Minuteman Senior Services   Toll Free (888) 222-6171 or (781) 272-7177



Health Benefits Counseling (The SHINE Program)

Serving Health Insurance Needs of Everyone...on Medicare (SHINE) provides free health insurance counseling for seniors and Medicare beneficiaries of all ages through a network of highly trained volunteers and staff. We strive to insure that Medicare beneficiaries have access to accurate, unbiased and up-to-date information about their health care options.

SHINE counselors provide assistance with:

  • Understanding rights and benefits under Medicare
  • Medicare (Parts A, B, C, D)
  • Medicare Supplement Plans (Medigap Plans)
  • Medicare Advantage Plans (HMOs, PPOs, PFFS)
  • Provide comparisons of Part D plans that will meet your needs
  • Provide comparisons of health insurance plans
  • Prescription Advantage
  • Insurance claim forms, questions, and appeals
  • Public benefits (MassHealth, Help with Paying for Medicare Part B, Long Term Care, Safety Net)
  • Limited Income Subsidy or Extra Help to Pay for Part D premiums and copays
  • Volunteers will help a client fill out applications related to health insurance
  • Volunteers will explain your current health insurance coverage
What is a SHINE Counselor?
How can a SHINE Counselor help me?
Where can I find a SHINE Counselor?
How can I become a SHINE Counselor?
How can I find out more information on my own? List of web resources.

Frequently Asked Questions
    Do I need to enroll in Medicare?
    When and how should I enroll in Medicare?
    Is there any help available to pay for Medicare?
    Do I need a supplement plan?
    What is a Medicare Advantage Plan?
    What is Part D?
    What is Prescription Advantage?
    Should I take the COBRA Option from my employer?
    What does creditable coverage mean?


What is a SHINE Counselor?
Community volunteers who are trained and certified by the Massachusetts Executive Office of Elder Affairs in health insurance issues and plans for people on Medicare. Counselors are trained in Medicare A, B, C and D, Medigap Insurance, Medicare Advantage Plans (HMOs, PPOs, PFFS), Prescription Advantage, MassHealth (Medicaid) including long term care options, Medicare Assistance programs, and other programs for people with limited income. Counselors receive an initial training of 12 days, must pass an exam each year, and attend monthly training.
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How can a SHINE Counselor help me?
SHINE Counselors can help you understand your rights and benefits under Medicare Plans and supplemental plans. Counselors can review your current coverage, prepare comparisons of health plans and Medicare Prescription plans, protect you from paying bills you should not pay and for coverage you do not need. Counselors can also help you fill out health insurance applications, claim forms, and appeals. When it is appropriate, counselors will refer you to other agencies or resources.
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Where can I find a SHINE Counselor?
We cover the towns and locations listed below and have SHINE Counselors at the local Senior Center. Call the number associated with your town to make an appointment. If you need a SHINE counselor in a town not listed, please call 1-800-AGE-INFO (1-800-243-4638) or check with your local Senior Center or Council on Aging.

Acton 978-264-9643 Arlington 781-316-3400
Bedford 781-275-6825 Boxborough 978-263-1116, Ext. 106
Burlington 781-270-1950 Cambridge 617-349-6220
Carlisle 978-371-2895 Concord 978-318-3020
Harvard 978-456- 4120 Lexington 781-861-0194
Lincoln 781-259-8811 Littleton 978- 540-2470
Maynard 978-897-1032 Somerville 617-625- 6600, Ext. 2300
Stow 978-897-1880 Wilmington 978-657-7595
Winchester 781-721-7136 Woburn 781-937-7899

This office also provides on-site counselors at the following locations:
Lahey Clinic 781-744-8201
Cambridge, Paine Senior Services 617-864-2520
Somerville-Cambridge Elder Services 617-628-2601
Minuteman Senior Services 781-221-7029
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How can I become a SHINE Counselor?
If you are a good problem solver, have good analytical skills and want to exercise your brain to stay young, you would make a good SHINE Counselor. You will truly find enjoyment and satisfaction that comes with helping people feel empowered to make decisions. Potential counselors will be provided with 12 days of training. This initial time commitment is substantial but will provide you with the tools and resources needed. Counselors are typically assigned to a local Council on Aging and are asked to make a time commitment of 3-4 hours per week. If this sounds like something you would like to do, please e-mail SHINE at e.killeen@minutemansenior.org.
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How can I find out more information on my own?
www.medicare.gov - Drug and health plan finder

www.ssa.gov - When and how to sign up for Medicare and applying for Low Income Assistance for drug plans.

www.medicareinteractive.org - This website is maintained by the Medicare Rights Center. The site provides an excellent overview of Medicare Basics and is easy to use and navigate.

www.benefitscheckup.org - Find out what Federal and/or state programs provide assistance (financial) with Medicare Part B premiums, drug plan premiums and copays, utilities and food. Also will find useful information on housing and elder care assistance.

www.massmedline.com - Provide resources for finding Drug Manufacturer Assistance Programs and identifying generic alternatives to brand name drugs.

www.gbls.org - Medicare Advocacy Project. Free legal advice for people on Medicare and help with filing Medicare appeals.

MassHealth (Medicaid)

Prescription Advantage - the Massachusetts state prescription plan that supplements Medicare Part D

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Frequently Asked Questions
Do I need to enroll in Medicare?
Everyone who has worked at least 40 quarters and has contributed to Medicare should enroll in the plan when they are first eligible.

When and how should I enroll in Medicare?
Enrollment for Medicare is made through the Social Security Office, either on-line or at an office. Please check their website link above for more details. You should enroll in Medicare Part A when you turn 65 even if you are still working. You should enroll in Medicare Part B when you first become eligible at age 65 or, if you are still working within 8 months of stopping active employment.

Is there any help available to pay for Medicare?
There are several programs available for those who meet the financial eligibility criteria. For those with "limited" income eligibility there is the Federal program - Extra Help - This plan assists beneficiaries with paying drug plan premiums and co-pays. A State program - Prescription Advantage - is an assistance program for those with low to moderate incomes. If eligible, this plan assists beneficiaries with drug costs through the do-nut hole. In addition there are programs that may assist to pay the Part B premium. To find out more and to see if you are eligible, contact your local SHINE Counselor. You can also find out information by going to the Benefits CheckUp link listed under the links section of this site.

Do I need a supplement plan?
If you enroll in Original Medicare, it might be prudent to enroll in a Medicare Supplement (Medigap) Plan. Original Medicare (Part A & B only) has deductibles and copayments of 20%. The Medigap plan pays for the deductibles and the 20% copayments. If you are in a Medicare Advantage plan you do not need a supplement.

What is a Medicare Advantage Plan?
A Medicare Advantage Plan is a Health Maintenace Organization (HMO), a Preferred Provider Organization (PPO) or a Private Fee for Service (PFFS) plan. These plans replace Original Medicare. It is often called Medicare Part C. Most of them have copayments for doctor visits, hospital deductibles and require you to receive services within a network of providers. There are no supplements to these plans as they are all-inclusive plans. Medicare provides the plan with funds to administer and provide all the services provided under original Medicare. Some Medicage Advantage Plans may provide some additional services such as health club membership discounts, eyeglasses, or limited dental coverage.

What is Part D?
Part D is the prescription portion of Medicare. You must sign up for this separately from Medicare A and B. You usually do this at the same time that you enroll in Medicare A and B. Even though this is a voluntary plan, there are financial penalties if you enroll after the date you are first eligible. If you are in a Medicare Advantage Plan, you must receive your prescription benefits through the same Medicare Advantage Plan. The one exception is that PFFS plans do not have this requirement.

What is Prescription Advantage?
Prescription Advantage is a supplemental prescription plan offered by the Commonwealth of Massachusetts. There is no premium except for the Category 5 (higher income) and it helps pay for your prescriptions once you fall into the do-nut hole. There is also an out-of-pocket maximum, which means that once you hit this maximum (total spending for co-payments), Prescription Advantage will cover 100% of your co-payments.

Should I take the COBRA Option from my employer?
When you leave your employment, your employer may offer you COBRA. COBRA allows you stay in your employer's plan for a specified amount of time while paying the full cost of the plan. You should be aware that COBRA for Medicare A, B, and C does not give you extra time to enroll in the Medicare plans. You still must enroll in Medicare when first eligible, not when COBRA ends. If you wait until COBRA ends, you will pay a lifetime financial penalty and will have to wait until the Medicare annual open enrollment period to enroll. This scenario may leave you without insurance for a period of time.

You can take COBRA for Medicare Part D - the prescription plan - if your employer's plan allows you to take just the Prescription portion of the plan. You will then have 60 days after the end of COBRA to enroll in a Part D plan without penalty.

What does creditable coverage mean?
Creditable coverage is a term used by Medicare to declare a plan is "either equal to or better than Medicare coverage". It is generally used in reference to the prescription plan - Part D - that you may have through your employer as a retiree or through COBRA. It can also be used to refer to an employer medical plan that you have through a spouse or through your employer if you still working after age 65. It is important to know that you must be actively at work or if covered through your spouse, the spouse must be actively at work.