通过州健康保险援助计划 (SHIP) 获得保险导航支持

Melissa M Garrido, David Biko, Allison Dorneo, Paul Shafer, Austin B. Frakt
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引用次数: 0

摘要

联邦医疗保险的投保非常复杂,特别是对于同时符合联邦医疗保险和医疗补助资格的低收入人群而言,错误的计划选择会对受益人的自付费用以及获得医疗服务和药物产生不利影响。州健康保险援助计划 (SHIP) 是一项联邦计划,提供有关联邦医疗保险的咨询服务,但低收入受益人在多大程度上可以获得 SHIP 服务尚不得而知。我们采访了州健康保险援助计划的顾问和协调员,以了解影响低收入受益人获得州健康保险援助计划服务及服务质量的因素。志愿者的可用性被认为是 SHIP 服务的主要障碍。与医疗保险和医疗补助双重资格相关的话题经常出现在咨询课程中,工作人员表示希望获得更多与医疗补助和综合护理计划相关的培训。我们的研究结果表明,增加咨询人员并加强与双重资格人员相关主题的培训可提高 SHIP 向低收入医疗保险受益人提供医疗保险相关信息的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Access to insurance navigation support through the State Health Insurance Assistance Program (SHIP)
Medicare enrollment is complex, particularly for low-income individuals who are dually eligible for Medicare and Medicaid, and the wrong plan choice can adversely impact beneficiaries’ out of pocket costs and access to providers and medications. The State Health Insurance Assistance Program (SHIP) is a federal program that provides counseling on Medicare coverage, but the degree to which SHIP services are accessible to low-income beneficiaries is unknown. We interviewed SHIP counselors and coordinators to characterize factors affecting access to and quality of SHIP services for low-income beneficiaries. Availability of volunteers was cited as the primary barrier to SHIP services. Topics related to dual eligibility for Medicare and Medicaid were frequently covered in counseling sessions, and staff expressed a desire for more training related to Medicaid and integrated care programs. Our results suggest that additional counselors and increased training on topics relevant to dually eligible individuals may improve SHIP’s ability to provide health insurance-related information to low-income Medicare beneficiaries.
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