On episode #168 of JoCo on the Go, we discuss Senior Health Insurance Counseling for Kansas. SHICK a free program offering Kansans an opportunity to talk with community volunteers and get answers to questions about Medicare and other insurance issues. Contact SHICK at either AHS-SHICK@jocogov.org or the hotline at 913-715-8856. In Johnson County, SHICK is provided by the Johnson County Area Agency on Aging with assistance from the K-State Research and Extension Office and Johnson County Aging and Human Services. Learn all about the program and how it can help you or those you love.

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Time	Subject
00:57	Introduction
03:30	What is SHICK?
08:33	Role of a SHICK counselor
13:16	How to become a counselor
15:53	The Medicare "donut hole"
19:05	Biggest takeaways about SHICK

Anne Christiansen-Bullers 0:00 

If you go to medicare.gov, one of the first videos you're introduced to starts off by saying, "When you're first getting started with Medicare, there can be a lot to learn." Most people will tell you that's an understatement. But where do you go to help make sense of Medicare and all those parts: part A, part B, part D, what happened to part C? And do I need to worry about that? Did you know that there's an organization that will give you free, unbiased advice on how to handle Medicare? It's called SHICK, S-H-I-C-K, and we'll talk to two experts to tell you all about it.

Announcer 0:42 

Whether you live in or just love Johnson County, Kansas, JoCo on the Go has everything Johnson County. Here's what's happening and what's coming up in the community you call home.

Anne Christiansen-Bullers 0:57 

Greetings, invited guests, and welcome to this week's discussion of all things Johnson County. My name is Anne Christiansen-Bullers, and I'm a communications specialist here at Johnson County. Today, we're here to talk about a little known, but in my opinion, a much-needed service for people 65 years and older, and for the people who love them, and that's Medicare assistance. If you've ever had to wade through the Medicare system, you know it can be very confusing. Sometimes you might have questions, and you don't know where to look for the answers. You have problems that you think you could solve just if you had the right guidance. That's where our two guests come in. Today, we're with Rachel Winter, who is the coordinator of a program to help seniors with Health Insurance Counseling like Medicare and the other insurance plans that seniors can buy to supplement Medicare. That program in Kansas is called SHICK, which is an acronym for Senior Health Insurance Counseling for Kansas. Welcome, Rachel.

Rachel Winter 2:10 

Hello. Thank you for having us.

Anne Christiansen-Bullers 2:13 

Thank you. Appreciate you being here. And we also have with us Joy Miller. Welcome, Joy.

Joy Miller 2:22 

Thank you.

Anne Christiansen-Bullers 2:23 

Joy, explain to us a little bit about what you do at SHICK.

Joy Miller 2:27 

Okay, so I get the privilege of doing SHICK counseling under my or through my job with K-State Research and Extension here in Johnson County. And so our organization works under the Aging and Human Services, who holds the SHICK grant for Johnson County. So this is an organization collaboration in meeting the needs of our residents through Medicare. Other SHICK volunteers may not be associated with an organization or through their job, such as, I am, so.

Anne Christiansen-Bullers 3:09 

Excellent. So that sounds like a lot of people are involved. A lot of agencies are involved. And we'll get into that. Rachel, if you could start us out with explaining what SHICK is, just in some basic, general terms, other than the acronym that I just presented.

Rachel Winter 3:30 

So SHICK is a state version of SHIP, which is the federal program, and so other states call it different things, but it's...

Anne Christiansen-Bullers 3:41 

And what is called, what is SHIP? What does that stand for? Are you saying SHIP, like a boat? SHIP?

Rachel Winter 3:48 

Yes, yes. So SHIP is the federal version of the program, and it's State Health Insurance Assistance Program, and then SHICK is the Kansas version of the program here. So we have 11 areas in the state, and different Area Agencies on Aging or K-State Extension offices throughout the state will apply to be the program holder, the grant, the subgrantee, and Johnson County Aging and Human Services is that, or the Area Agency on Aging for Johnson County holds the grant. K-State is one of our partners, and so we offer free, unbiased Medicare counseling for those in Johnson County. This is for beneficiaries. This is for people that are going to go onto Medicare. Maybe they're aging in or they have disability, or their caregivers and their family members that are trying to navigate this for them.

Anne Christiansen-Bullers 4:51

Excellent. You mentioned about the grant, the fact that SHICK is grant funded. Can you go a little bit into that? Like, where does the money come to pay for this program and the expenses that you might have?

Rachel Winter 5:10

So the grant is from the ACL, which is the Administration for Community Living. It's a federal grant that we get, and then, depending on the population within each area in Kansas, you get a set amount for this program. And so that goes towards funding events, materials, flyers, anything that does need to go into the program so that we can get that outreach and provide that counseling.

Anne Christiansen-Bullers 5:45 

Excellent. Thank you for laying the groundwork. Appreciate that. These next questions are for you, Joy, because you have directly helped some of the people who have reached out for Medicare assistance and other forms of senior insurance. What would you say is the most common problem that you see?

Joy Miller 6:08 

I see more than one common problem when people are ready to go on Medicare. The first is they can feel quite overwhelmed learning what Medicare is, all the routes they can take, all the choices they may have, and how complex the rules are related to Medicare, because there's always a different rule that applies to a different product or part of Medicare.

Anne Christiansen-Bullers 6:37 

It's not like, then, the Medicare is just a one-size-fits-all kind of thing where everybody gets the same thing and it's pretty cut and dried. There's a lot of nuances to it.

Joy Miller 6:50 

There is, and there's lots of different, I would say, agencies or organizations involved to get all those pieces in parts. So it's not one-stop shopping to get everything you need. So you know, to enroll, you might visit two or three different places, you know, social security and then different health care companies. Or anyway...there's just options, and everybody has their own special way to enroll into those pieces. The second most common problem I see is we do not understand always that Medicare has a cost to it, and that's related to premiums and the out-of-pocket expenses associated with health care. So some people are surprised that there is a cost and that it doesn't cover everything, and so they're not always prepared for that as they...financially when they choose to go on to Medicare or coming into retirement years.

Anne Christiansen-Bullers 8:07 

That's got to be a shock, and you've got to deal with a lot of emotional feelings about that, if that's not what people expected.

Joy Miller 8:17 

Yes.

Anne Christiansen-Bullers 8:19 

Okay, so what would you say, then, is the role of a SHICK counselor? Like, if I seek out help, what is it that my counselor is going to do for me?

Joy Miller 8:33 

So where I personally start is finding out where, we call them beneficiary, a Medicare beneficiary, is at. So we might have to start with the basics of just understanding what Medicare A and B are, which I always call the foundation to all your Medicare health insurance products. But some have narrowed it down, and we can just speak on or talk about a certain aspect of Medicare that they want to focus on. So as a SHICK volunteer, we can personalize that conversation with one-on-one counseling, cover the whole, you know, all the pieces and parts, or sometimes after people are enrolled, then they have very specific questions about how this works, or how can I change a policy? And so we cover just a large variety of topics, from I have like, I'm continuing to work, I have retiree benefits, I have military health insurance pieces to I think I'm going to live outside of the United States for a while. That's been a hot topic here lately. To just even why am I being billed this way? Or why do I have different copays or co-insurances with different things? So we tackle a lot of basics and a lot of personal, individual questions too. The other thing, besides just offering one-on-one counseling, is doing educational classes. So we usually call them, like, New to Medicare, Medicare Basics, and so it's a great way to get an overview of all the pieces of Medicare, to get you familiar with the language and the different options and the routes. And I always think classes are great because you get to hear everybody else's questions that they ask too, that you may not have thought about asking or you might not have heard about. So a class is always great to get familiar with what it is and the terms, and then coming in for a one-to-one to help get the education you need for your personal situation.

Anne Christiansen-Bullers 11:02 

Okay, you mentioned these classes. How would I find out where they were and when they were?

Joy Miller 11:11 

So classes are advertised a couple of ways. One is through on the Aging and Human Services website. So they have an upcoming class. And then the ones that I will be presenting are on our K-State Research and Extension Johnson County website.

Anne Christiansen-Bullers 11:30 

Okay.

Joy Miller 11:31 

I would like to add there is always companies who are doing the Medicare educational classes too, and they're a great option to attend and listen. So it's just a great way to get introduced, is finding the one that works for where you're at, you know, location-wise, time-wise, date-wise. So any of them will give you a good, broad overview of Medicare.

Anne Christiansen-Bullers 12:01 

Now you mentioned when we were talking about these volunteer counselors, are the counselors that I would come see, are they volunteers or are they employees?

Rachel Winter 12:15 

Most of them are volunteers. Joy is the exception that she gets paid to do that as part of her job. But the vast majority, and really the core of the program, are volunteers. And these folks have likely gone through Medicare themselves and gone through the process. They've seen loved ones go through it, and they know that there are pitfalls that are common, and they want to help people avoid those. They're also just natural problem solvers, and they enjoy it. They authentically enjoy helping people figure out these complicated issues on a personal level. So the people that we have are...they're truly in it to help people, and it's something that draws kind of a certain type of person.

Anne Christiansen-Bullers 13:02 

Excellent, if I'm a real problem solver, and I have had some, you know, insurance issues of my own, and I would like to help other people, how do I go about becoming one of your counselors?

Rachel Winter 13:16 

Well, first thing is just going to be a dealbreaker right off the bat is that you cannot be affiliated with an insurance company, a broker. You cannot have an insurance license currently, and that is to protect the citizens of Johnson County, because that could be used as, basically, a source of referrals. And we don't want that to happen. But you would go to...if you just Google "SHICK Kansas," there is a website at the state level that you can fill out an application, or you can call and email me, and I can send that to you or mail it to you. Fill out an application, go through a brief interview process, background check, paperwork is submitted. And then once we get that far, the state will allow you to start doing the pre-training. And that is, it's a firehose of information, that's probably upwards of 30 hours of online training at your own pace. And then there is a two-day in-person training from the state level. That is basically, that's the worst of it. And then every year after that, you have just a one-day training.

Anne Christiansen-Bullers 14:25 

Okay, that's a pretty rigorous process. People have to be very interested in helping to go through that. And yet they do apparently.

Rachel Winter 14:37 

Yes.

Anne Christiansen-Bullers 14:38 

Okay, great. Well, let's say that I'm on the other side now. Instead of, you know, talking about being a volunteer, now I have a problem with Medicare, and I'm getting some paperwork that I don't understand. I just need help. Is this where I come to SHICK?

Rachel Winter 15:03 

Yes, there is a state hotline phone number. I don't remember it off top my head. That is one way we get referrals for clients. Otherwise, you can email me or call me directly...we have a Johnson County SHICK hotline number, and most likely, you'll leave a message, and then I will call you back, get a little bit more information, and then I will triage it out to our counselors.

Anne Christiansen-Bullers 15:28 

If I'm correct, one of the issues with Medicare, according to dealing with my folks who are on Medicare, is this Medicare donut. For listeners who don't necessarily know what the donut is, can you explain what that is? And if you deal with those issues.

Rachel Winter 15:51 

I will let Joy do that.

Joy Miller 15:53 

Okay. So the donut hole, commonly referred to...

Anne Christiansen-Bullers 15:59 

Okay, donut hole.

Joy Miller 16:00 

...is related to the Medicare Part D prescription plan. So a Medicare Part D prescription plan technically has four phases in it. And so the first phase can be the deductible, where you pay the full cost of the meds. When you meet that, then you go into the second phase, called the initial coverage phase. So this is when you would have a co-insurance or a copayment for a prescription. For this year, when you and the drug company have contributed whatever the designated dollar amount is, I believe it's $5,000 and some this year, then you enter this third phase called the donut hole, or the coverage gap. And this is where the Medicare beneficiary would pay 25% of the full cost of that med until they reach another number. And again, this is you and and what the insurance and whoever else contributes to that reaches about $8,000, and that's for 2024. And then you enter the fourth phase, which is known as catastrophic phase. So people who are on very expensive medications, or they may experience all four of those phases, and others may never feel any of those. Like, they take a preferred generic and still, even though they have a deductible, they still may pay $0 or $2 for a 30-day supply. So that's what the donut hole is. Some people experience it, and others don't. But with the Inflation Reduction Act, we're seeing lots of changes, and so next year brings a new change, where the maximum out of pocket for beneficiaries will be $2,000 a year. So just hang on tight. We're evolving the Medicare Part D and how it all works through several years to come.

Anne Christiansen-Bullers 18:15 

So you and your counselors really have to stay on top of any changes that are made to Medicare, and can they happen at any time?

Joy Miller 18:24 

Well, while the changes happen, they're usually rolled out at a designated time. So what will happen in 2025, we'll see the real, like, on our side as the counselor, we'll see how it really rolls out when they preview the plans about October 1.

Anne Christiansen-Bullers 18:47 

And the biggest takeaway, if you were in an elevator with somebody, and you wanted to tell them about SHICK, and the doors were about to open, what would you say about SHICK?

Rachel Winter 19:05 

I would say that because it's unbiased and you're not getting a sales pitch, this is a good opportunity to sit down with someone that has nothing to gain but to help you. And I will say, in addition to that, that the team that we have, they're very good, and they're truly interested in what is going on with Medicare, and they share that with each other. If one of us has a question that we don't know the answer to, they're emailing the group, and they're very good about helping each other. And so we've got people that care about accuracy, and I think that it's a program that has a lot of value.

Anne Christiansen-Bullers 19:43

Joy...

Joy Miller 19:43 

I would probably have two things. One is, if they're new to Medicare, is to come to a Medicare class or come meet with a SHICK volunteer for counseling and then seek out, like, a insurance broker or salesman or agent, because when they hear...they get the terminology first and a little bit of understanding. And then when somebody's trying to talk to them about a product to potentially buy, they'll have a better understanding of what is being presented to them. And then they can make some decisions on whether they want that product or to work with that particular person. My second, if I had a second, two seconds there, when people are on Medicare, it is always a good idea to just review it every year. It is not a set it and forget it, especially with that Medicare Part D or Advantage plans. And so we're here to help them review that. I say 50% of the time you can save some money by switching plans, but even if changing to a new plan isn't going to save you money, at least you know you did your due diligence to know you're on the best plan for you. And being on Medicare is about as unique as everybody's personality. So what works for even married couples? One plan will work best for one person, and something else will be the better plan for their, you know, their spouse.

Anne Christiansen-Bullers 21:23 

It does sound very complicated. Do you deal with a lot of people's fear of making the wrong choice because of the amount of money that we're talking about?

Rachel Winter 21:34 

Yeah, I think there's some concern that if you don't make the right choice off the bat, then trying to change later on is going to be really difficult, especially for those that go on Medicare Advantage, if they try to go back just on their own to original Medicare, that's going to have underwriting, and there's some things with it. There's sometimes, there are penalties, there are just things. There's so many roadblocks that could come up along the way, and our counselors are good about understanding your personal situation and how to avoid some of those extra fees and the extra premiums and that kind of thing.

Anne Christiansen-Bullers 22:15 

Excellent. I'd like to close out with perhaps a story that maybe one of you knows of, a success story, someone who came to you with an issue and then you were able to provide that assistance.

Joy Miller 22:36 

I just yeah, I just got a thank you card today. So I don't know if you want me to read it word for word, but it just said thank you for helping and educating me about my upcoming Medicare coverage. She was referred to a private broker by a friend that she had a lot of confidence in, and he put her at ease, and she feels good about her choice. But she says it all started with a great presentation that I did, and thank you for making yourself available to give the correct information to the public.

Anne Christiansen-Bullers 23:15 

That's a great success story, and kudos to that person for sending you a card.

Joy Miller 23:21 

Yes.

Anne Christiansen-Bullers 23:22 

These days where people forget gratitude sometimes, it's always wonderful to hear. Any other closing thoughts before we wrap up today?

Joy Miller 23:33 

Just one last thing. Coming to a SHICK counselor, especially during the fall open enrollment, we present you, if we're looking at your Part D prescriptions, an estimated cost for the year, when you will, you know, what to kind of estimate your expected expenses are throughout the year. So sometimes that is just a great budgeting tool so you know when you're going to have highs and lows in your financial budgets. And then you're not, quote, "sticker shocked" when you go to the pharmacy, and you've come out of that initial coverage phase and you're in the donut hole phase. And you know why. You know why. So part of it is just, we're here to help you understand how your plans work and what to expect throughout the year. Specifically with that Part D plan, where you're taking prescriptions on a regular basis, and it can just put people at ease that they know what to expect for the next year.

Rachel Winter 24:34 

And I've got one other thing. I don't know if you want to include this, but so our area was awarded the SMP, the Senior Medicare Patrol grant that will start, I believe, in August officially. So this grant, or this program, is about Medicare fraud abuse and errors, and so it's to promote and help people be proactive about making sure that they are not a victim of any kind of Medicare-related or health care-related fraud. And unfortunately, the Medicare community, some of them are very vulnerable, and it's unfortunately happening quite a bit in Johnson County. So we're going to be trying to roll that out in the next month and a half or so and try to get some educational events going so that we can help people avoid any kind of fraudulent, any kind of activity.

Anne Christiansen-Bullers 25:31 

And what was the name of that program again?

Rachel Winter 25:34 

Senior Medicare Patrol, or SMP. And it does, it's kind of a partner program with SHICK or SHIP, and it is something that's also a federal program that comes down to the states.

Anne Christiansen-Bullers 25:47 

Excellent. And just to underline the fact that these services are free, correct? There's never a fee charged, correct?

Rachel Winter 25:56 

Correct.

Anne Christiansen-Bullers 25:57 

Okay, excellent. Well, I'd like to thank you both very much for talking to me today. Appreciate the work that you're doing, and thank you invited guests for coming to listen to us today. Bye bye.

Announcer 26:12 

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