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State Health Insurance and Assistance Programs

DESCRIPTION

The State Health Insurance Assistance Program, or SHIP, is a state-based program that offers local one-on-one counseling and assistance to people with Medicare and their families. Through CMS funded grants directed to states, SHIPs provide free counseling and assistance via telephone and face-to-face interactive sessions, public education presentations and programs, and media activities.

BACKGROUND

SHIP (formerly the Information, Counseling and Assistance (ICA) Grants Program) was created under Section 4360 of the Omnibus Budget Reconciliation Act (OBRA) of 1990 (Public Law 101-508). This Act authorizes the Centers for Medicare and Medicaid Services (CMS), the Federal Medicare agency, to make grants to states for health advisory services programs for people with Medicare. Currently, there are SHIPs in all 50 states plus Washington, D.C., Guam, Puerto Rico and the Virgin Islands.

Grant funding is available for SHIPs to plan and operate a variety of information, counseling, and assistance activities. States have wide latitude in providing SHIP services. However, programs must offer locally accessible services to all eligible persons requesting assistance, develop an intra-state agency referral system, and communicate timely and accurate health care information.

The SHIPs were originally established to address the confusion caused by the increase in choices of Medicare supplemental insurance, or Medigap. Since the program’s inception, however, the role of the SHIPs in serving people with Medicare has greatly expanded. Today, trained counselors offer information, counseling and assistance to Medicare beneficiaries on a wide range of Medicare and Medicaid, and Medigap matters, including, enrollment in Medicare prescription drug plans, Medicare Advantage options, long-term care insurance, claims and billing problem resolution, information and referral on public benefit programs for those with limited income and assets, and other health insurance benefit information. In addition, SHIPs also support efforts to inform Medicare beneficiaries about fraud and abuse.

CURRENT STATUS

The state grantees have built the SHIP network nationwide to include over to 1,300 local sponsoring organizations supporting over 12,000 counselors (mostly volunteers) and staff. Last year, the SHIPs served over 2.5 million Medicare beneficiaries through one-on-one, in-person and over the telephone counseling sessions and presentations and public education programs.

SHIPs are currently providing community outreach, education, and one-on-one enrollment assistance to people with Medicare living in the communities served by these local programs.

The Centers for Medicare & Medicaid Services awarded $31.7 million in grants to states in FY 2005 in support of local programs to help Medicare beneficiaries understand and take advantage of new benefits and programs in Medicare, including the Medicare prescription drug coverage.

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Related Links Inside CMS

List of State Health Insurance Offices

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Page Last Modified: 12/14/2005 12:00:00 AM
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