Free Medicare Help: SHIP Counseling and Spotting Medicare Scams

Medicare decisions involve real money, and the people most eager to help are not always the ones you should trust. Some are selling a plan. A few are trying to steal your Medicare Number. Meanwhile, a free, government-funded counseling service is available in every state.

This guide explains what State Health Insurance Assistance Programs (SHIPs) are, what they can help with, and how to reach other official sources. It then covers Medicare scams that federal agencies warn about, the Senior Medicare Patrol, and where to report problems.

This is an independent guide and general information only, not legal, insurance or financial advice, and it is not affiliated with Medicare, CMS, SHIP or any government agency. If you think you've lost money to a scam, contact the agencies listed below and your bank right away.

What SHIP is

The U.S. Administration for Community Living (ACL), part of the Department of Health and Human Services, describes SHIP as a national program that offers one-on-one assistance, counseling and education to Medicare beneficiaries, their families and caregivers, to help them make informed decisions about their care and benefits.

According to ACL, there is a SHIP grantee in each of the 50 states, plus Puerto Rico, Guam, the District of Columbia and the U.S. Virgin Islands. Services are delivered by state units on aging or state departments of insurance, working with local area agencies on aging and other community partners. Counselors help in person and by phone, and the network includes staff and volunteers. ACL says SHIPs were created under the Omnibus Budget Reconciliation Act of 1990.

The SHIP national technical assistance center describes the service as local, one-on-one Medicare counseling at no cost to you, from a trusted, unbiased source, and says counseling is confidential and personalized.

What a SHIP counselor can help with

Medicare.gov's contact page says SHIPs help people with Medicare and their families:

• Choose a plan.
• Review coverage.
• Understand costs.
• Apply for Extra Help.
• File a complaint or an appeal.
• Make informed Medicare decisions.

That list covers most of the cost questions on this site: whether you might qualify for Extra Help or a Medicare Savings Program, how a premium change affects you, or whether to appeal a decision. The SHIP center adds that counselors can help you compare costs, review coverage and check provider networks during Open Enrollment.

To find your SHIP, use the state-by-state list on the SHIP national center's website or call the center at 877-839-2675.

A session goes further if you bring your Medicare card, a list of your prescriptions and doctors, your current plan materials, and any letters you've received, such as a premium notice or a penalty letter.

Other official places to get answers

• 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048): Medicare.gov says you can talk or live chat with a person 24 hours a day, 7 days a week, except some federal holidays.
• The Social Security Administration: Medicare.gov's contact page lists SSA for signing up for Part A and Part B, changing your address, and applying for Extra Help.
• Your state: Medicare.gov says to contact your state about Medicare Savings Programs, Medicaid and other state programs that help with health costs.

Scams to recognize

The Federal Trade Commission (FTC) warns about callers, emails, texts and social media messages from someone claiming to work for Medicare. Its guidance is clear on several points:

• Medicare sends its cards to you automatically for free; you never have to pay anything for one.
• Real government agencies won't contact you to ask for your Medicare Number or other personal information unless you called 1-800-MEDICARE first.
• Medicare won't call, email, text or message you on social media to sell you anything.
• Caller ID can be faked, even when it shows a real agency name or number.
• No government agency will demand that you wire money or pay with gift cards, cryptocurrency or a payment app.

Medicare.gov adds that Medicare will never call to sell you anything or visit you at your home, and advises against joining a Medicare health or drug plan over the phone unless you called and asked for help. It also warns against accepting money or gifts for free medical care.

The Senior Medicare Patrol (SMP) programs, which ACL says help beneficiaries prevent, detect and report health care fraud, errors and abuse, are another free resource. ACL says SMPs operate in all 50 states, the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. Official sources describe several common schemes:

• Card scams. The FTC says impostors may ask for your Medicare, bank account or credit card numbers for a "new" Medicare card. If you're unsure whether mail or a call is really from Medicare, call 1-800-MEDICARE yourself and ask.
• Offers in exchange for your Medicare Number. Medicare.gov's examples of fraud include someone who comes to your house or calls, offering to sign you up for hospice care if you give them your Medicare Number, and a provider billing Medicare for services or supplies you never got, like a back brace.
• Misleading marketing. The Medicare & You 2027 handbook says to report plans or agents that ask for personal information by phone or email, call to enroll you, visit unexpectedly or use false information.

Protect your number and check your statements

Medicare.gov recommends a few habits:

• Give your Medicare card or number only to your doctor or people you know should have it, such as an insurer acting on your behalf or your SHIP.
• Compare the dates and services on your calendar with your Medicare statements to make sure you got every service listed.
• Create a secure Medicare.gov account to view Original Medicare claims as soon as they're processed.

Where to report

• Suspected Medicare fraud: call 1-800-MEDICARE or report online, per Medicare.gov.
• Suspected fraud involving a Medicare Advantage or drug plan: Medicare.gov says you can also call the Investigations Medicare Drug Integrity Contractor (I-MEDIC) at 1-877-7SAFERX (1-877-772-3379).
• Help from SMP: ACL says many SHIP grantees also provide SMP services, so your local SHIP is a good place to ask how to reach your state's SMP.
• Government impostor scams: the FTC asks people to report them through its online ReportFraud site.

Key takeaways

• Every state has a SHIP offering free, confidential, one-on-one Medicare counseling; call the SHIP national center at 877-839-2675 to find yours.
• SHIP counselors can help you compare plans, understand costs, apply for Extra Help and file appeals.
• Medicare sends cards for free and won't call, text or visit to sell you anything.
• No government agency demands payment by gift card, wire transfer, cryptocurrency or a payment app.
• Check your Medicare statements, guard your Medicare Number, and report suspected fraud to 1-800-MEDICARE, SMP or the FTC.

Sources

• Administration for Community Living (HHS), State Health Insurance Assistance Program (SHIP)
• SHIP National Technical Assistance Center, Get Medicare Help from Your Local SHIP Program
• Medicare.gov (CMS), Contact Medicare (Talk to someone)
• Medicare.gov (CMS), Reporting Medicare fraud & abuse
• Federal Trade Commission, How To Avoid a Government Impersonation Scam
• Administration for Community Living (HHS), Senior Medicare Patrol (SMP)
• Centers for Medicare & Medicaid Services, Medicare & You 2027 (official handbook)