Come Oct. 15, a SHINE counselor might just become your new best friend.
That date marks the start of Medicare’s annual enrollment period when thousands of adults turning 65 are faced with the daunting task of signing up for the complex health insurance program.
Through SHINE, trained counselors offer free support for making the best choices for both people’s wellbeing and their wallet.
But not everyone takes advantage of the program, say those involved.
“People don’t know what we do and that we’re here,” said Christie Rexford, regional SHINE director for Southeastern Massachusetts, including the South Coast. “There are people who have no idea that we exist, as busy as we are.”
Busy year-round, SHINE activity ramps up during open enrollment which ends Dec. 7. November is by far their busiest month, according to Rexford.
A statewide program, SHINE – which stands for Serving the Health Insurance Needs for Everyone – operates locally from Rexford’s base at the Middleborough Council on Aging. Counselors explain insurance and prescription options, help people find the right coverage, identify ways to reduce costs, and assist with the application process and timing.
Many appointments happen at Senior Centers whose support for SHINE is vital, according to Rexford. They provide computers and office space among other help, she said.
“We’re constantly strategizing what needs to be done right away, because timing is important. What’s short term and can be done quickly? What takes more time? What kind of resources does this person have – physical and mental, not just income. We want to get most the bang for our buck with their energy,” Rexford said.
“We’re going to determine what your doctors will work with because there’s like 50 plans. We also look at your medications,” she continued. “We can talk about the pieces of a Medicare Advantage plan, the things to watch for, the supplemental benefits offered like dental, vision, and hearing or the over-the-counter benefits. We can do all of that in a group setting, but to really choose one plan, then you have to sit down one-on-one and go through the specifics.”
Rexford’s job is to oversee and support 93 counselors in the region, recruit and train new counselors annually, and ensure people in the 29-town area – including Brockton and New Bedford — can connect with a counselor when needed. She relies on the volunteers who give their time and energy to the program.
“About half of (SHINE counselors) are truly volunteers,” said Rexford. “They’ve retired from their career and they’ve decided to give their time for this, which is mind-boggling. It’s a lot of work and they’re dedicated…And then the other half are people who are working in their position, like a (Senior Center) outreach worker, and SHINE is just a piece of what they do.”
Despite a dip in numbers during the pandemic, SHINE has been growing, getting more calls and helping more people. In 2023, the regional office helped 10,466 people with Medicare questions, Rexford said. To date, 2024 is trending above that number with a 17% increase in contacts during the first quarter of the year over the same period in 2023. The number of people connected to public benefits, including the Medicare Savings Program, has also risen, Rexford said, adding that 1,100 applications were submitted, a 132% increase over the year prior.
Beyond the numbers, the biggest change Rexford sees is how complicated the health insurance program has become, particularly with Medicare Advantage and the Medicare Savings plan.
“Things are much more complicated and more complex than they ever used to be with benefit programs and enrollment periods,” she said. “The Medicare Savings Program is huge and a driving force with a lot of our work now.
“Also, Medicare Advantage has just expanded so much and with supplemental benefits they can be very attractive. We spend a lot of time sorting those out with people. And then just complexities with people’s health, with their finances, with mental health. There’s a lot of things that intersect.”
Medicare Advantage comes with pros and cons that people aren’t always aware of, Rexford said.
“It’s good for some and not good for others. So that’s what’s so difficult,” she said. “And when you see the ads on TV, they’re leading with all of the pros, but you have to know all the cons, too. There’s more to the story. You can’t just go by an ad on TV or a postcard in the mail.”
Given the complexity of the topic, it’s not surprising that people often reach out to SHINE not knowing how to get started or what questions they should even ask. That’s normal, said area counselors, emphasizing people should call them anyway.
Fairhaven resident Dianne Perkins remembers that feeling of confusion when her parents needed to sign up for Medicare and she began looking into it for them. When she showed an aptitude for it, they encouraged her to keep “figuring it out.” The Medicare instructor in the class she took also noticed Perkins, commenting on her smart questions and recommending she consider becoming certified as a SHINE counselor.
That was almost 20 years ago, Perkins said.
“That’s how it all began,” she said with a laugh. “Even though it’s a volunteer job you get to help so many people that if they didn’t come see you, they would never have known about parts of the program. It’s a volunteer job but it’s also very, very rewarding.”
Asked how she helps people, Perkins rattles off a series of steps she takes with people for Medicare Parts A, B, and D. Part A is hospital coverage, B is medical coverage including doctors’ services, bloodwork, etc., and D is prescription coverage, she explains. Part C is also known as Medicare Advantage plans.
“I tell them that when you do Medicare Advantage, it’s also called Part C and it combines (Medicare) A, B, and D, so it’s all on one card,” she said.
Perkins also helps people understand what they need to do and when to avoid any penalties if they are still working, a growing concern as more people continue to work past the age of 65.
“Also, what I do is list the costs of things,” she said. “You don’t want them to pay for the best insurance if they can’t afford it and it means they can’t eat. It’s not going to do them any good.”
Perkins and fellow SHINE counselor Carolyn Dantoni are both based at the Fairhaven Council on Aging. Both women have been doing this long enough that they’ve gotten a reputation for their skills, according to Rexford.
“Once people have worked with their community person, they usually stick with them and that’s their person,” she said, adding that’s the case with both Perkins and Dantoni.
“I don’t know what I’ll do when they ever retire,” she laughed.
Rexford encourages anyone interested in becoming a SHINE volunteer to take the annual spring training and certification test. Volunteers, she said, have come from many backgrounds, including health fields and just about any other role.
They always have one quality in common though, she said, and that’s compassion.
“You’re not going to do it if you’re not compassionate.”
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