Exercising Your Right to Choose
Submitted by Annette Morrison, M.S., CRS-A/D, DCS, CCSI Case Coordination, LLC
Jason took a deep breath and rejoiced at the tightness of the skin on his chest – right over his heart. He was recovering from a recent heart attack and triple bypass surgery. As he paced on the treadmill during his cardiac rehabilitation, Jason marveled at being alive, but he still felt a little knot of tightness in his chest – anxiety for the future. His Medicare Advantage plan, according to the bills and his Explanations of Benefits, paid quite a bit. He was astounded, however, at the out-of-pocket cost he had to pay before the plan kicked in at 100% – $10,000. Jason had been on his current plan for three years. It went well the first two years – his copays were rare. But this year was different. As if having a major heart issue wasn’t enough to worry about, he received a letter mid-year that his Medicare Advantage Plan Company was closing December 31st. Even if he wanted to stay in his current plan – he did not have a choice but to change. He needed to do it in the next two months – as the Medicare annual open enrollment period only ran from October 15th to December 7th. Jason decided he needed to talk to someone who knew more about Medicare, someone who could run different scenarios past him and produce a better game plan. He needed an expert.
Every state in the USA has a program that trains counselors to help beneficiaries look at their Medicare options. In Illinois, this help is SHIP Counseling, short for the Senior Health Insurance Program. A SHIP Counselor consults with beneficiaries as a volunteer or as an employee of an organization that receives grants to work with Medicare beneficiaries through the Centers for Medicare and Medicaid Services and the Older Americans Act. SHIP counselors are trained & certified through the Illinois Department on Aging to answer your questions about Medicare, when to sign up, help discover your options, and take a serious look at what the coverage will mean for you when you need it most. SHIP Counselors are non-biased educators who show you all your options and let you choose based on your preferences. SHIP counselors use the Medicare.gov website and resources developed by the Centers for Medicare & Medicaid Services to help beneficiaries make educated choices. Jason had heard of a Senior Health Insurance Program Counselor through a friend and decided to make an appointment with CCSI Case Coordination Services.
Jason wished he had known about CCSI years ago. His SHIP Counselor was amazing, asking him questions about his lifestyle, traveling, budget, looking at his medications, and making suggestions to help bring down costs. They made sure that the plan he chose not only covered his medicines, but also the new cardiologist and surgeon he was seeing. She explained to him that the reason his out-of-pocket cost was so high in 2025 was that the hospital and surgeon were not in his current Advantage Plan’s network. Once they figured these providers into his coverage, he found he had five companies to choose from. Even if 2026 was just as bad of a health year for him, the maximum out-of-pocket cost would only be $5,500. He was also relieved to know that his plan would not be an obstacle to his being able to afford his medications. What he liked most about seeing a SHIP Counselor was that she did not pressure him to decide on either company. When he had to decide, she helped him prioritize his health needs to consider the most expensive costs and make sure the plan he was considering addressed his needs. The SHIP Counselor helped him enroll and printed off confirmations for his own records. He felt like a weight had lifted off his chest. The tightness in his chest was no longer anxiety, just his healing surgical scar. Jason could not wait to tell his friends and family about CCSI’s SHIP Counseling program. He decided he would come in each fall to review his Medicare Advantage Plan to make sure it would still cover him well – no matter how good or bad of a year he was having.
To schedule your SHIP Counseling appointment, contact CCSI Case Coordination, LLC at 309-661-6400. We are located at 3601 G.E. Road, Suite 2, Bloomington, IL 61704. Funding is provided through ECIAAA, CCSI Case Coordination and IDOA. Donations are accepted but not required to receive assistance from our counselors.