Written & Reviewed by
Last updated: 17 September 2026
SHIP and SMP are two different free Medicare help programs. SHIP helps you understand coverage, costs, enrollment, complaints, appeals, and ways to lower Medicare costs. SMP helps when a claim, bill, caller, supplier, or package may involve Medicare fraud, errors, or abuse.
Bottom Line
Call SHIP when you need neutral Medicare guidance. Call SMP when something looks suspicious or wrongly billed. For a Medicare account, claim, card, or urgent coverage question, call 1-800-MEDICARE help at 1-800-633-4227. Medicare says a real person or live chat is available 24 hours a day, 7 days a week, except some federal holidays.
Need Help Right Now?
- Call 911 for a medical emergency, immediate threat, or danger. SHIP and SMP are not emergency services.
- Hang up if an unexpected caller asks for your Medicare Number, bank information, credit card, payment, or threatens to cancel your benefits. Medicare says to protect your Medicare Number like a credit card and call Medicare yourself using an official number. See the Medicare card safety rules.
- Call Medicare and SMP if you find a claim for care, equipment, tests, or supplies you did not receive. Keep the bill, Medicare Summary Notice, Explanation of Benefits, package label, voicemail, or screenshot.
- Start identity-theft recovery if someone may have used your identity beyond Medicare. The Federal Trade Commission’s IdentityTheft.gov creates a recovery plan.
Start Here
- Say the problem in one sentence. For example: “I need plan help,” “I have a denial,” or “I see a charge I do not recognize.”
- Call the office that controls the next step. SHIP explains Medicare choices. SMP helps sort suspicious activity. Medicare handles Medicare account and claim questions. Your plan handles its live network, drug list, and prior-authorization records.
- Write down the deadline and case number. If a denial or coverage notice has a deadline, do not wait for a counseling callback before protecting that deadline.
| Your problem | Best first call | Why |
|---|---|---|
| You need help comparing Medicare choices without a sales pitch | SHIP | SHIP provides free, local Medicare counseling. Use the SHIP locator or call 1-877-839-2675. |
| You see a strange claim, scam call, or equipment you never ordered | SMP | SMP helps people prevent, detect, and report suspected Medicare fraud, errors, and abuse. Use the SMP locator or call 1-877-808-2468. |
| You need Medicare claim, card, complaint, or coverage help now | 1-800-MEDICARE | Medicare can see Medicare records and route many account and claims issues. |
| You need Part A or Part B sign-up, an address change, or Extra Help processing | Social Security | Medicare’s contact page directs these tasks to Social Security. |
| You need Medicaid or a Medicare Savings Program decision | Your state office | SHIP can explain the program, but the state makes the eligibility decision. |
| Your Medicare Advantage or Part D plan has a network, pharmacy, drug, or prior-authorization problem | Your plan | The plan controls the live record. Ask for a reference number and written reason if something is denied. |
What Has Changed
This September 2026 review reconfirmed the national SHIP and SMP contact routes, Medicare’s current plan-marketing rules, Open Enrollment dates, and Medicare’s authorization form for family helpers. It also adds the published hours for the national SMP Resource Center line: Monday through Friday, 9:00 a.m. to 5:30 p.m. Eastern Time. The basic roles have not changed: SHIP is for Medicare counseling, while SMP is for suspected fraud, errors, and abuse.
What SHIP and SMP Do
The State Health Insurance Assistance Program, or SHIP, is a federally funded Medicare counseling program. The Administration for Community Living says there are 54 SHIP grantees: one in every state, the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands. SHIP services are delivered through state agencies and local partners such as Area Agencies on Aging and community organizations. See the current ACL SHIP overview.
Your local SHIP may use another name. Examples include HICAP, SHIIP, SHINE, SHICK, or VICAP. The official About SHIPs page explains that counselors can help with enrollment timing, Original Medicare, Medicare Advantage, Part D, Medigap, Medicaid coordination, Medicare Savings Programs, Extra Help, complaints, and appeals.
Senior Medicare Patrol, or SMP, has a different job. SMP helps Medicare beneficiaries, families, and caregivers prevent, detect, and report suspected health care fraud, errors, and abuse. The ACL SMP overview says SMP teams may help resolve billing disputes and refer suspected fraud to the proper state or federal authority.
SMP programs are present in all 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands. The national SMP Resource Center lists 1-877-808-2468 for help connecting to a local SMP. Its Resource Center page lists national line hours as Monday through Friday, 9:00 a.m. to 5:30 p.m. Eastern Time.
| Question | SHIP | SMP |
|---|---|---|
| Main job | Medicare choices, coverage, costs, enrollment, complaints, and appeals | Suspected fraud, suspicious claims, billing errors, abuse, and scam concerns |
| Does it sell plans? | No. SHIP is not connected to an insurance company or health plan. | No. SMP is an anti-fraud and consumer-assistance program. |
| Can it make the final eligibility or coverage decision? | No. The plan, Medicare, Social Security, or state agency makes the decision. | No. SMP can help document and refer a suspected problem. |
| Who can ask for help? | People with Medicare, Medicare-eligible people, families, and caregivers | Medicare beneficiaries, families, and caregivers |
When to Use SHIP
SHIP is a strong first call when you want a trained person to slow the problem down and explain your options. Medicare itself tells people to contact SHIP for free personalized health-insurance counseling. SHIP can be especially useful when several systems overlap and you are not sure which one matters. If you are in Maine and your question is how to pay for care at home rather than how Medicare coverage works, see GFS’s Maine home care guide.
Common SHIP questions include:
- Should I use Original Medicare or Medicare Advantage?
- Which Part D plan covers my drugs and pharmacies?
- When can I enroll without a late penalty?
- What does this Annual Notice of Change mean?
- Is this a complaint, an appeal, or a billing issue?
- Could I qualify for help paying Medicare costs?
If enrollment timing is the problem, SHIP can help you understand the rule before you act. GFS has a separate guide on avoiding Medicare penalties when you need more detail.
If cost is the problem, ask SHIP to explain Medicare Savings Programs and Part D Extra Help. Medicare says states administer Medicare Savings Programs, while Social Security accepts Extra Help applications. SHIP can help you understand and prepare, but the responsible agency decides eligibility.
SHIP also helps people under age 65 who have Medicare because of disability. Family members and caregivers can call too. For private claim details, however, Medicare may need the beneficiary’s permission.
When to Use SMP
Use SMP when something looks wrong rather than merely confusing. Examples include a claim for a service you never received, a medical-equipment shipment you never ordered, a caller saying your Medicare card is expiring, or a supplier billing repeatedly for items you do not use. If the real problem is getting legitimate equipment rather than reporting suspicious billing, GFS has state-specific DME reuse guides for Utah DME reuse and Georgia DME reuse.
Start by checking the record. If you have Original Medicare, your Medicare Summary Notice shows services and supplies billed to Medicare, what Medicare paid, and the maximum amount you may owe. GFS also has a plain-language guide to reading an MSN.
For a charge you do not understand, first ask the provider or supplier if you recognize them. The SMP Resource Center says that if the provider, supplier, or billing company cannot resolve the concern, local SMP staff can help you sort out whether it looks like an error, abuse, or suspected fraud.
If fraud appears likely, SMP may refer the case to the proper authorities. You can also report potential fraud, waste, or abuse directly through the HHS OIG Hotline. The Office of Inspector General warns that its hotline is not a way to get an individual refund or benefits decision, so keep working the normal Medicare, plan, or provider route if you also need personal relief.
How to Avoid Medicare Sales Traps
A licensed agent or broker is not the same as SHIP. An agent may be useful if you want sales help, but SHIP is the safer first stop when you want neutral counseling without a sales pitch.
Medicare’s current plan marketing rules say people representing Medicare plans cannot come to your home uninvited, require you to speak to a sales agent just to get plan information, or call unless you are already a member or gave permission. They also cannot offer cash or gifts worth more than $15 to make you join a plan.
Another warning sign is pressure. Medicare says agents cannot tell you that you must join a particular plan or you will lose coverage next year. If a caller says your Medicare benefits will be cancelled unless you give personal information or money, hang up and call Medicare yourself.
Do not trust caller ID alone. Scammers can make a call look as if it came from an official office. Find the number yourself on Medicare.gov, SHIP, SMP, your plan card, or another trusted official source.
What to Gather Before You Call
You do not need every Medicare paper you own. Gather the few items that prove the problem. If you are helping a parent or spouse, try to have that person on the call when possible.
| Issue | Have ready | Best first question |
|---|---|---|
| Plan choice | Medicare card, current plan card, drug list, doctors, pharmacies, ZIP code, Annual Notice of Change | What are my choices and deadlines? |
| Denial or appeal | Denial notice, deadline, case number, plan card, provider notes | Who must receive the appeal, and by what date? |
| Billing problem | MSN or EOB, bill, date of service, provider name, amount, call notes | Is this a denial, billing error, or duplicate charge? |
| Possible fraud | Claim, voicemail, screenshot, package label, supplier name, dates | Does this look like an error or suspected fraud? |
| Help with costs | Income information, Medicare card, recent premium or drug-cost notices | Should I apply for an MSP, Extra Help, or both? |
If Medicare needs ongoing permission to discuss private claims or health information with a helper, its Other Forms page lists the Authorization to Disclose Personal Health Information form, CMS-10106.
How to Start Without Wasting Time
- Use one sentence first. “I need help comparing plans.” “My home health was denied.” “I see equipment I never ordered.”
- Give the date. If there is a denial, deadline, service date, or strange charge, say the date early in the call.
- Ask what office owns the next step. A good counselor may explain the issue but still need to send you to Medicare, Social Security, the plan, provider, state Medicaid office, or fraud authority.
- Ask for a case or reference number. Write down the date, time, name, and next action.
- Protect deadlines. If an appeal is due soon, do not wait for a later callback. A Medicare Advantage denial may need a formal appeal through the plan. See the GFS guide to Medicare Advantage appeals.
- Confirm live plan details. A SHIP counselor can help compare choices, but the plan and provider are better sources for a current doctor network, pharmacy status, formulary, or prior-authorization record.
During Medicare Open Enrollment, local counseling offices can be busy. Medicare’s Open Enrollment page confirms the annual window is October 15 through December 7, with changes effective January 1 when the plan receives the enrollment request by December 7. Contact SHIP early if you want a one-on-one appointment.
Accessibility note: TTY users can call Medicare at 1-877-486-2048. If you need language or accessibility help from a local SHIP or SMP, ask what assistance is available when you make the appointment.
Reality Checks
- SHIP is guidance, not an approval office. It cannot guarantee a plan enrollment, appeal result, Medicaid decision, or provider network.
- SMP is not law enforcement. SMP helps document, counsel, and refer suspected fraud. It does not arrest scammers or reverse bank transfers.
- Local service can vary. SHIP and SMP are national programs delivered through local networks. Appointment times, office names, and local partner agencies differ.
- Plan records can change. Verify doctors, pharmacies, drugs, and plan requirements before relying on an enrollment decision.
- Some problems need two routes. A suspicious claim may need SMP for fraud help and Medicare or the plan for your own claim correction.
If the First Call Fails
A voicemail, wrong transfer, or unhelpful first answer does not always mean the issue is finished.
- If SHIP is booked: Leave a clear message, then call 1-800-MEDICARE if the question cannot wait.
- If Medicare sends you to the plan: Call the number on the plan card and ask the representative to document the call.
- If the plan says the provider caused the problem: Ask the provider for the billing code, submission date, and denial reason.
- If a charge still looks fake: Call SMP and Medicare. If there is strong evidence of fraud, use the HHS OIG reporting route too.
- If care is ending quickly: Do not wait for ordinary callbacks. Some Medicare situations have fast-appeal rights. See the GFS fast appeals guide.
If you have the Qualified Medicare Beneficiary program and a provider keeps billing you for Medicare-covered cost-sharing, the issue is not just general counseling. Review the GFS guide to QMB billing protections and call Medicare if the improper billing continues.
Common Mistakes to Avoid
- Calling the first “Medicare help” ad you see. Start with Medicare, SHIP, SMP, your plan, Social Security, or your state office.
- Giving a Medicare Number to an unexpected caller. Medicare says not to share it with someone who contacts you unless you contacted them first and gave permission.
- Waiting until the end of Open Enrollment. SHIP appointment demand rises during October 15 through December 7.
- Thinking SHIP can force a plan to approve care. SHIP can explain rights and steps, but it does not control the plan’s decision.
- Thinking SMP replaces Medicare. SMP can help investigate the situation and report suspected fraud, but Medicare or your plan may still need to correct the claim.
- Throwing away letters or packages. Keep notices, envelopes, labels, screenshots, and case numbers until the problem is resolved.
- Missing a Medigap timing issue. If you are leaving Medicare Advantage, do not assume you can always buy Medigap later. Review the GFS Medigap trial right rules before switching.
Backup Options for Cost, Appeals, and Local Help
SHIP and SMP are strong navigation tools, but another office may control the final action.
- Medicare Savings Programs: States can help pay some Medicare Part A and Part B costs for people who qualify. Medicare’s MSP page lists 2026 federal limits and warns that some states use higher or different rules.
- Extra Help: Social Security’s Extra Help application can lower Part D costs for people with limited income and resources.
- Formal appeals: When there is a written denial, protect the appeal deadline even if you are also asking SHIP for counseling.
- Fraud reporting: SMP can help you decide how to report, while HHS OIG handles reports of fraud, waste, and abuse involving HHS programs.
- Identity theft: If the problem reaches beyond Medicare claims, use the FTC recovery process and contact financial institutions if money or accounts are involved.
Phone Scripts You Can Use
Calling SHIP
“I need free Medicare counseling. My main issue is [plan choice, enrollment, costs, denial, or billing]. What should I have ready, and which deadline matters?”
Calling SMP
“I see a claim, charge, call, or package I do not recognize. I have the date and the provider or supplier name. Can you help me decide whether this is an error or suspected fraud and what I should report?”
Calling Medicare
“I need help with a claim, card, complaint, or possible misuse of my Medicare Number. Please tell me the next step and give me a case or reference number.”
Calling a Medicare plan
“Please check the live record for this doctor, drug, pharmacy, prior authorization, or denial. Can you document this call and give me the reason and reference number?”
Resumen en español
SHIP ofrece ayuda gratis con Medicare y no vende planes. Puede ayudarle a entender opciones de cobertura, costos, inscripción, quejas, apelaciones y programas que pueden reducir gastos. Llame al 1-877-839-2675 o use el localizador de SHIP.
SMP ayuda cuando hay un cargo sospechoso, una llamada falsa, equipo médico que usted no pidió, o posible fraude con Medicare. Llame al 1-877-808-2468. El centro nacional indica horario de lunes a viernes, de 9:00 a.m. a 5:30 p.m., hora del Este.
Si alguien le llama sin aviso y pide su número de Medicare, datos bancarios o dinero, cuelgue. Llame usted mismo a Medicare al 1-800-MEDICARE. Guarde cartas, facturas, números de caso, fechas, mensajes y etiquetas de paquetes.
Frequently Asked Questions
Is SHIP the same as a Medicare broker?
No. SHIP provides free Medicare counseling and is not connected to an insurance company or health plan. A broker or agent sells private insurance products.
Is SMP the same as Medicare?
No. SMP is not Medicare and is not law enforcement. SMP helps beneficiaries, families, and caregivers prevent, detect, document, and report suspected Medicare fraud, errors, and abuse.
Should I call SHIP or SMP about a suspicious bill?
Call SMP if the bill looks fake, repeated, or connected to care or equipment you did not receive. Call SHIP if the main problem is understanding coverage, a denial, an appeal, or which Medicare office should handle the issue.
Can SHIP help me enroll in a plan?
SHIP can explain plan choices and enrollment rules, and local programs may provide hands-on enrollment assistance. If you already know the plan you want, Medicare or the plan can also process enrollment during an allowed enrollment period.
What if Medicare will not talk to me about my parent?
Try to call while your parent is with you. For ongoing access to private claims or health information, Medicare may need permission through the Authorization to Disclose Personal Health Information form, CMS-10106.
Can SHIP or SMP help someone under age 65?
Yes, when the person has Medicare. SHIP specifically serves Medicare beneficiaries under age 65 with disabilities, and SMP helps Medicare beneficiaries, families, and caregivers with suspected fraud, errors, and abuse.
What if my local SHIP only has voicemail?
Leave your name, ZIP code, phone number, best callback times, and one sentence about the problem. If a written deadline is close, also call Medicare, your plan, provider, or state office the same day.
About This Guide
Sources: This guide uses official federal, state, local, and other high-trust nonprofit and community sources linked in the article.
Editorial note: This guide is produced under the GFS Editorial Standards using official and other high-trust sources. GFS is not affiliated with a government agency and is not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Corrections: Despite careful verification, errors may occur. Readers may email info@grantsforseniors.org with corrections.
Disclaimer: This article is for informational purposes only and is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, funding, and availability can change. Readers should confirm current details directly with the responsible official program before acting.
Last updated: 17 September 2026 · Next review: 17 January 2027
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