SHIP Open Enrollment: Support, guidance and education to Medicare consumers and their care partners
Three of Rush’s SHIP Counselors, Fernando Garcia, Anabelen Diaz, and Sonia Serrano (from left to right), all of whom offer Medicare counseling in both English and Spanish to the Chicagoland community .
Pumpkin spice, haunted hayrides, apple-picking and... Medicare open enrollment! It’s that time of year again. As many of us enjoy the changing of the seasons, a new academic year, and preparation for the upcoming holidays, many existing and prospective Medicare consumers and their care partners are navigating the complicated and ever-evolving world of Medicare.
Medicare is an essential program that provides coverage for preventive, acute and long-term services. It is also nuanced, ever-changing, and endlessly complicated. It can leave the most seasoned social care and medical providers scratching their heads, so imagine how complex it must be for the older adult and caregiver community to navigate.
Here are some highlights about Medicare open enrollment as well as what we hope will serve as some helpful resources.
Open Enrollment Basics
Open enrollment runs every year from October 15-December 7, and is a period of time in which Medicare consumers can do the following:
Switch from original Medicare to a Medicare Advantage plan or from a Medicare Advantage plan back to original Medicare;
Switch Medicare prescription drug plans (also known as part D plans) in original Medicare, or;
Switch to another Advantage plan.
Note that Medicare has other special enrollment periods for consumers new to Medicare as well as special cases (refer to Medicare.gov’s “Joining a Plan”). Changes made during open enrollment go into effect on January 1 the following year.
2025 Policy Changes and Impact
Provisions in the 2025 Budget Reconciliation Act will impact Medicare. We will see two major impacts to Medicare:
Reduced support for individuals with the low-income subsidy (also known as “extra help”), which helps eligible individuals afford prescriptions and goes into effect on January 1, 2026
Elimination of Medicare for non-citizens, which goes into effect October 1, 2026
Policy changes mean new territory for consumers, caregivers and providers to navigate. You can learn more about upcoming changes in a previous blog post here.
Senior Health Insurance Program (SHIP) as a Resource
Medicare can feel like a maze, and consumers and their loved ones often end up in plans that are not a good fit for them due to things like low health literacy, confusion, or challenges navigating systems. The Senior Health Insurance Program, or SHIP, is a national program managed by the Administration for Community Living that offers one-on-one support, guidance and education to Medicare consumers and their care partners. SHIP counselors have been trained in Medicare and offered unbiased counseling regarding the many areas of Medicare ranging from enrollment to prescription drug plans to Advantage plans and special enrollment rules (not an exhaustive list)! SHIP is available in all 50 states and is a free program.
Rush proudly partners with Illinois SHIP, offering Medicare counseling in-person and virtually, depending on consumer preference. Rush has eight SHIP counselors across the institution. These counselors provide SHIP support in addition to their primary role at Rush, and do so throughout the entire year; however, their efforts increase significantly during open enrollment. They have been trained prior to offering counseling and they engage in annual re-training to stay abreast of relevant changes to Medicare and policies. SHIP counseling pairs well with the larger scope of services Rush provides, allowing care managers, psychotherapists, pharmacists, medical providers and many more disciplines to offset the complexity of Medicare navigation to an unbiased expert.
To find your local SHIP site, visit www.shiphelp.org or call 1-877-839-2675. If you would like to consider partnering with SHIP as a counseling site, please use the aforementioned contact information, as well. More sites and counselors are always needed!
At CHaSCI, we envision a system that achieves equitable outcomes for patients and families with whole-person care and strong communities; we do this by working to actively break down barriers to health. SHIP is a prime example of this mission—it provides tailored support that empowers consumers and care partners to make decisions that are based on what is best for them (not a “one size fits all” approach). It helps restore trust in healthcare providers and reconnect community members to vital preventive and acute healthcare services.