A State Health Insurance Assistance Program (SHIP) is a free service that helps people understand and manage Medicare coverage.
These programs provide in-depth, one-on-one counseling to individuals who are eligible for Medicare, as well as their families or caregivers. Each state has its own SHIP.
A SHIP counselor can help someone compare different Medicare plans, prescription drug plans, supplemental insurance, or long-term care coverage. They can also check whether a person is eligible for financial assistance for healthcare costs.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
SHIPs help Medicare-eligible individuals with their healthcare insurance.
Federally funded SHIPs are available in all 50 states in the United States, as well as in the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands. They are not affiliated with insurance companies, which means that counselors will not try to sell any products or services.
SHIP counselors, volunteers, and staff all get specialized training, which includes a four-level, 17-course on various topics, including Medicare basics, coverage, coordination of benefits, and appeals. People can also complete other courses on special topics.
History of SHIPs
Congress created SHIPs as part of a budget bill in 1990, according to the Administration for Community Living (ACL), which is part of the Department of Health and Human Services. The goal was for each state to offer health insurance counseling and assistance to people with Medicare.
SHIPs in each state get federal funding, and the ACL oversee the program. In 2020, the ACL predicted that there would be more than 77 million people over the age of 60 years by the end of the year. They also reported that in the year between April 2017 and March 2018, SHIPs worked with 2.9 million Medicare beneficiaries or their caregivers.
How does it work?
Counselors meet with individuals on the phone or in person. An average counseling session in 2016 lasted 30 minutes, according to ACL.
SHIPs provide counseling that is:
In addition to providing one-on-one counseling, SHIPs host community events, such as their “Medicare Boot Camp” for people who will soon become eligible for Medicare.
People refer to SHIP programs by different names in various states.
While many states — including Arizona, Colorado, Illinois, Maryland, Minnesota, Tennessee, Wisconsin, among others — call the program SHIP, it has other names in some states.
Other names for the programs include:
- DMAB: Delaware Medicare Assistance Bureau
- HICAP: Health Information, Counseling, and Advocacy Program in Texas
- HICAP: Health Insurance Counseling & Advocacy Program in California
- HIICAP: Health Insurance Information, Counseling, and Assistance Program in New York
- MMAP: Michigan Medicare Assistance Program
- OSHIIP: Ohio Senior Health Insurance Information Program
- SHIBA: Senior Health Insurance Benefits Assistance (or Advisors) in Oregon, Idaho, and Washington
- SHIC: State Health Insurance Counseling in North Dakota
- SHICK: Senior Health Insurance Counseling for Kansas
- SHINE: Serving Health Insurance Needs of Elders in Florida
- SHIIP: Senior Health Insurance Information Program in Arkansas, Iowa, Louisiana, and North Carolina
- VICAP: Virginia Insurance Counseling and Assistance Program
This online tool can help a person find a SHIP center in their area.
SHIPs help people with the following topics:
- Original Medicare (Part A and Part B)
- Medicare Advantage plans (Part C)
- Medicare prescription drug coverage (Part D)
- Medicare supplement insurance (Medigap)
A SHIP counselor can explain Medicare’s eligibility and enrollment rules and help a person compare Medicare plans.
According to the SHIP TA Center, SHIPs provide additional services, including:
- helping people review their coverage options during Medicare’s annual open enrollment period
- researching financial assistance that might be available for a person with Medicare
- providing information on what Medicare does and does not cover
- describing how Medicare works with other healthcare coverage, such as supplemental policies, Medicaid, or retiree programs
- assisting with appeals of denied claims
Some SHIP programs may also offer:
- help with sorting out medical bills and statements so that a person can determine what they need to pay (North Dakota SHIC)
- study guides to allow someone to do their own Medicare research (New Hampshire SHIP)
- legal assistance or referrals for issues with Medicare or long-term care insurance (California HICAP)
SHIP services are available to Medicare-eligible individuals, their family members, and their caregivers. People in the U.S. are typically eligible for Medicare when they reach 65 years of age, although younger people with certain disabilities may also qualify.
People who will soon be eligible for Medicare may also get SHIP services.
SHIPs provide their services free of charge. Federal grants pay for the programs in each state.
SHIP services are available to Medicare-eligible individuals, their family members, and their caregivers.
SHIPs provide personalized counseling and education to help someone make informed choices about their healthcare benefits.
This service is free and not affiliated with insurance companies, which means that counselors will not try to sell any products or services.