How HICAP Can Help

HICAP is a volunteer-supported program that provides free counseling and educational services for older adults and their families. Individuals can arrange for a one-on-one counseling appointment with a HICAP counselor to get the most current information available needed to navigate the maze of health insurance regulations and coverage.

HICAP counselors provide unbiased information to help individuals make the best choices for their health care needs. A HICAP counselor cannot sell, endorse, promote or recommend a specific insurance policy. What HICAP can do is help individuals understand their:

• New Medicare drug coverage
• Rights as a health care consumer
• Medicare benefits, including how to appeal Medicare and HMO denials
• Medicare and health insurance jargon
• Private Medicare supplemental health insurance policy benefits and exclusions
• HMOs and how they work, including emergency assistance with denials
• Long-term care insurance

In addition, HICAP can:

• Provide legal assistance and representation at Medicare appeals and administrative hearings
• Explain the pros and cons of Health Maintenance Organization (HMO) membership
• Provide guidance for evaluating supplemental insurance policies and HMOs, and how to deal with high pressure sales tactics
• Help recognize and combat Medicare fraud and abuse
• Provide speakers on the above topics to community groups

HICAP Legal Referral

Medicare rules and regulations are complex and confusing. Because of this complexity, seniors often have difficulty with important aspects of Medicare, such as filing claims, appeal rights, Medicare assignment and how Medicare supplemental insurance policies and HMOs relate to Medicare. HICAP was created to help Medicare beneficiaries deal with such issues and obtain all the benefits to which they are legally entitled.

HICAP contracts with an attorney to provide free advocacy services for seniors and their caregivers who are in need of legal help. Assistance is not limited to information and advice. If need be, HICAP's legal advisor can provide representation through the appeals process and administrative hearings.

All HICAP agencies throughout the state are committed to strengthening senior citizens’ rights through the legislative and/or legal process.