Towards the end of Geof’s email were instructions on how to get reimbursed for 2025 copays, which I decided to follow just for the heck of it.
The nice lady at the right is Pat Rojas, who runs SHIP. She says in a short video that SHIP enrollees – not everyone who paid copays that year, mind you – could get back up to $105 of them.
Sounds like the cost of a dinner for two at a moderately priced restaurant, but okay if there’s not much work involved.
Not what happened, though. After spending some time going through what needed to be done, I felt the overwhelming urge to tell my friends and Medicare counseling buddies what I encountered, but why stop there. Everyone should know about it.
Thus this post.
----------------------------------------------------------------------------------------------
Hello, good evening,
You must have received the notice from the UFT below (or a similar email from your own union) that SHIP will reimburse copays between Jan 2022 and Feb 2023. I’m not sure all the unions have SHIP, so only read further if you do have it.
At the end of that email is a link to website explaining that SHIP, if you’re enrolled in it (and not everyone in Senior Care is), will reimburse you for up to $105 in copays per calendar year once you’ve met your annual deductible. You can do this for 2025, dating your request up to the end of the following year (in this case Dec. 2026). I’m not sure if it’s just too late to process the 2024 copays this way, or if this arrangement was only meant for 2025 and later.
They of course mean the Medicare deductible, not the $50 Senior Care deductible, which the video doesn’t even mention. That’s always confusing on the Emblem statements, by the way.
If you are in Medicare, then this chart during the video tells you what you need to collect and send them.
The SHIP exec implies it’s easy: “You have to get a hold of 4 documents.”
What a hoot.
In reality, you have to go through all your bills, receipts, and statements from Medicare, providers, and EmblemHealth, then fill out a SHIIP form and send it all off to them. This is not 4 documents. This is multiple items in 4 categories, not 4 documents.
I tried it anyway.
Going through my 2025 papers, which I have kept but always been tempted to throw out the minute I get them, I ran into these problems:
1. Medicare Part B summaries: She asks to find page one of the MSN to show that the deductible has been met, and I can save you some trouble by telling you exactly where to look. Start with the first MSN of the year and look towards the top of the first page: it tells you where you are in meeting that deductible. Keep going through one or two more MSNs until you get one that says the it’s been met. Here are those lines from my first two statements in 2025:
I assume they want me to send them the 2nd one, and presumably from here down, they’re looking for items after that 2nd statement, until that $105 is reached.
2. Now for provider statements, with dates and copays paid. I guess they mean bills, which in my case came in all different forms, some requested the day of the visit, some billed later. Some I paid in cash, or didn’t collect a statement for at the time, so I had to call a doctor or two to ask them to send me a bill by email.
3. Receipts: again in different formats, or none at all and you have to rely on your credit card statement or your checkbook. I hadn’t even asked for a receipt for some of the ones I paid for in cash. My bad.
4. Emblem Health in my case. The problem with EmblemHealth is that it always sends duplicate statements. (And ALWAYS snail mail, even though I’ve asked for electronic ones and may have even filed a grievance about that waste of our money.) Pat asks for complete EOBs for all the service dates that match the invoices. Not to mention that these are ridiculously hard to scan, I could reduce the pile by half because of their tremendous duplicative mailings, but I still had to go through each one looking for the copays. If you do this search online, it still means screenshotting each one.
Then you have to get all this to them one way or another.
I ask you: is this worth it for a max of $105?
The hourly rate for tech editing is $32 - $42. I did about an hour and a half just the first 3. By the time I got to no. 4, I decided it wasn’t worth it and just quit.
To whom can I complain about this? The unions who set up this arrangement?
The question is: did the city and SHIP actually rely on the fact that we all wouldn’t bother?
