A reader raises a worthy question about being counseled by a volunteer Medicare counselor.

“The Medicare counselor would be a stranger to me,” she begins. “How do I know I can trust the person with sensitive personal information?”

Short answer: You are not obligated to share sensitive personal information in speaking with a Senior Health Insurance Benefits Assistance (SHIBA) Medicare counselor. 

To make the appointment (details at the end of this column) you will need to provide your name, phone number and ZIP Code, and it’s helpful to share why you would like to speak with the counselor. The certified counselor with whom you speak is among thousands of volunteers across America who help people with their Medicare. 

These are key questions one might ask about personal privacy:

Do I have to share my Medicare number? It’s up to you. The reason the Medicare counselor would ask for your Medicare number would be if he or she enrolls you in Medicare insurance. But if you don’t want to share your Medicare number, the counselor can give you the name of the insurance you’ve chosen as well as its phone number. Then you can enroll yourself on the phone.

Do I have to share my income? No. The counselor is supposed to ask you an income question, this to determine if you qualify for benefits such as reduced drug costs at the pharmacy or waiver of Medicare’s Part B $202.90 monthly premium. But you’re welcome to say you don’t wish to discuss income. If you do agree, the question should be whether your monthly income is above or below a certain amount; you should not be asked your income.

Do I have to tell the counselor my prescription drugs? Virtually all people do, but no, you don’t have to. The SHIBA counselor usually helps Medicare beneficiaries by entering their prescription drugs on the Medicare.gov website to learn which insurance plans cover their drugs and at what price. However, if you prefer not to share your drug list, the Medicare counselor can show you how to use the Medicare website so you can do this yourself. If you choose to be shown how to use the Medicare website, this is most effectively done in either an in-person or Zoom appointment, although it could be done over the phone.

What if the counselor needs my personal information to check my Medicare benefits or insurance status, say? Here again, you need to share very little. First, the SHIBA volunteer counselor doesn’t have access to records about you. The counselor would call the SHIBA state office to obtain the information being sought. To do so, the counselor would need only your name and date of birth. If you would prefer instead to speak with a State of Oregon employee, then call the SHIBA state office at 800-722-4134 (don’t enter your ZIP Code; just stay on the line). However, if you are seeking information about your Medicaid or Oregon Health Plan enrollment, please call 800-699-9075. 

Can anyone off the street become a SHIBA Medicare counselor? Not necessarily. People who apply to be SHIBA counselors undergo a background check through a system used by 27 U.S. states and territories. The system, whose acronym is ORCHARDS, was developed on behalf of the federal Centers for Medicare and Medicaid Services. Beyond Medicare training, SHIBA counselors receive annual training in privacy restrictions.

A corollary question: How should I prepare for a SHIBA Medicare appointment?

These are considerations to get maximum benefit for your time:

• Have available a list of your prescription drugs including dosage and frequency for each.
• Have your Medicare number with you in case you have reason to share it with the SHIBA counselor.
• Make a list of questions you wish to ask the SHIBA counselor. 
• Ask the office of your primary care physician (1) whether the doctor will bill Medicare and (2) what Medicare Advantage insurance plans the doctor accepts. 
• If you’re an overachiever, you might spend some time with the Oregon Guide to Medicare Insurance Plans before the appointment. This will help you to understand Original Medicare, Medicare Advantage insurance, Medicare supplement (Medigap) and prescription drug insurance. 
• If you are a public employee and a PERS beneficiary, you might contact the PERS Health Insurance Program (503-224-7377) to learn your Medicare insurance options there. 
• In making your SHIBA appointment, understand that you have a choice of in person at one of the SHIBA locations, over Zoom or on the phone. 

Jim Sellers of Salem is a certified Medicare counselor with the Senior Health Insurance Benefits Assistance (SHIBA) program. To ask a question to be answered in this column, e-mail [email protected]. To schedule a free SHIBA in-person, phone or Zoom appointment with a volunteer Medicare counselor, please call 800-722-4134.

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