Susan J. Penner, RN, MN, MPA, DrPH, CNL

Author, Economics and Financial Management for Nurses and Nurse Leaders, Second Edition, 2013. 

Medicare Open Enrollment for 2015 coverage starts on October 15, but with all the options available, deciding on the best Medicare plan can be difficult and confusing. The premiums vary from one health plan to another. Senior citizens who have problems reading and understanding the details of these plans may feel lost. Enrollees might wonder about joining an HMO. They may be uncertain about what their prescription drug deductible might be for the next year, or what supplemental coverage they might need.  There are also serious concerns about Medicare health plan fraud.

New Medicare enrollees might be even more confused about these decisions. In most cases, open enrollment for Medigap plans start with one’s 65th birthday. Roughly 10,000 Americans turn 65 every day. These American seniors need good advice about Medicare health plan choices. This advice is available, and it’s free.

Free healthcare plan counseling for Medicare enrollees, families and caregivers is available through the State Health Insurance Assistance Program (SHIP).  SHIP is administered within each state, so the program name might differ.  For example, California’s program is called the Health Insurance Counseling & Advocacy Program (HICAP).  Florida’s program is called Serving Health Insurance Needs of Elders (SHINE).  In Michigan, the program is called the Medicare/Medicaid Assistance Program (MMAP).  A directory to locate SHIP programs in every state in the US is available online.  People can also call their local senior center to learn more about SHIP.

SHIP is funded by the Federal government and is not affiliated with the health insurance industry. Services are provided through local Area Agencies on Aging, with counselors visiting senior centers to offer assistance. Services include face-to-face counseling, advice over the phone, and workshops. Anyone eligible for Medicare is eligible for services from SHIP programs.

Nurses and Medicare enrollees should know about the SHIP program offered in their state. Nurses are often in contact with enrollees, families and caregivers.  When enrollees are confused about Medicare health plan decisions, they may share their worries or ask nurses for advice. As trusted health professionals, nurses can guide enrollees to this free, dependable service. Many Medicare enrollees are unaware of SHIP programs, so it’s important for nurses and other healthcare professionals to know about this resource and share it with their patients.

Americans who are not eligible for Medicare also have open enrollment for health insurance plans. For coverage starting in 2015, the Open Enrollment Period is November 15, 2014–February 15, 2015. Next month’s post will offer some tips for people enrolling in employer sponsored or Obamacare health plans.

Economics and Financial Management for Nurses and Nurse Leaders, Second Edition

Susan J. Penner, MN, MPA, DrPH, RN, CNL, is the author of Economics and Financial Management for Nurses and Nurse Leaders, Second Edition, a key health care financial management textbook designed to build the economics and financial management skills nurses and nurse leaders need to use daily.