information: Financial documents to help determine if you qualify for additional programs like Extra Help (LIS) or Medicare Savings Program (MSP).
2. Understand Your Current Situation:
   • Review your current health coverage and any issues or concerns you may have.
   • Note any specific questions or areas where you need clarification.
3. Define Your Goals:
   • Are you looking for ways to reduce costs, enhance coverage, or find a plan that better fits your healthcare needs?
4. Complete Evergreen Commons’ Medicare Worksheet and Authorization Form and return them to the Resource Center prior to your appointment.

During the Meeting 

1. Review Your Options:
   • Original Medicare: This includes Part A (hospital insurance) and Part B (medical insurance). The SHIP counselor will explain how these parts work together and discuss the possibility of adding a Medigap policy for supplemental coverage and Part D (prescription drug coverage).  This is often recommended as Original Medicare has no prescription coverage or cap on out-of-pocket medical costs.   
   • Medicare Advantage Plans: These are private plans, often called Part C, that contract with Medicare to provide your health Insurance.  These plans combine Part A(hospital), Part B(medical) and typically Part D(prescription) coverage, with additional benefits. The SHIP counselor will help you compare these plans to find one that meets your needs.
   • Prescription Drug Plans (PDP’s): If you need Part D coverage, the counselor will help you compare different plans based on your prescription needs.  These plans are often needed if you have Original Medicare or are enrolled in Original Medicare and Medicaid.
2. Discuss Financial Assistance Programs:
   • Extra Help: For those with limited income and resources, this program helps with prescription drug costs.
   • Medicaid Coverage: If you qualify, Medicaid can help cover health care costs and the Medicare Part B premium.
3. Clarify Your Questions:
   • Make sure you understand the coverage details, costs, and any potential out-of-pocket expenses associated with each option. It’s a lot of information to take in, so don’t feel embarrassed if things are unclear. This meeting is for you, so make the most of your time to ask any remaining questions. See our article, Start Here: Medicare, for more information.
   • Ask about enrollment periods and deadlines to ensure you don’t miss important dates.
4. Explore Additional Resources:
   • Your SHIP counselor may provide you with brochures, websites, or contact information for further assistance. 

After the Meeting 

1. Review Your Choices:
   • Take time to carefully review the information provided and consider how it fits with your healthcare needs and financial situation.
2. Follow Up:
   • If you have additional questions or need further clarification, don’t hesitate to contact Evergreen Commons’ SHIP again.
3. Make an Informed Decision:
   • Once you’ve made your choice, follow the enrollment instructions provided by the SHIP counselor or request that the counselor assist you with enrollment.
4. Stay Informed:
   • Medicare plans and policies can change annually, so it’s a good idea to review your coverage each year and stay informed about any updates or new options. 

Meeting with a SHIP Counselor is a valuable step in ensuring you make the best decisions regarding your Medicare coverage. With their help, you can approach Medicare with confidence and peace of mind, knowing that your healthcare coverage is tailored to your unique situation.