How to Become a Volunteer for Your Local Senior Medicare Patrol

Attention to details can solve puzzling billing

Dubin started as a SHINE counselor helping people with their Medicare decisions. After she saved a client $13,500 by helping him pick a new Part D plan during open enrollment, she was quickly recruited to join the Senior Medicare Patrol, which works with the SHINE program.

“My background in accounting and human resources seemed to mesh well with dissecting and understanding the many details of the Medicare world,” she says. “I think it was my inquisitive nature and desire for details that got me noticed.”

Dubin participates in community outreach programs, teaching Medicare beneficiaries how to spot fraudulent charges on their Medicare summary notices and the importance of protecting their Medicare number. She primarily works with beneficiaries who suspect fraudulent activity and call in to the state’s Senior Medicare Patrol hotline.

Past experience put to use again

Some who had helped people with Medicare issues in their careers are drawn back after retirement.

Dick Anderson, now 84, started in the insurance business, then spent years working in the Office of the Insurance Commissioner in Olympia, Washington, where he trained SHIBA Medicare volunteers, wrote continuing education courses and did public presentations for the commissioner’s office.

“About 10 years after I left the commissioner’s office, my wife and I moved to eastern Washington to be closer to grandkids. I saw an ad in the local paper for SHIBA volunteers, and I volunteered,” he says. “I had enjoyed working in the SHIBA unit and welcomed the opportunity to give back.”

Dick Anderson spent years working in the Office of the Insurance Commissioner in Olympia, Washington. Now he volunteers to help Medicare beneficiaries with questions about coverage and suspicious charges.

David Ryder

Public can learn about potential for fraud

Anderson has been a SHIBA counselor and Senior Medicare Patrol volunteer since 2007. He gives presentations about Medicare fraud and even has his contact information on his business card so people can reach out to him for help with Medicare questions or to ask about suspicious charges or calls.

“I get a lot of calls, sometimes just for clarification or a quick answer,” he says. He also does one-on-one counseling at least one day a week. Sometimes Medicare beneficiaries and their caregivers have questions about Medicare coverage or discover that a provider made a billing error.

But sometimes the suspicious activity is a scam. He recently helped a client in an assisted living facility who received a leg brace he didn’t order, which is a common scam. The client’s son recognized the fraud, and Anderson worked with the son to file a complaint to Medicare.

“I enjoy the clients, I enjoy my coworkers and helping professionals I come in contact with, and gradually one gets to be a part of a sort of community of people who like helping others,” he says.

Sometimes the volunteer work leads to a full-time job. Phillip Hartshorn became a Senior Medicare Patrol volunteer in Washington state while helping his mother, who had dementia, with her Medicare problems.

“During that time, I wanted a challenging volunteer opportunity to keep my mind moving,” he says. After volunteering for three years, he’s on staff to handle complicated cases.

Volunteers get training to educate others

Senior Medicare Patrol training and time commitments can vary a lot depending on the state. In Florida, Washington and some other states, the organization is affiliated with the State Health Insurance Assistance Program. Volunteers there must also be SHIP counselors, which requires instruction to help people make Medicare decisions in addition to learning to detect fraud.

In other states, the Area Agency on Aging, which can be a government or private nonprofit entity; the Better Business Bureau; other local nonprofits; or the state insurance department runs the program. And in a handful of states, Senior Medicare Patrol volunteers give presentations at community events and man booths at health fairs to answer questions about Medicare fraud, but they refer fraud cases to staff members for investigation.

Tom Call retired in 2015 after a career in compliance for an investment firm. He was looking for volunteer opportunities online and found the Senior Medicare Patrol of southeast Texas.

To learn the ropes, he accompanied experienced volunteers after receiving four weeks of training. Now he gives presentations about detecting and avoiding Medicare fraud to church groups, health fairs, retirement centers and senior centers in the Houston area.

“You have to be interested in interacting with individuals,” he says. “And you have to see helping people as a rewarding activity.” Call has learned about a variety of deceptions:

• Being charged for the same service or item repeatedly.

• Receiving “free” diabetic kits never ordered.

• Seeing a questionable doctor billing on a Medicare summary notice.

If he sees what looks like potential fraud on a Medicare statement, he’ll refer the beneficiary to Senior Medicare Patrol staff who can help research a case.

“Don’t be embarrassed about asking questions,” Call says.