Last updated September 26, 2023
When to use:
Guidance when making a call to SHIP.
How to:
Medicare SHIP: 1-888-647-6701
You will enter your SHIP ID
Press 1 for general questions (unless calling regarding Part A or B services)
“Hi, my name is ___ and I am with the SHIP office in MN. I have some questions regarding a beneficiary’s coverage.”
Must provide the following client information:
- Medicare number (SSN can be used if they don’t have their Medicare card yet or if you’re checking to see if they have Medicare at all)
- First and last name
- Date of Birth
- Current address (This may be a guardian’s address or Rep Payee’s address)
- Alternative to using address (if it doesn’t match) is Part A and B start date
What is their current coverage showing as?
- Plan Name
- Full plan name and contract number and PBP (the dash after the contract number)?
- (ex: Humana Basic Rx Plan (S5884-145) – to confirm the exact plan
- When did it start? Has the coverage ended? When?
- If ended, why did that coverage end?
Do they have Extra Help or LIS? Use both terms when asking:
- If Extra Help, what is their copay level and amounts? How did they get the extra help?
- I.e., level three with zero copay amount (NH resident or HCBS waiver).
- When in the last quarter of the year, ask if they show Extra Help for next year? Or an end date? Will they have the same copay level?
Is there a future enrollment showing? What is the start date?
- Ex: If no Part D is showing and they have Extra Help- ask, “Is this an auto-enrollment by CMS?”
- If no auto-enrollment, ask, “Are they eligible for Part D currently?” If they have issues with immigration or incarceration, you have to ask about this specifically
- Ex: You filed a complaint for bad marketing and Medicare made an enrollment back into an old plan. You may have to provide more information for them to look into specific situations like this
What is the Rx billing information for the plan?
- BIN, PCN, ID, and Group # - This is helpful when someone doesn’t know they have a Part D plan, they need their medications at the pharmacy. You can collect the billing information from SHIP, share it with the person or call the pharmacy with the person and share the information and have them run a test med through. The person would want to call the plan to request a card be sent if they don’t have one.
Part A, B, or medical supply (DME) questions:
- At the start of the call, press the Part A or Part B (2) or medical supply (3) questions option on the prompts.
- Ship can let you know if specific claims were covered, what codes were used, if appeals are pending, etc.
- It helps to have as much information as possible like provider name, date of service, etc.
