Keep Medicare advice SHIP
afloat for U.S. seniors
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[June 30, 2016]
By Mark Miller
(Reuters) - Would you call a U.S. program that helps 7 million seniors
save money on Medicare annually “unnecessary”?
Probably not. But a network of more than 3,300 free Medicare counseling
services could lose its $52 million in federal funding due to budget
cuts. The State Health Insurance Assistance Program (SHIP) is on a list
of more than a dozen programs lined up to get the axe from the Senate
“Duplicitous or unnecessary,” said U.S. Senator Roy Blunt, explaining
the rationale. The Missouri Republican probably meant “duplicative”
there, but never mind. He is wrong either way. This is one SHIP that
definitely should be kept afloat.
Navigating the Medicare program is complicated - more complicated than
it needs to be. Over the years, Congress has added coverage options
built around marketplaces offering commercial plans. The typical senior
selecting a Part D prescription drug plan must choose between an average
of more than 20 choices, according to the Medicare Rights Center (MRC).
Those who opt for a Medicare Advantage plan must choose from an average
of 19 possible prescription drug plans.
That approach is driven mainly by conservative ideology, which holds
that the private market can deliver superior efficiency and products.
But there is precious little evidence that this approach works in
healthcare. Independent studies have shown repeatedly that Medicare
enrollees waste money by over-insuring themselves in the Part D program.
A new analysis of hospital networks in the Medicare Advantage program by
the Kaiser Family Foundation (KFF) finds spotty participation by
hospitals in plans, and that shopping for a plan with a specific
hospital in network “can be tough for consumers.” The study also finds
that some plans lack access to the highest quality academic medical
Adding insult to injury, the powerful Senate Appropriations Committee
recently voted to end funding for SHIPs, which help seniors navigate
these messy options. SHIPs operate in all 50 states, plus Puerto Rico,
Guam, the District of Columbia and the U.S. Virgin Islands. The local
SHIPs have more than 14,500 counselors - 57 percent of whom are highly
trained volunteers, according to MRC. (Find your local SHIP here: (bit.ly/1OU0sfN)
Medicare offers an annual enrollment period during which beneficiaries
can shop for new prescription drug or Medicare Advantage plans. During
last year’s autumn enrollment period (Oct. 15 to Dec. 7), SHIPs helped
nearly 1.1 million seniors, according to MRC data.
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few enrollees bother to re-shop their coverage annually - but they should.
Insurance companies often change their offerings year-to-year in ways that can
increase drug costs, or make it more difficult to obtain certain drugs. At the
same time, a senior’s drug needs may have changed since the last plan selection
period in ways that make a plan less beneficial.
study by the Kaiser Family Foundation found that, on average, just 13 percent of
enrollees voluntarily switched their drug or Medicare Advantage plans - but that
nearly half of those who did switch plans saved at least 5 percent the following
year, mainly on premiums.
SHIPs also helped nearly 1.3 million low-income seniors with Medicare enrollment
last year, according to MRC. Much of that work was focused on options to save
money on premiums, such as Extra Help, which often covers up to 75 percent of
prescription drug costs (http://reut.rs/1OXKZ9b). About 1.2 million low-income
beneficiaries who qualified for Extra Help were enrolled in higher-cost Part D
plans last year, according to KFF - a sure sign that greater outreach and
assistance is needed.
SHIPs also help with enrollment in Medigap plans, which help cover gaps in
traditional Medicare such as copayments, coinsurance and deductibles. They also
can help seniors make sure they enroll on time, avoiding costly late enrollment
The budget cuts approved by the Senate Appropriations Committee were part of a
broader move to increase funding in some areas where dollars are needed. All
told, $2 billion would be shifted to the National Institutes of Health, and used
to restore year-round Pell Grants for college students, and to increase
resources to prevent and treat opioid abuse.
“Our understanding is that some tough decisions were made,” said Stacy Sanders,
federal policy director at MRC. “It’s the product of a tight budget
SHIP funding actually has declined against inflation - spending for fiscal 2017
would be just over $66 million if it had kept up with inflation, according to
the National Council on Aging.
A vote by the Senate is not expected until this fall, and the House of
Representatives has yet to weigh in. Here is hoping that Congress can somehow
right the SHIP.
(Editing by Matthew Lewis)
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