Access to insurance navigation support through the State Health Insurance Assistance Program (SHIP)

TL;DR

The SHIP program helps people enroll in Medicare, but low-income individuals face challenges accessing its services due to limited staff and training.

Contribution

This study identifies barriers to SHIP accessibility for low-income Medicare beneficiaries and suggests ways to improve service quality.

Findings

Availability of volunteers is the main barrier to SHIP services.

SHIP counselors frequently address dual eligibility for Medicare and Medicaid.

Staff expressed a need for more training on Medicaid and integrated-care programs.

Abstract

Medicare enrollment is complex, particularly for low-income individuals who are dually eligible for Medicare and Medicaid, and the wrong plan choice can adversely impact beneficiaries’ out-of-pocket costs and access to providers and medications. The State Health Insurance Assistance Program (SHIP) is a federal program that provides counseling on Medicare coverage, but the degree to which SHIP services are accessible to low-income beneficiaries is unknown. We interviewed SHIP counselors and coordinators to characterize factors affecting access to and quality of SHIP services for low-income beneficiaries. Availability of volunteers was cited as the primary barrier to SHIP services. Topics related to dual eligibility for Medicare and Medicaid were frequently covered in counseling sessions, and staff expressed a desire for more training related to Medicaid and integrated-care programs. Our results suggest that additional counselors and increased training on topics relevant to dually eligible individuals may improve SHIP's ability to provide health insurance–related information to low-income Medicare beneficiaries.

Enrolling in Medicare is becoming increasingly complex. The complexity increases further for low-income individuals who are dually eligible for Medicaid and Medicare. The wrong plan choice can adversely impact beneficiaries’ out-of-pocket costs and access to providers and medications. An information resource for beneficiaries is the State Health Insurance Assistance Program (SHIP), which is overseen by the Administration for Community Living. Recent federal communications tout SHIP as a source of unbiased information that can be used to combat deceptive marketing of Medicare Advantage plans, which often target low-income beneficiaries. However, there are concerns about the degree to which SHIP services are accessible to beneficiaries, particularly those who are low-income.