DC SHIP Medicare Counseling — Free Help With Medicare Appeals and Part D
A Free Resource Most DC Families Don't Know Exists
When your parent gets a Medicare denial letter — for a skilled nursing stay, a home health referral, or a piece of medical equipment — the instinct is to call an elder law attorney. That's a $300-to-$500 conversation before anything gets filed.
What most families don't realize is that the District of Columbia runs a State Health Insurance Assistance Program (SHIP) that provides free, one-on-one Medicare counseling from trained volunteers and staff. SHIP counselors help with everything from comparing Medicare Advantage plans to walking you through a formal appeal of a coverage denial. No income requirements. No fees. No sales pitch.
In D.C., the SHIP program is housed within the Department of Aging and Community Living (DACL). You can reach a SHIP counselor at (202) 727-8370 to request an appointment.
What SHIP Counselors Actually Help With
SHIP is not a hotline that reads you the same information from Medicare.gov. These are trained counselors who sit down with your parent's specific coverage situation and work through it. The most common scenarios they handle after a hospital discharge:
Medicare coverage denials and appeals. If Medicare denied coverage for a skilled nursing facility stay, a home health episode, or durable medical equipment, a SHIP counselor can help you understand why the denial happened and whether an appeal is worth pursuing. They walk you through the five levels of the Medicare appeals process — from the initial redetermination through the Medicare Appeals Council and, if necessary, federal court review.
Medicare Advantage plan disputes. If your parent is on a Medicare Advantage plan and the plan denies a service the hospital ordered, the appeal process differs from Original Medicare. SHIP counselors understand the plan-specific grievance and appeals procedures and can help you draft the appeal letter with the right clinical language.
Part D prescription drug coverage. The 2025 Inflation Reduction Act changes capped Medicare Part D out-of-pocket spending at $2,000 per year starting January 2025. But the cap doesn't eliminate confusion — formulary changes, tier exceptions, and prior authorization requirements still trip up families managing complex medication regimens after discharge. SHIP counselors help with Part D plan comparisons during Open Enrollment and assist with exception requests when a prescribed medication isn't on the formulary.
Medigap policy comparisons. For parents on Original Medicare, understanding the ten standardized Medigap plan types (A, B, C, D, F, G, K, L, M, and N) and how they interact with SNF coinsurance and Part B cost-sharing is genuinely confusing. SHIP counselors compare plans side by side using your parent's actual medical utilization.
How SHIP Connects to Hospital Discharge
The biggest value of SHIP during a hospital-to-home transition is the appeals assistance. When a skilled nursing facility delivers a Notice of Medicare Non-Coverage (NOMNC), the family must contact the Quality Improvement Organization (Livanta, for D.C.) and file an expedited appeal by noon on the calendar day before the planned coverage end date. SHIP counselors can help you prepare for that call, make sure you have the right documentation, and explain what happens during the QIO review.
They can also help after the immediate crisis — reviewing the Explanation of Benefits statements that arrive weeks later, identifying billing errors, and flagging situations where your parent was charged for services that should have been covered.
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How to Reach DC SHIP
Contact the DACL SHIP helpline at (202) 727-8370 to schedule a counseling appointment. Ask the helpline about current in-person and community appointment locations.
During Medicare Open Enrollment (October 15 through December 7), SHIP counselors also hold community events at libraries and senior centers throughout D.C. where they do side-by-side plan comparisons. These sessions fill up quickly — call early in October to reserve a slot.
For families managing a parent's discharge from a DC hospital, the District of Columbia Hospital-to-Home Transition Toolkit pairs with SHIP counseling by giving you the step-by-step appeal templates and discharge checklists, while SHIP provides the personalized coverage analysis for your parent's specific Medicare situation.
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Download the District of Columbia — Hospital Discharge Checklist — a printable guide with checklists, scripts, and action plans you can start using today.