Medicare, Medicaid, and fraud prevention assistance

Medicare Counseling & Information on Healthcare Benefits

The Senior Health Insurance Information Program (SHIP) is a free health benefits counseling service for Medicare beneficiaries and their families or caregivers. SHIP educates, advocates, counsels and empowers people to make informed healthcare benefit decisions. SHIP is a federally funded program and is not affiliated with the insurance industry. 

Salt Lake County Aging & Adult Services is the SHIP Agency for Salt Lake County. SHIP counseling is FREE of charge. Call (385) 468-3200. 

SHIP helps older adults navigate the complexities of Medicare. We provide assistance to help minimize out of pocket healthcare expenditures and resolve billing errors, fraud, and abuse issues.

Senior Medicare Patrols (SMPs) empower and assist Medicare beneficiaries, their families, and caregivers to detect and report health care fraud and abuse. 

State Health Insurance Assistance Programs (SHIPs) provide free help to Medicare beneficiaries who have questions or issues with their health insurance.

Resources

• Medicare.gov
• Medicare Plan Finder
• Medicare Cost-Sharing Programs
• Utah Medicaid
• Social Security

If you’re not a resident of Salt Lake County, you can call a counselor or attend a workshop in your area by contacting your Local Area Agency on Aging.

Are you eligible for Medicare or Medicaid?

• Call SHIP for free at (385) 468-3200.
• To determine Medicaid eligibility call the Department of Workforce Services at (801) 526-0950.
• To determine Medicare eligibility call Social Security at (800) 772-1213.

Medicare Eligibility

You may qualify for Medicare if:

• You are 65 years of age or older
• Are under the age of 65 but have been receiving Social Security disability benefits for 24 months
• Have End-Stage Renal Disease (ESRD) or Lou Gehrig’s disease (ALS)

Some people automatically get Part A and Part B. Find out if you’ll get Part A and B automatically. If you're automatically enrolled, you'll get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability. If you don't get Medicare automatically, you’ll need to apply for Medicare online.

The first time you can enroll is called your Initial Enrollment Period. Your 7-month Initial Enrollment Period includes the three months before the month you turn 65, the month in which you turn 65, and the three months that follow. During this time, you may enroll into Part A and Part B, as well as pick up prescription drug coverage.

Outside of the Initial Enrollment Period there are several other circumstances which will grant you a Special Enrollment Period, such as when you move outside of your service area or you lose creditable coverage through an employer. See if your special circumstance qualifies you for a Special Enrollment Period.

For Part D or Medicare Advantage plans, you can visit Medicare.gov to self-enroll or contact your local SHIP agency for further assistance.

If you do not qualify for Medicare or Medicaid, you may check to see what your options are with the Health Insurance Marketplace at healthcare.gov.

Medigap Insurance

Medigap is extra health insurance that you buy from a private company to pay health care costs not covered by Original Medicare.

The best time to buy a Medigap policy is during your 6-month Medigap open enrollment window. This window begins when you are 65 years of age or older AND you get Medicare Part B. During this time, you have Guaranteed Issue Right – that is, you cannot be subject to medical underwriting when companies are providing you with quotes.

If you apply for Medigap coverage after your open enrollment period, there's no guarantee that an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements. You may purchase a Medigap policy at any time otherwise.

• Medicare Supplemental Insurance Policies (Medigap)
• Medigap Policies Coverage Guide

Volunteer Opportunities

Volunteers help beneficiaries with healthcare benefits information, healthcare fraud and abuse, and difficult insurance concerns. Tasks may include:

• Medicare presentation & enrollment events
• Medicare Part D screenings, counseling & enrollment
• Medicare Advantage screenings, counseling & enrollment
• Medigap/Medicare Supplement resources & counseling
• Medicaid & Extra Help applications
• Medicare and fraud & abuse public presentations
• Distribute information to the public, including doctor's offices and pharmacies
• Data entry & reporting

Volunteer Requirements

To volunteer you must:

• Pass a background check
• Possess a valid Utah driver's license
• Maintain records accurately
• Be in compliance with HIPPA
• Maintain client confidentiality
• NOT enter into any financial or business relationship with ANY clients
• Contribute at least 8 hours per month and submit monthly reports
• Maintain patience and tactfulness
• Have the ability to work with diverse populations including those with significant physical and mental impairments
• For counselors - attend 40 hours of Medicare training

Training and Support

• Orientation and training is provided to all volunteers prior to beginning assigned duties.
• On-the-Job and SHIP training is also provided.

Contact Person

Contact Information

• Full name as listed on your Medicare Card
• Full Date of Birth
• Full address you list with the Social Security Office
• Medicare Number and effective Medicare Dates

If calling regarding fraud/insurance concerns, have appropriate documentation.