SHINE helps seniors, disabled with Medicare issues and questions

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By K.B. Sherman, Contributing Writer

The SHINE Program (Serving the Health Insurance Needs of Everyone) is a Massachusetts health insurance assistance program providing health insurance information, counseling and assistance to Massachusetts residents with Medicare and their caregivers. It is administered by the Massachusetts Executive Office of Elder Affairs along with elder service agencies, social service and community based agencies, and Councils on Aging. The program is partially funded by the federal agency Centers for Medicare & Medicaid Services.

SHINE supplies to towns in the 50 Plus Advocate area a series of DVDs that inform citizens about Medicare and changes to Medicare access. Called Medical Choices, the DVD, produced by the Massachusetts Executive Office of Elder Affairs, is broadcast once a month on public TV and made available locally through the Central Massachusetts Agency on Aging in West Boylston. The 28-minute DVD is mailed to each central Massachusetts local cable company for broadcast to their service areas. The contact number for the Central Mass SHINE program is 1-800-243-4636. SHINE has also teamed with Milford TV ​(http://milfordtv.net/) to create an on-going series of live television broadcasts discussing Medicare and other topics.

SHINE deals in many areas of health insurance, including Medicare Part A, Part B, and Part D; Medigap insurance, Medicare HMOs, retiree insurance plans, prescription drug programs, Medicaid, Medicare assistance programs (QMB, SLMB and QI), and other programs for people with limited resources.

Typical questions for SHINE counselors include:

  • What does Medicare pay for?
  • What is “Medigap” insurance?
  • Which Medigap policy is best for me? When can I buy a Medigap policy?
  • Where can I get help paying for my prescription drugs?
  • What is “Medicare + Choice” or a “Medicare Health Plan”?
  • How do I appeal a denial of service under Medicare or a Medicare HMO?
  • What do “balance billing” and “accepting assignment” mean?

The regional office is located at 60 North Bow St., Milford. It  provides services to more than over 60 cities and towns in Central Massachusetts. SHINE is administered by the Massachusetts Office of Executive Affairs under a grant from the Administration for Community Living. The Central Region office partners with Council on Aging, Elder and Disability Service providers and other public and private community-based organizations.

The Massachusetts Council on Aging (MCOA) is a non-profit membership organization comprised of municipal Councils on Aging.  Their mission is to support the independence of adults 60 and older by advocating for programs and services to meet their needs, promote the growth and quality of Councils on Aging and senior centers and strengthen the professional skills of Council on Aging staff.

One Care, a new program, is available to adults age 21-64, who are eligible for both MassHealth and Medicare (dual eligible). The One Care target population includes non-elderly adults with physical disabilities, developmental disabilities, serious mental illness, and substance abuse disorders. The goal of One Care is to provide higher quality care for dual eligible adults under age 65 at a lower cost than MassHealth and Medicare provide separately.

Trained SHINE volunteers offer free, confidential counseling on all aspects of health insurance to anyone on Medicare at 1-800-MEDICARE (633-4227), seven days a week, 24 hours a day.