AARP Examines the Importance of State Health Insurance Assistance Programs

Last month, the AARP Public Policy Institute released a report on the State Health Insurance Assistance Programs (SHIPs), outlining the critical role these Medicare counselors have in improving beneficiary health and well-being.

SHIPs provide objective, free, one-on-one assistance to Medicare beneficiaries, their families, and caregivers. With locations in every state, over 2,000 offices in communities nationwide, and 12,500 trained staff and volunteers, the SHIP network is a trusted resource with proven success: In 2022 alone, SHIP counselors provided education and support to over four million older adults and people with disabilities, empowering them to make informed decisions about their coverage and care.

Growing Demand for SHIP Services

Demand for SHIP services is on the rise. Over the past decade, the number of people with Medicare has climbed by more than 25% and the average duration of a SHIP counseling session has lengthened by nearly 20%. The drivers of these trends—a surging Medicare population approaching 70 million people, more than half of whom are now enrolled in Medicare Advantage (MA), as well as an increasingly complex Medicare landscape—show no signs of abating.

In 2025, beneficiaries had access to 42 MA plans on average—more than double the number in 2018. This cluttered plan landscape hinders effective evaluations, and aggressive marketing adds to beneficiary confusion and overwhelm. Beneficiary complaints to CMS about these abuses have risen in recent years, drawing attention to flaws in MA payment methodology and problematic incentive structures that can lead to steering, sub-optimal enrollments, and barriers to care.

Unlike Other Resources, SHIPs Offer Unbiased, In-Depth Assistance

While recent rule changes have taken steps to reign in certain marketing abuses and financial kickbacks within MA, problems remain. For example, AARP explains that when agents and brokers speak with a beneficiary, they “are not required to present all options and can earn higher commissions for selling certain plans. Furthermore, they typically do not screen beneficiaries for eligibility for income-based assistance programs and are not required to be trained on complex Original Medicare issues, such as coordination of initial enrollment in Parts A and B with secondary insurance, like employer-sponsored or retiree coverage.”

SHIP counselors’ independence and training allow them to provide comprehensive, personalized, assistance that is truly beneficiary-centered

SHIP counselors, by contrast, have no such conflicts or limitations. They are not compensated by insurers for enrolling beneficiaries in certain plans and have expertise on “a wide array of subjects facing consumers, including Original Medicare questions, coordination of benefits, Medicaid, and low-income assistance programs.” Their independence and training allow them to provide comprehensive, personalized, assistance that is truly beneficiary-centered, helping enrollees evaluate their coverage options, troubleshoot complex issues, and access care.

SHIPs are further distinguishable by the level of service they offer, complementing but not duplicating other key resources, such as CMS’s 1-800-MEDICARE call center. A typical SHIP counseling session lasts 33 minutes and covers high-intensity issues. This is over three times as long as the average call to 1-800-MEDICARE (9.5 minutes), which generally focuses on more routine matters. These distinctions are widely recognized, including by MA and Part D plans. AARP notes insurers “frequently refer beneficiaries to SHIPs when their situations are too complex for the 1-800-MEDICARE call center to resolve.”

A typical SHIP counseling session lasts over three times as long as the average call to 1-800-MEDICARE.

The report also clarifies that online self-help tools, such as Medicare.gov, are a vital but distinct service. They “can offer general guidance, but they cannot match the personalized, face-to-face support SHIPs provide. SHIP counselors help beneficiaries navigate complex decisions, understand local resources, and build trust through direct interaction.” Similarly, Medicare Plan Finder contains critical information. But for many beneficiaries, it is maximally useful in conjunction with hands-on assistance from a SHIP counselor.

SHIP Funding Is Inadequate

Despite being the only program that supports free and objective Medicare counseling in every state, SHIP funding has not kept pace with growing needs. From 2015 to 2025, Medicare enrollment surged by 15 million people (25%). Federal appropriations, meanwhile, inched up by only $3 million (6%). AARP recommends, and Medicare Rights agrees, that Congress should address this funding shortfall. Stronger investments in the program would better “help a growing number of Medicare beneficiaries navigate complex coverage options through the assistance of one-on-one unbiased counseling.”

Opportunities to Improve the Beneficiary Experience

To more fully protect people with Medicare, we also urge policymakers to improve marketing guardrails and enrollee safeguards. This includes maintaining reference to SHIPs in standard beneficiary communications, setting and enforcing standards for the marketing of supplemental benefits, boosting plan oversight, and properly aligning payment incentives.

To simplify enrollment, we support swift passage of the BENES 2.0 Act and making plans easier to compare through reforms such as Medicare Plan Finder modernizations and plan standardization.

We support swift passage of the BENES 2.0 Act and making plans easier to compare through reforms.

Reducing barriers to care will also require aligning benefits and cost protections across Medicare and easing Medigap restrictions, as well as greater attention to MA coverage denials, appeals, and disenrollments.