Insurance Counseling Assistance

For seniors in South Carolina, the State Health Insurance Program (SHIP) is known as ICARE, Insurance Counseling Assistance and Referral for Elders (ICARE). The ICARE program is federally funded to provide health insurance counseling for Medicare and its many parts. The ICARE program is a free, confidential service through which certified insurance counselors can provide clear, objective information. Some of the many services a certified ICARE counselor can provide include:

Explanation of Medicare benefits including preventive services
Instruction on how to read Medicare Summary Notices
Assistance with Medicare Enrollment for Parts A, B, C and D
Plan comparison during Medicare Open Enrollment (October 15-December 7)
Screen for and apply to cost-savings programs such as the Low Income Subsidy (LIS) and the different Medicare Savings Programs
Facilitate coordination of benefits amongst providers (Medicare, Medicaid, Tricare, etc)
Identify different types of Medicare and Medicaid Fraud and explain how to report and prevent them

Medicare Open Enrollment 2023

SMP Mission

Senior Medicare Patrols (SMPs) empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse through outreach, counseling, and education. SMPs are grant-funded projects of the federal U.S. Department of Health and Human Services (HHS), U.S. Administration for Community Living (ACL). Their work is in three main areas:

Conduct Outreach and Education. SMPs give presentations to groups, exhibit at events, and work one-on-one with Medicare beneficiaries.
Engage Volunteers. Protecting older persons’ health, finances, and medical identity while saving precious Medicare dollars is a cause that attracts civic-minded Americans.
Receive Beneficiary Complaints. When Medicare beneficiaries, caregivers, and family members bring their complaints to the SMP, the SMP makes a determination about whether fraud, errors, or abuse is suspected. When fraud or abuse is suspected, they make referrals to the appropriate state and federal agencies for further investigation.

FRAUD PREVENTION TIPS:

Walk away if people approach you in parking lots, shopping centers or other public areas and offer free goods or services in exchange for your Medicare number.
Simply hang up the phone if someone calls you claiming to be conducting a health survey and asks for your Medicare number.
Do not give your Medicare or Social Security information over the telephone.

4R’s for Fighting Medicare Fraud

It is important to remember that you are the first line of defense in protecting yourself against Medicare fraud, and should make a habit of monitoring online accounts.

Remember the four R’s for fighting fraud:

Record doctors’ appointments and services
Review claims for any you don’t recognize
Report suspected fraud to CMS by calling 1.800.MEDICARE (1.800.633.4227)
Remember to protect your Medicare Number

Fight Back, Use the 4D’s

Deter – Protect your Personal information
Detect – watch out for common fraud schemes
Defend – Watch out for potential errors, fraud and abuse
Disclose – If you suspect that you have been a target of errors, report it

Samantha McClary
Medicare Specialist
843-436-6252
smcclary@wrcog.org