SHINE: Serving the Health Insurance Needs of Everyone
- Written by The Medicare Rights Center
Most people become eligible for Medicare when they turn 65. Your Medicare enrollment steps will differ depending on whether or not you are collecting retirement benefits when you enter your Initial Enrollment Period (IEP), (the seven months surrounding your 65th birthday- 3 months before, the month of, and the 3 months following).
- If you are receiving Social Security retirement benefits or Railroad Retirement benefits, you should be automatically enrolled in both Medicare Part A and Part B.
- If you are not receiving Social Security retirement benefits or Railroad Retirement benefits, you will need to actively enroll in Medicare by contacting the Social Security Administration.
If you are eligible for automatic enrollment, you should not have to contact anyone. You should receive a package in the mail three months before your coverage starts with your new Medicare card. There will also be a letter explaining how Medicare works and that you were automatically enrolled in both Parts A and B. If you get Social Security retirement benefits, your package and card will come from the Social Security Administration (SSA). If you get Railroad Retirement benefits, your package and card will come from the Railroad Retirement Board.
Typically, you should not turn down Part B unless you have insurance based on your or your spouse’s current work (job-based insurance).
Typically, you should not turn down Part B unless you have insurance based on your or your spouse’s current work (job-based insurance). If you do not have job-based insurance and you turn down Part B, you may incur a premium penalty if you need to sign up for Medicare coverage in the future. Also, if your job-based insurance will pay secondary after you become eligible for Medicare, you should consider enrolling in Medicare in order to have primary coverage and pay less for your care.
If you are 65 but are not receiving Social Security retirement benefits or Railroad Retirement benefits, you will need to actively enroll in Medicare.
Signing up for Medicare
Follow the steps below if you need to actively enroll in Medicare. If you decide to enroll in Medicare during your Initial Enrollment Period, you can sign up for Parts A and/or B by:
- Visiting your local Social Security office
- Calling Social Security at 800-772-1213
- Mailing a signed and dated letter to Social Security that includes your name, Social Security number, and the date you would like to be enrolled in Medicare
- Or, by applying online at www.ssa.gov
If you are eligible for Railroad Retirement benefits, enroll in Medicare by calling the Railroad Retirement Board (RRB) or contacting your local RRB field office.
Keep proof of when you tried to enroll in Medicare, to protect yourself from incurring a Part B premium penalty if your application is lost.
- Take down the names of any representatives you speak to, along with the time and date of the conversation.
- If you enroll through the mail, use certified mail and request a return receipt.
- If you enroll at your local Social Security office, ask for a written receipt.
- If you apply online, print out and save your confirmation page.
This article is made available to you with permission from the Medicare Rights Center in Washington DC, www.medicarerights.org. The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs and public policy initiatives.
The SHINE program, (Serving Health Information Needs of Everyone…on Medicare), provides free, confidential and unbiased health insurance counseling for Medicare beneficiaries. To reach a trained and certified counselor in your area, contact the Regional Office at 1-800-498-4232, LifePath at 413-773-5555, or contact your local Council on Aging.
- Written by Janis Merrell
On Friday, June 7, 11 women graduated from the SHINE program at LifePath’s office in Greenfield. SHINE is an acronym for “Serving the Health Insurance Needs of Everyone” and that is just what these fantastic volunteers will be doing. As newly certified SHINE counselors, they will work in their own communities to provide free and unbiased health insurance information, education, and assistance services to Medicare beneficiaries and adults with disabilities. Lorraine York-Edberg, SHINE Regional Program Director, provided the intensive 60 hour training. “I have a greater respect for SHINE counselors because of the complexity and amount of information they have to learn,” said graduate Linda Talbot of Whately. “Lorraine is an excellent instructor, enjoyable and informative.”
Graduate Leanne Dowd of Greenfield said, “When it started, the training seemed overwhelming, but with the education from Lorraine and the materials provided, it became completely understandable.”
“She made it fun,” added graduate Wanda Kelly of Pelham.
Reasons for becoming a SHINE volunteer varied. Graduate Buliah Mae Thomas of Easthampton explained, “I’m a senior myself although I’m still working full-time. I wanted to give seniors and people with disabilities my knowledge after going through the program. I wanted them to have more knowledge than I had. I want to thank Lorraine for giving me the opportunity to be a SHINE counselor.”
“As newly certified SHINE Counselors, they will work in their own communities to provide free and unbiased health insurance information, education, and assistance services to Medicare beneficiaries and adults with disabilities.”
Each graduate received a rose, a datebook, and a certificate of graduation at the final class, before enjoying a potluck meal. York-Edberg said, “This was a great group of SHINE trainees. They have and will go above and beyond to assist the Medicare beneficiaries in our service area!”
If you have questions about Medicare options, you can consult with SHINE counselors over the phone or in person at your area senior center, in your home, or at another location that is convenient for you. The SHINE program (Serving the Health Insurance Needs of Everyone) provides free, confidential, and unbiased health insurance counseling for Medicare beneficiaries. To reach a trained and certified counselor in your area, contact the Regional Office at 1-800-498-4232 or 413-773-5555 or contact your local Council on Aging.
- Written by Anne Campbell
Social Security and OIG Alert Public About Telephone Impersonation Scheme
The Social Security Administration (SSA) and its Office of the Inspector General (OIG) launched a joint Public Service Announcement (PSA) campaign addressing a nationwide telephone impersonation scheme. Social Security and the OIG continue to receive reports from across the country about fraudulent phone calls from people falsely claiming to be Social Security employees. Calls can even “spoof” Social Security’s national customer service number as the incoming number on the caller ID. The new PSAs will air on TV and radio stations across the country to alert the public to remain vigilant against potential fraud.
“We urge you to always be cautious and to avoid providing sensitive information such as your Social Security number or bank account information to unknown people over the phone or Internet,” said Nancy A. Berryhill, Acting Commissioner of Social Security. “If you receive a call and are not expecting one, you must be extra careful – you can always get the caller’s information, hang up, and contact the official phone number of the business or agency the caller claims to represent. Do not reveal personal data to a stranger who calls you.”
“Do not reveal personal data to a stranger who calls you.”
Social Security employees do occasionally contact people—generally those who have ongoing business with the agency—by telephone for business purposes. However, Social Security employees will never threaten a person or promise a Social Security benefit approval, or increase, in exchange for information. In those cases, the call is fraudulent and people should not engage with the caller. If a person receives these calls, he or she should report the information to the OIG Fraud Hotline at 1-800-269-0271 or online.
“These calls appear to be happening across the country, so we appreciate SSA’s partnership in this national public outreach effort,” said Gail S. Ennis, the Inspector General for the Social Security Administration. “Our message to the public is simply this: If you or someone you know receives a questionable call claiming to be from SSA or the OIG, just hang up.”
- Written by Lorraine York-Edberg
To apply, fill out a simple one-page application.
Medicare buy-in programs, also called Medicare Savings Programs, can help low-income Medicare beneficiaries pay their share of the standard Medicare Part B premium, which is currently $135.50 monthly. Medicare beneficiaries may be eligible for different buy-in programs based on their income and assets. The three programs are called QMB (Qualified Medicare Beneficiary); SLMB (Specified Low Income Medicare Beneficiary); and QI-1 (Qualified Individuals).
Eligibility Guidelines for these programs are as follows:
- QMB is at 100% Federal Poverty Level as follows for an
- Individual $1,041 monthly and less than $7,730 in assets
- Couple $1,410 monthly and less than $11,600 in assets
- SLMB is at 120% Federal Poverty Level as follows for an
- Individual $1,249 monthly and less than $7,730 in assets
- Couple $1,691 monthly and less than $11,600 in assets
- QI-1 is at 135% Federal Poverty Level as follows for an
- Individual $1,406 monthly and less than $7,730 in assets
- Couple $1,872 monthly and less than $11,600 in assets
These programs are not subject to estate recovery since January of 2010, so the state will NOT place a lien on your property to recover benefits following your death.
And better still...
If you qualify for any of the three Medicare Savings programs, you will also automatically qualify for a full subsidy under the Medicare Part D Low Income Subsidy (LIS), which is also known as "Extra Help." This program will pay the monthly premiums for your Part D plan, provided you are enrolled in a qualified plan. The LIS will also assist with covering drugs during the Part D deductible and coverage gap.
If you are eligible as a Qualified Medicare Beneficiary (QMB), this program will pay for your Part A (hospital insurance) deductible and Part B annual deductible of $185 annually. The 2019 Part B standard premium is currently $135.50 monthly, and the hospital deductible is $1,364 for each hospitalization.
If you are eligible as a Specified Low Income Medicare Beneficiary (SLMB) or the Qualified Individual Medicare Beneficiary (Q I-1), this program will pay for your Part B (medical insurance) premium.
To apply, it is a one-page application, and simple to fill out. To get this application, you can contact MassHealth at 1-800-841-2900 and request the Medicare Buy-In application, and they can send it to you. We also have applications available here at the regional SHINE office upon request. If you need assistance filling it out, we are happy to assist.
The SHINE program (Serving Health Information Needs of Everyone…on Medicare), provides free, confidential, and unbiased health insurance counseling for Medicare beneficiaries. To reach a trained and certified counselor in your area, contact the Regional Office at LifePath at 1-800-498-4232 or 413-773-5555, or contact your local Council on Aging.
- Written by Lorraine York-Edberg, Western Mass. Regional SHINE Program Director
Volunteer Spring Training 2019 begins in April
If you’re interested in healthcare and looking for a volunteer opportunity, consider signing up to become a SHINE counselor with LifePath. The 2019 Spring Training is coming up in a few weeks, and there is no better time to get started.
SHINE, Serving Health Insurance Needs of Everyone, is a program that provides free, confidential and unbiased health insurance counseling for all Medicare beneficiaries. Volunteers in the LifePath SHINE program serve communities in all of Franklin County as well as the North Quabbin region of Worcester County and parts of Hampden and Hampshire counties.
SHINE counselors work one-on-one with individuals in their own communities providing information, counseling and assistance on Medicare, Medigap, Medicare Advantage Plans, Medicare Prescription Drug Coverage, Public Benefits, One Care Plans, and more. Those interested in becoming counselors should be comfortable working with a population consisting primarily of elders and persons with behavioral health challenges and physical disabilities.
SHINE Counselor Larry Bezio enjoys the volunteer work the program offers, adding that he finds “personal satisfaction to be able to help someone” and “good socialization” with other counselors.
Counselors benefit from ongoing monthly meetings, allowing them to stay up-to-date with new healthcare policies and programs, which are always changing. This year’s training is vast and comprehensive, and will address changes that have taken place in the past year.
The 2019 Spring Training is set to take place at LifePath in Greenfield from 10 a.m. to 3 p.m., with a break for lunch, beginning on April 2, 2019. Participants will meet weekdays for 11 sessions. A graduation celebration will take place in June.
More about the SHINE Program
The SHINE Program, Serving the Health Information Needs of Everyone, provides free, confidential, and unbiased health insurance counseling for Medicare beneficiaries. To reach a trained and certified counselor in your area, contact the regional office at 1-800-498-4232 or 413-773-5555.