Medicare Supplements (Medigaps) Training Part 3: WSHIP July 2022

Medicare Supplements (Medigaps) Training Part 3: WSHIP July 2022 continuing education Created June 10, 2022

Medigaps Part 3 of a three-part series to be presented in May, June and July of 2022 SHIBA advisor continuing education July 2022

Why WSHIP? SHIBA advisor continuing education July 2022

What happens today? Training and building SHIBA advisor continuing education July 2022

Today’s program Training Practice counseling clients about Medigap plans. Build our tool kit together Create some tools we can use when we counsel clients about Medigap plans. SHIBA advisor continuing education July 2022 5

Agenda Topic Tim e Notes Welcome and introductions 3 RTC-led Review agenda 2 RTC-led Preview course objectives 2 RTC-led Check materials 3 RTC-led Introduction to exercises 5 RTC-led Small-group exercise 20 Small group conversations Share perspectives 15 Whole team conversation Review course objectives 2 RTC-led Wrap-up and survey reminder 8 RTC-led SHIBA advisor continuing education July 2022 6

Course objectives 1.Based on a client interview, the volunteer can determine whether the beneficiary has any special rights and protections, with regard to Medigap plans. 2.Using a SHIBA publication, describe to a client what coverage a standard Medigap Plan G provides. (after Medicare) and what the beneficiary liability is. 3.Summarize, for a client, the general rules (federal and state) about medical underwriting SHIBA advisor continuing education July 2022 and waiting periods for pre-existing conditions. 7

Course objectives (continued) 4. Develop an example list, which applies the general rules to the case of this client to explain their specific rights and protections. 5. Create a checklist as a way to organize our work when providing direct service to clients. 6. Screen a client for eligibility for WSHIP. 7. Explain to a client the eligibility rules for WSHIP. SHIBA advisor continuing education July 2022 8

Materials check Print and online SHIBA advisor continuing education July 2022

Materials for today For counseling Scenarios [1, 2 or 3] that describe the client perspective. Guidance for role play exercise. Approved Medicare Supplement (Medigap) plans – which includes (last page). o 10 Standardized Medicare Supplement (Medigap) plans chart WSHIP website SHIBA advisor continuing education July 2022 10

Introduction to exercises Context and scenarios SHIBA advisor continuing education July 2022

Medigap training Medigap OEP Guaranteed issue (GI) rights Not OEP, not GI rights May June July Case #1 Turning 65 and MA plans: You getting Part B, at move from the same time. service area. Over age 65, focus on pre-x, creditable coverage. Case #2 Already past 65 – just getting Part B, now: deferred (SEP). Under age 65 (disabled), focus on HCA / Premera; c/b MA plan. Case #3 Already Part B, just turning 65, now: disabled beneficiary. SHIBA advisor continuing education MA plans: “Trial right” period (a) started in MA (b) started in Original Medicare. Switch from one Medigap plan BN to another Medigap plan B July 2022N. WSHIP 12

Eligibility for WSHIP (slide 1 of 2) Criteria for eligibility Criteria for eligibility Criterion #1? Criterion #2? SHIBA advisor continuing education July 2022 13

Eligibility for WSHIP (slide 2 of 2) Criteria for eligibility Criterion #1 Criterion #2 Criteria for eligibility You were rejected for coverage by a health carrier; and You do not have access to a reasonable choice of Medicare Advantage Plans (Part C). SHIBA advisor continuing education July 2022 14

Medigap scenarios Scenario 1 I’m kind of late – now what? Scenario 2 I might reconsider a MA plan. Scenario 3 I might consider WSHIP. SHIBA advisor continuing education July 2022 15

Small-group work Instructions and materials SHIBA advisor continuing education July 2022

Instructions Use the scenario document on My SHIBA with this exercise. Client Read your persona and stay in character. Read the guidance. Make notes about the circumstances you adopt. Advisor Prepare for your role. Make notes that: Help you advise. You’ll put in STARS later. Record the key questions you ask and assistance you provide. SHIBA advisor continuing education July 2022 17

Scenario #1 I’m kind of late – now what? Monique retired from her job and left her employer group health plan (EGHP). She did enroll into Medicare Part A and Part B when she retired – this was 10 months ago -- but she declined retiree coverage (cost) and did not enroll into a MA plan or a Medicare Supplement. She wants to talk about options. Continued on next page SHIBA advisor continuing education July 2022 18

Scenario #1 (continued) What’s important about the timing of her actions and plans? What resources would you use in counseling or send to her before or after the appointment? What makes this scenario challenging? SHIBA advisor continuing education July 2022 19

Scenario #2 I might reconsider an MA plan. Elliott left his job when he was no longer able to work, due to his disability. He enrolled in Medicare Part A and Medicare Part B – because he thought he had to. He did not enroll in any other insurance. This was about 11 months ago. Now, his condition has worsened, and he wants more insurance. Rates for plans for people under age 65 are “too high,” he’s concluded. Continued on next page SHIBA advisor continuing education July 2022 20

Scenario #2 (continued) What’s important about the timing of his actions and plans? What resources would you use in counseling or send to him before or after the appointment? What makes this scenario challenging? SHIBA advisor continuing education July 2022 21

Scenario #3 I might consider WSHIP. Olivia lives in Kennewick. She applied for a Medicare Supplement plan but was denied coverage due to several expensive medical conditions for which she has recently been treated. She expects to need ongoing therapies that she can’t afford. Continued on next page SHIBA advisor continuing education July 2022 22

Scenario #3 (continued) What’s important about the timing of her actions and plans? What resources would you use in counseling or send to her before or after the appointment? What makes this scenario challenging? SHIBA advisor continuing education July 2022 23

Scenario discussion SHIBA advisor continuing education July 2022

Small-group exercise Please raise your hand or use the chat feature to share your ideas. SHIBA advisor continuing education July 2022 25

Next steps Thank you! We’re going to use these ideas to build out our toolkit, including getting ready for the program next month. SHIBA advisor continuing education July 2022 26

Course objectives Review SHIBA advisor continuing education July 2022

Course objectives 1.Based on a client interview, the volunteer can determine whether the beneficiary has Guaranteed Issue for Medigap rights and protections. 2.Using a SHIBA publication, describe to a client what coverage a standard Medigap Plan G provides (after Medicare) and what the beneficiary liability is. 3.Summarize, for a client, the general rules (federal and state) about medical underwriting and waiting periods for preSHIBA advisor continuing education July 2022 existing conditions. 28

Course objectives (continued) 4. Develop an example list, which applies the general rules to the case of this client to explain their specific rights and protections. 5. Create a checklist as a way to organize our work when providing direct service to clients. 6. Screen a client for eligibility for WSHIP. 7. Explain to a client the eligibility rules for WSHIP. SHIBA advisor continuing education July 2022 29

Wrap up Feedback is the real breakfast of champions SHIBA advisor continuing education July 2022

SHIBA survey: Your opinion counts! SHIBA will email the web link to you in June. The survey will ask for your thoughts on the ideal state of a mentoring program. There will be an opportunity for you to share: Materials that you find helpful as a mentor or mentee. Examples of training or support materials that will help with mentoring. The ideal way to reply is via the survey. Or if you prefer, you may email [email protected] with “Mentoring Survey” as the subject line. Share your thoughts and attachments! The deadline to reply to the survey is July 17. Thank you! SHIBA advisor continuing education July 2022 31

Evaluation Your responses help to improve SHIBA’s training program. Did you find today’s training helpful or useful for your SHIBA counseling or outreach? What would’ve made this training better for you? Please take some time to send thoughts to [email protected] or to your trainer. Or you may use our brief online survey at https://www.surveymonkey.com/r/SHIBA-TrainingEvalua tion . SHIBA advisor continuing education July 2022 We appreciate your feedback! 32

2022 training schedule August: No CE training celebrate summer! September and October Medicare OEP preparations SHIBA advisor continuing education July 2022 33

Photo credits Slide 1 Photo by Vladimir Soares on Unsplash Photo by Visual Stories Micheile on Unsplash Photo by Nathan Anderson on Unsplash SHIBA advisor continuing education July 2022 Photo by Jixiao Huang on Unsplash Photo by Ekaterina Shakharova on Unsplash 34