As if dealing with a global pandemic wasn’t bad enough, seniors are also among some of the most vulnerable citizens to fraud and exploitation.
When it comes to protecting against Medicare fraud the counselors and volunteers of Senior Health Insurance Benefit Advisors (SHIBA) are trying to help.
“We see anything you can imagine,” said Angie Holick of the Idaho Department of Insurance SHIBA division.
“We do a lot of education about preventative services and fraud and we promote education about fraud because we want to protect people and protect the Medicare dollars.”
SHIBA serves Idahoans on Medicare by offering free, unbiased Medicare benefits information and assistance. The group’s services often are presented through workshops, group presentations and personal counseling. One such workshop scheduled in Grangeville in March was canceled because of the COVID-19 outbreak.
SHIBA is a service of the Idaho Department of Insurance and is partially funded by and operated under the authority of the U.S. Department of Health and Human Services Administration for Community Living.
Holick said some of the more common hoaxes that popped up during the coronavirus outbreak included calls to seniors asking for their Medicare numbers to pay for coronavirus testing. It’s a scam to obtain Medicare numbers that can then be used by criminals to bilk the system.
Another scheme involved phone calls to seniors telling them they needed to hire a service to have their homes disinfected and asking for Medicare numbers to pay for it. Or salesmen may try to sell things like back and knee braces and other durable equipment in an effort to rip off Medicare system.
The counselors at SHIBA try to alert seniors to these rackets and help direct complaints to the attorney general’s office or other authorities. Holick said the Medicare system did switch from using people’s Social Security numbers to random assigned numbers in an attempt to prevent fraud.
SHIBA relies heavily on local volunteers for its programs because there are only 10 paid employees in the state, she said.
“There are over 150 volunteers statewide, and they go through training to learn about Medicare and have background checks and fingerprinting, and we certify them.” Holick said.
The volunteers come from all walks of life and “these people are awesome. They give so much time and they’re so incredibly smart. They become well-educated in the program and provide services.”
That primarily includes educating people to understand and learn more about the Medicare program. Holick said SHIBA counselors and volunteers help people understand what benefits they have or need and assist in filing appeals or grievances.
Last year, the program assisted about 15,000 people in Idaho on an individual basis and closer to 30,000 in groups and health fairs.
Many times the biggest problems, she said, are people getting a grip on the coordination of benefits.
“A lot of times they may have other insurance through their employer and they don’t need to take all the parts of Medicare,” Holick said. “But they don’t know that, so they’re spending money unnecessarily.
“Also they don’t understand that the decisions that they make when they first go on Medicare are going to affect their health care coverage for the rest of their life. If you don’t take a supplement when you’re initially eligible for Medicare you may not be able to take it later.
“We also deal a lot when Medicare is not paying for something (helping people to) understand why and helping them to get corrected billing.”
More information about SHIBA is available by calling (208) 334-4250, the helpline at (800) 247-4422 or visit https://doi.idaho.gov/shiba/.
Hedberg may be contacted at firstname.lastname@example.org or (208) 983-2326.
If you go
SHIBA has scheduled two workshops for the coming months:
l 6-8 p.m. June 16 in Moscow.
l A workshop that had been scheduled for this month in Lewiston was canceled because of COVID-19; it has been rescheduled for 6-8 p.m. Aug. 10.
People may call SHIBA at (800) 247-4422 to register and get meeting locations.