Benefits Counseling

Understanding Medicare and other public benefits can be complicated. The Area Agency on Aging of the Coastal Bend Benefits Counseling Program provides information, counseling, and assistance to help older adults, people with Medicare, family members, and caregivers better understand health care coverage and benefits.

Certified Benefits Counselors can help consumers understand available options, compare Medicare coverage, identify programs that may help with health care and prescription drug costs, and address certain Medicare or insurance-related concerns.

How a Benefits Counselor Can Help

Benefits Counselors provide information and assistance with topics that may include:

  • Original Medicare

  • Medicare Part A and Part B

  • Medicare Advantage Plans

  • Medicare Part D prescription drug plans

  • Medicare Supplement Insurance (Medigap)

  • Medicaid eligibility

  • Medicare Savings Programs

  • Low-Income Subsidy/Extra Help programs

  • Medicare and private insurance billing concerns

  • Medicare or Medicaid claims and appeals

  • STAR+PLUS managed care concerns

  • Social Security-related benefit issues

  • Long-term care options counseling

  • Health insurance disputes

  • Medicare fraud, errors, and abuse prevention and reporting

Medicare Counseling

Medicare has different parts and coverage options. A Benefits Counselor can help you understand how Medicare works and review information about available coverage so you can make an informed decision based on your individual needs.

Counseling may be particularly helpful if you are:

  • Preparing to enroll in Medicare

  • New to Medicare

  • Reviewing Medicare coverage

  • Considering a Medicare Advantage or prescription drug plan

  • Experiencing a change in health coverage

  • Having difficulty understanding a Medicare notice or bill

  • Looking for programs that may help with Medicare or prescription drug costs

State Health Insurance Assistance Program (SHIP)

The State Health Insurance Assistance Program, commonly known as SHIP, provides Medicare beneficiaries with information, counseling, and assistance. In Texas, the Health Information, Counseling and Advocacy Program (HICAP) provides these services.

Through SHIP/HICAP, trained Benefits Counselors provide individualized assistance with Medicare and related health insurance questions.

Benefits Counselors can help explain:

  • Medicare eligibility and enrollment

  • Original Medicare

  • Medicare Advantage

  • Medicare Part D prescription drug coverage

  • Medicare Supplement Insurance

  • Medicare preventive services

  • Programs that may help eligible beneficiaries with Medicare-related costs

  • Medicare claims and appeals

Benefits Counselors do not represent an insurance company when providing SHIP counseling. Counseling helps consumers understand their options and make informed choices.

Medicare Open Enrollment

Medicare Open Enrollment is held each year from October 15 through December 7. During this period, people with Medicare can review their Medicare health and prescription drug coverage and make changes for the following year.

Medicare health and prescription drug plan costs, coverage, provider networks, pharmacies, and drug formularies may change from year to year. Reviewing your coverage annually can help you determine whether your current plan continues to meet your health care and prescription drug needs.

During Medicare Open Enrollment, Area Agency on Aging Benefits Counselors can provide individualized counseling and help Medicare beneficiaries review available coverage options.

Visit a Benefits Counselor

Walk-ins are welcome on Thursdays. Benefits Counseling appointments may be scheduled Monday through Wednesday and Friday.

To schedule an appointment, contact the Area Agency on Aging of the Coastal Bend at (361) 883-3935.

Prepare for Your Medicare Plan Review

When meeting with a Benefits Counselor to review Medicare coverage, please have your current Medicare and insurance information available. For a prescription drug plan review, it is also helpful to have an up-to-date list of your prescription medications, including the name, dosage, and frequency of each medication, as well as your preferred pharmacy.

Help With Medicare Costs

Some Medicare beneficiaries may qualify for programs that help with Medicare premiums, deductibles, coinsurance, or prescription drug costs.

A Benefits Counselor can provide information about programs such as:

  • Medicare Savings Programs

  • Medicare Part D Extra Help/Low-Income Subsidy

  • Medicaid

  • Other benefits and assistance programs for which an individual may qualify

Eligibility requirements can change. A Benefits Counselor can help you understand current requirements and identify the appropriate agency or application process.

MIPPA Outreach and Assistance

The Medicare Improvements for Patients and Providers Act (MIPPA) supports outreach and assistance for Medicare beneficiaries, including efforts to connect eligible individuals with programs that may help reduce Medicare and prescription drug costs.

Benefits Counselors can help consumers learn about Medicare Savings Programs, Extra Help, and other benefits for which they may qualify.

Senior Medicare Patrol (SMP)

The Senior Medicare Patrol program helps Medicare beneficiaries, their families, and caregivers learn how to recognize, prevent, and report suspected Medicare fraud, errors, and abuse.

The Area Agency on Aging incorporates Senior Medicare Patrol education into Medicare counseling, presentations, and outreach activities.

Protect Yourself From Medicare Fraud

  • Protect your Medicare number and other personal information.

  • Do not provide your Medicare number to an unexpected caller or visitor simply because the person claims to represent Medicare or another health care organization.

  • Review your Medicare statements and notices for services, equipment, or supplies you do not recognize.

  • Keep records of health care appointments and services you receive so you can compare them with Medicare statements.

  • Ask questions when you do not recognize a charge or service.

  • Report suspected Medicare fraud, errors, or abuse.

Remember: Protect, Detect, Report

Protect your Medicare information. Detect possible problems by reviewing your Medicare statements. Report concerns when something does not look right.

Assistance With Medicare Problems and Appeals

If Medicare or a health plan denies coverage for a service, prescription, or other benefit, a Benefits Counselor may be able to help you understand the notice, identify applicable appeal information, and determine where to obtain additional assistance.

Benefits Counselors may also assist consumers with certain Medicare and private insurance billing concerns and insurance disputes.

Preparing for Your Benefits Counseling Appointment

Depending on the reason for your visit, it may be helpful to have the following information available:

  • Your Medicare card

  • Your current health or prescription drug plan information

  • A current list of your prescription medications, dosages, and preferred pharmacy

  • Medicare, Social Security, Medicaid, or insurance notices related to your question

  • Medical bills or Medicare statements related to a billing concern

  • Information requested by the Benefits Counselor for the program you are discussing

Protect your personal information. Only provide sensitive information when it is necessary for the assistance you requested and you understand why the information is needed.

Benefits Counseling Throughout the Coastal Bend

The Area Agency on Aging works to make Benefits Counseling available throughout the Coastal Bend, including rural communities. Counseling, community presentations, outreach activities, and Medicare education may be offered at the Area Agency on Aging office and through community locations and events.

Contact the Area Agency on Aging for current outreach locations and information about scheduling an appointment.

Medicare and Benefits Resources

External links are provided for informational purposes. Medicare plan availability, costs, benefits, eligibility requirements, and program rules may change.

Contact Benefits Counseling

Contact the Area Agency on Aging of the Coastal Bend to speak with a Benefits Counselor or request information about Medicare, benefits assistance, Medicare fraud prevention, or upcoming Medicare education and outreach activities.

Walk-in Benefits Counseling is available on Thursdays.
Appointments may be scheduled Monday through Wednesday and Friday.

Area Agency on Aging of the Coastal Bend
2910 Leopard Street
Corpus Christi, TX 78408
Phone: (361) 883-3935
Toll-Free: 1-800-252-9240

Medicare: 1-800-MEDICARE (1-800-633-4227)