You know how frustrating and confusing health insurance can be in general, right? Well, imagine that you are 65 years old, facing surgery, and when you show up at your doctor’s office for a pre-op appointment, you get unwelcome news about your coverage. This is what happened to “Mrs. K”, a JCA client this past December.
Luckily for Mrs. K, she knew that SHIP (State Health Insurance Assistance Program), a JCA program, was here to help her. The primary function of SHIP is to provide Montgomery County seniors with health insurance counseling, enrollment guidance, and problem resolution for issues relating to Medicare benefits.
Mrs. K had surgery coming up and was worried about bills. She had already checked SHIP about her insurance status. And the SHIP counselor had verified that her Medicaid eligibility had been approved. This was crucial because the client could not afford the Medicare deductible and co-pays and thus needed to rely on Medicaid, as her secondary insurance, to pay. But now, the doctor’s office was claiming she was not covered by Medicaid. This was hugely troubling to Mrs. K.
Fortunately, the SHIP counselor jumped into action, calling the Maryland Health Connection marketplace customer service line. Unfortunately, neither the representative nor their supervisor was able to resolve the problem. So, the SHIP Director got involved, sending an e-mail directly to the MHC Director of Consumer Assistance, explaining that Mrs. K’s Medicaid should not have been cut off due to the pandemic-related Federal Public Health Emergency Act extension.
It took the MHC Director of Consumer Assistance less than a week to re-establish Mrs. K’s Medicaid eligibility. She was very grateful for SHIP’s advocacy on her behalf.
