Ask SHIBA

SHIBA Inquiry

Are you currently enrolled in Medicare?

What help do you need? (Check all that apply)

I don’t know

Medicare Prescription Drug Plan

Medicare Advantage (Part C)

Medicare Supplement Insurance

Medicare and my employer-based health plans

Medicaid or Extra Assistance Program

Long-term care coverage/insurance

Other

What else do you need help with?

Which of the following most closely describes your questions? (Check all that apply)

I need help choosing a good Medicare plan for me.

I need help paying for my prescription medications.

I have a problem getting medical care.

I have a question about my bills from my insurance company, the hospital, or my doctor.

I need help with my Low Income Subsidy (LIS) and/or Medicare Savings Program (QMB, SLMB, or QI-1) application.

Other

Please describe your question.

We can help you find the Drug Plan that is most cost effective for you. Do you want to learn more about a cost-comparison of your Prescription Drug Plan options?/

(Open Enrollment for your Prescription Drug Plan is October 15 – December 7 of each year OR you may be eligible for a Special Enrollment Period.)

Do you qualify for “Extra Help” with Medicare costs?

(This may be the case if your income is below $1,956/month for a single individual or $2,644/month for a married couple and you meet asset limit tests.)

First Name

Last Name

Best way to contact you?

Phone number

Knowing your zip code and county will help us connect you to the person who can best help you.

What is your zip code?

What is your county of residence?

What is your age?

Is there anything else you would like us to know?

HAVE MEDICARE QUESTIONS? WE HAVE ANSWERS.