The SHINE Program (Serving Health Information Needs of Everyone) is a state health insurance assistance program that provides free health insurance information, counseling and assistance to Massachusetts residents with Medicare and their caregivers. The SHINE Program is administered by the Massachusetts Executive Office of Elder Affairs in partnership with elder service agencies, social service and community based agencies and Councils on Aging. The program is partially funded by the federal agency Centers for Medicare & Medicaid Services. Ethos hosts the SHINE program in Boston.
In 1985, in response to this problem, the Massachusetts Executive Office of Elder Affairs (Elder Affairs) started the Serving Health Information Needs of Elders (SHINE) Program. It was initially tested in three pilot sites for two years before expanding to eight Regional Programs in 1988. The Regional SHINE Programs are administered in partnership with local Councils on Aging, Area Agencies on Aging and Aging Services Access Points and provide services at the local level in almost every community in the state.
In October of 1992, Elder Affairs received a federal grant from the Centers for Medicare & Medicaid Services (CMS) under the Health Insurance Information, Counseling and Assistance Grant Program. The Centers for Medicare & Medicaid Services funds 53 State Health Insurance Assistance Programs (SHIPs) across the nation. The Massachusetts SHINE Program was one of the model state programs used to develop the national SHIP system that began operating in 1993. The grant allowed Elder Affairs to expand the Program statewide. Currently, 14 Regional SHINE Programs provide information, counseling and assistance services to Medicare beneficiaries and their family members and caregivers throughout Massachusetts. In addition, regional program directors supervise bilingual staff at several community service agencies who have been trained and certified to provide SHINE counseling statewide to beneficiaries with limited English proficiency (LEP).
What is a SHINE Counselor?
A committed volunteer who is trained and certified by the Executive Office of Elder Affairs in many areas of health insurance, including Medicare Part A, Part B, and Part D; Medigap insurance, Medicare HMOs, retiree insurance plans, prescription drug programs, Medicaid, Medicare assistance programs (QMB, SLMB and QI), and other programs for people with limited resources.
How Can a SHINE Counselor Help Me?
The SHINE Program assists elders and individuals with disabilities in understanding their Medicare and MassHealth benefits and other health insurance options. The SHINE program ensures that Massachusetts residents with Medicare and their caregivers have access to accurate, unbiased and up-to-date information about their health care options.
Counselors may review present coverage, provide written comparisons of plans, protect Medicare beneficiaries from paying for bills they should not pay, and prevent paying for unnecessary duplicate coverage. Counselors also help with claim forms and applications. They will make referrals when appropriate.
Typical Questions for SHINE Counselors.
- What does Medicare Pay for?
- What is “Medigap” insurance?
- Which Medigap policy is best for me? When can I buy a Medigap policy?
- Where can I get help paying for my prescription drugs?
- What is “Medicare + Choice” or a “Medicare Health Plan”?
- How do I appeal a denial of service under Medicare or a Medicare HMO?
- What do “balance billing” and “accepting assignment” mean?
- Is an HMO better for me?
- If I join a Medicare HMO, will I have to change physicians?
- Does Medicare or Medigap insurance pay for nursing home or home health care?
- Where do I go to apply for Medicaid?
- Do I qualify for Supplemental Security Income ( SSI)
- When can I sign up for Medicare Part B? Can I get help paying for the monthly premium?
- Where can I find a SHINE counselor?
SHINE Counselors are available throughout the state at local Councils on Aging, senior centers, elder service agencies, hospitals and other community based agencies. SHINE counselors are available to meet with individuals in person through one-on-one counseling, via telephone, email and through public education presentations. To schedule an appointment with a counselor call: 1-800-AGE-INFO (1-800-243-4636) and press 3 or contact your local Regional SHINE Program Office or senior center at: SHINE Telephone Directory by Town (PDF) .
How Can I Become a SHINE Counselor or Have a Counselor Work at My Agency?
If you would like to volunteer for the SHINE Program, or are interested in recruiting a SHINE Counselor for your site, within Boston, please contact Ethos at 617-522-9270 or email SHINE@ethocare.org. For all other areas, please contact your local regional SHINE Program Director at: 1-800-AGE-INFO (1-800-243-4636).
How do I contact the Boston SHINE Program at Ethos?