Medicare Guidance for Hub Staff

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Medicare Guidance – Hub Staff Q&A Format

1. What is the purpose of the Medicare Guidance for Hub staff?

The purpose of this guidance is to help Disability Hub MN staff support people who have questions about Medicare—especially those starting Medicare due to disability.
Hub staff are not Medicare experts but are responsible for:

• Answering basic questions
• Providing trusted Medicare resources
• Connecting people to Minnesota Aging Pathways (MAP) for detailed assistance

2. What is the Hub’s role when assisting someone with Medicare questions?

When someone contacts the Hub about Medicare, staff should:

1. Check health care coverage
   • Begin with health care options counseling (SNBC, MA, MSP if applicable).
   • Verify Medicare Part A and B start dates in MN–ITs.
   • If the person has both MA and Medicare, determine if they are in Integrated SNBC (I-SNBC).
   • If not in I-SNBC, explain they may be in a non-integrated SNBC or a standalone Medicare plan.
2. Share trusted resources
   • Disability Hub MN – Medicare: Common Questions
   • DB101 Minnesota – Medicare: The Basics
   • I’m getting Social Security benefits before 65 | Medicare
   • What’s Medicare Drug Coverage (Part D)? | Medicare
   • Medicare Interactive – searchable Medicare Q&As
3. Provide self-help instructions for Medicare.gov or 1-800-MEDICARE.
4. Warm transfer to MAP for complex or enrollment-related issues.

3. What information should people have when calling or visiting Medicare resources?

Encourage people to have:

• A list of their prescription medications
• Their Medicare card
• Any other insurance cards
• Their preferred pharmacies

This information helps Medicare or MAP staff provide accurate plan comparisons and guidance.

4. How can people use Medicare.gov or 1-800-MEDICARE?

• Medicare.gov allows users to view current coverage, review claims, and compare plans.
• People (or their authorized reps) should create or log into their Medicare.gov account to review plan options.
• Hub staff must not log in or create accounts for callers.
• 1-800-MEDICARE (1-800-633-4227) is available for additional help.

5. When should Hub staff transfer a caller to Minnesota Aging Pathways (MAP)?

Warm transfer callers to MAP when:

• They need plan comparisons or enrollment support.
• They have complex Medicare questions or urgent issues.

Transfer procedure:

• Press option 2 for Medicare calls (Hub transfers go to the top of the queue).
• Stay on the line to explain the caller’s situation before handing off.

6. What is the Medicare Chat and when should it be used?

Use Medicare Chat when you need Part D or Extra Help (LIS) information.

To start a chat:

1. In CRM, click Medicare Chat → Start Chat.
2. Enter:
   • First Name, Last Name
   • Email (info@disabilityhubmn.org)
   • Subject line (e.g., Part D Plan Info or LIS status)
3. Select Chat Now.

Include in chat message:

• Person’s full name (as on SSA/Medicare card)
• Date of Birth
• Full mailing address
• Medicare or SSA number
• Part A and B effective dates
• Clearly state what information is needed (e.g., plan name, billing info, LIS status)

If MAP provides additional details beyond LIS or Part D, warm transfer to MAP for follow-up.

7. What should Hub staff do if MAP refers them back to Medicare Chat?

If during a warm transfer MAP refers the staff back to Medicare Chat, escalate the case to the DSD Team for additional support.
Hub staff are not responsible for coordinating issue resolution with MAP.

8. What is the role of Minnesota Aging Pathways (MAP)?

MAP staff are Minnesota’s Medicare experts and operate as the State Health Insurance Assistance Program (SHIP) and Senior Medicare Patrol (SMP).
MAP can:

• Do Part D plan comparisons and enrollments
• Create Medicare.gov accounts on behalf of clients
• Support Extra Help/LIS applications
• Address complex Medicare issues (penalties, appeals, employer coverage, fraud, etc.)
• Handle emergency situations (out of meds, cancelled coverage)
• Take reports of fraud, abuse, or scams

9. How should Hub staff handle common Medicare-related scenarios?

Scenario	Action for Hub Staff
Caller doesn’t know if they have Medicare	Ask if they have a red/white/blue card. If unsure, check MNITs. If yes, begin options counseling.
Starting Medicare (due to disability)	Explain what Medicare is and why they’re getting it. Check MA/MSP and I-SNBC status. Share resources. Transfer to MAP for plan or enrollment questions.
Already on Medicare but unsure about Part D	Explain Part D. Use Medicare Chat to confirm enrollment. Transfer to MAP if they want comparisons or plan help.
Caller has a list of medications	Verify MA/Medicare status. Show how to use Medicare.gov for drug plan comparisons. Transfer to MAP for enrollment or further help.
Can’t afford meds or premiums	Verify MA/MSP. Screen for Extra Help. Share NeedyMeds.org. Transfer to MAP for application support.
Received a letter about Extra Help	Reference “Guide to Consumer Mailings from CMS, SSA, and Plans” to identify the notice and required action.
Urgent – Out of meds or plan cancelled	Verify coverage in MNITs. Use Medicare Chat for Part D status. If not on a PDP, transfer to MAP. If on a PDP, offer a 3-way call with the pharmacy, then transfer if needed.
Medication not covered by plan	Suggest contacting doctor for alternatives or requesting a formulary exception. Warm transfer to MAP for help.
Needs a replacement Medicare card	Guide them to their mySocialSecurity or Medicare.gov account to print a copy. Provide SSA phone number (1-800-772-1213) if they lack internet access.

10. What should Hub staff NOT do?

Hub staff must not:

• Complete plan comparisons or enrollments
• Log into or create Medicare.gov or SSA accounts
• Resolve penalties, appeals, or employer coverage conflicts

11. What resources should Hub staff know about?

• Programs for people who need help with Medicare costs | DHS
• Apply for Medicare Part D Extra Help | SSA
• NeedyMeds.org – Patient assistance for free or discounted medications
• 2025 Medicare Costs, 2026 Benchmark Plans, and Program Guidelines (internal Hub resources)