Name of the Organization : Lieutenant Governor Office
Type of Facility : VI SHIP Virgin Islands State Health Insurance Assistance Program
Country : United States Virgin Islands
Website : https://ltg.gov.vi/
VI SHIP Virgin Islands State Health Insurance Assistance Program :
The Virgin Islands State Health Insurance Assistance Program (VI SHIP) is the Virgin Islands local Medicare source, which is locally administered by the Office of the Lieutenant Governor and federally funded by the Centers for Medicare and Medicaid Services (CMS).
Related : Lieutenant Governor Office Property Tax Bills Payment U.S. Virgin Islands : www.statusin.org/8175.html
Currently, there are SHIP Offices in all 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands. VI SHIP provides free information and personalized or group counseling to persons with Medicare, family members, and caregivers in the territory on:
** Medicare
** Medigap (Medicare Supplement Insurance)
** Long Term Care Insurance and Financing Options
** Medicare Prescription Drug Coverage
** Billing/Claims Resolution Assistance
** Referrals to the Appropriate Government or Community-based Organizations.
Education and information are also provided to the general public by trained counselors via public forums, workshops, health fairs, etc. The goals of VI SHIP are to “assess, inform, advocate, protect, educate, and empower” Medicare beneficiaries.
Medigap:
** A Medigap policy is available to persons who are seeking extra help (insurance coverage) with paying for services not covered by the Original Medicare Plan. A Medigap policy fills in the “gaps” in the Original Medicare Plan. Buying a Medigap policy is not mandatory. Medigap policies are offered by private insurance companies who must follow federal and state laws established to protect persons with Medicare.
** The front of the Medigap policy must clearly identify it as “Medicare Supplemental Insurance”.
** A Medigap policy must be one of ten standardized policies (Plans A – J) so comparisons can be made easily. Each policy has a different sent of benefits and different premiums that must be paid monthly.
** Medigap policies have changed due to the Medicare Modernization Act (MMA) of 2003. Starting January 1, 2006, new Medigap policies with prescription drugs coverage (i.e., H, I, or J) can no longer be sold.
** Plans K and L are new polices that were added in 2005 as a result of the MMA of 2003.
** Two of the standardized policies (Plans F and J) may have a high deductible option.
** Additionally, any of the standardized policy may be sold as a “Medicare SELECT” policy. Medicare SELECT policies are usually less expensive because certain hospitals and doctors must be used.
The best time to buy a Medigap policy is during the Medigap open enrollment period which lasts for 6 months. The enrollment period begins on the first day of the month in which the individual is age 65 and enrolled in Part B.
Medicaid:
Medicaid is health care assistance that helps people with low incomes and limited resources to obtain medical care for some or all of their bills. Medicaid also helps to pay for nursing home care. Medicaid programs differ from state to state. In the U.S. Virgin Islands, Medicaid is called the Medical Assistance Program (MAP). The Department of Health’s Bureau of Health Insurance and Medical Assistance is the division responsible for administering Medicaid in the Virgin Islands.
Eligibility for MAP is determined by the Certification Units and is based on family income, resources, and other factors. Examples are documents needed for eligibility determination are:
** Verification of U.S. Citizenship and age and
** Verification of resources
** Other documents may be required as well.
Individuals who receive cash assistance from the Department of Human Services and are classified as “Categorically Needy” are automatically eligible for Medicaid. Assistance (Spend-Down Program) is also available to persons whose incomes and resources are above or in excess of the allowable income level. The excess income is expected to be expended (spent down) before assistance is provided by MAP.
In addition, persons with Medicare who meet the eligibility requirements of MAP can receive assistance from MAP with paying their Medicare Part A deductible, Medicare Part B premium, and the share of allowable costs not covered by Medicare. Persons with both Medicare and Medicaid are called “Dual Eligibles” (DEs).
Starting January 1, 2006, Medicare will begin covering prescription drugs for DEs. MAP will still cover other care that Medicare doesn’t cover. MAP will be using Medicare and local funds to assist DEs with paying their premium, deductible, and co-pays for the Medicare prescription drug plan they are enrolled in. In order to get this help, DEs must enroll in a Medicare Prescription Drug Plan by December 31, 2005. For DEs who fail to enroll in a plan by this date, MAP will automatically assign them to a plan. (For more information on how DEs prescription coverage will be affected starting January 1, 2006, click on the link below the subject heading Medicare Prescription Drug Coverage).
For more information, contact the MAP Certification units at (340) 444-3325 in St. Thomas and (340) 773-1311, ext. 3095 in St. Croix.