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  • Writer's pictureJanelle Doll

Spotlight: Health Insurance Counseling and Advocacy Program (HICAP)

Imagine, turning 65 and needing to make important life altering decisions about your healthcare benefits and being bombarded with mailers, phone calls, emails, and insurance agents…..all stating that they can “help.”


What should you do? Contact HICAP! Day after day, HICAP receives calls from frustrated and overwhelmed beneficiaries desperately seeking assistance from someone they can trust. Too often, HICAP receives these calls after a beneficiary has been coerced into changes they were not aware they were even making, and now cannot see their doctor of choice. This “can” really happen, but it does not have to happen to you.


Your local HICAP is one of four programs located at Valley Caregiver Resource Center, and is happy to provide free, confidential, and unbiased counseling services to the 172,000 Medicare beneficiaries located in both Fresno and Madera counties.


All HICAP counselors are trained and registered with the California Department of Aging and are equipped to provide one on one counseling appointments via phone, virtual appointment, or in person. HICAP counselors meet beneficiaries where they are at in their Medicare journey and empower them with information to make decisions for themselves.


Below are just a few of the most common issues addressed at HICAP:

  • How to sign up for Medicare now that they are almost 65

  • Explanation of all the different parts to Medicare—do they need A, B, C, D

  • Questions on prescription drug coverage, co-pays, or eligibility rules

  • Help with filing an appeal or challenging a denial

  • Long-term care insurance policies

  • Have they fallen victim to Medicare Fraud

HICAP counseling is provided to:

  • Persons 65 years of age or older and are eligible for Medicare

  • Persons younger than age 65 years of age with a disability and are eligible for Medicare

  • Persons soon to be eligible for Medicare

When HICAP receives a call, the beneficiary is quickly assessed and scheduled for an appointment. HICAP is able to work with the family and friends of beneficiaries who have received permission to speak on the beneficiary’s behalf or have provided documents stating such.


During appointments, HICAP counselors screen all beneficiaries for programs that they may qualify for, whether it is low-income assistance or plan coverage options. The counselor will assist the beneficiary with all of their concerns and questions. After the appointment, the counselor will provide all new clients with a blue HICAP folder containing their appointment information, documents needing further attention, contact information, and a client survey.


HICAP provides assistance with all things Medicare, including Medicare fraud. Your counselors also serve as trained liaisons for the nationally recognized Senior Medicare Patrol Program. Our counselors can help to prevent, detect, and report Medicare fraud. Together VCRC and HICAP host an annual free shredding event for seniors and caregivers in both Fresno and Madera counties. During the event, participants are able to securely destroy their outdated personal documents and receive community resources. This event helps to save beneficiaries from potential fraudsters.


Have you heard the term, “Medi-Medi? “ This refers to a beneficiary who is both a Medicare and Medi-Cal recipient. HICAP works diligently to provide inclusive counseling services to our diverse beneficiaries. HICAP has collaborated with the Fresno County Department of Social Services Outreach Unit to provide an on-site Medi-Cal Eligibility Worker at VCRC on the 2nd Wednesday of every month. These workers are able to assist our Medi-Medi beneficiaries with their applications, general relief, and casework. This is a true benefit to all of our four programs here at VCRC.


How often do our beneficiaries contact HICAP? It just depends on what their needs are and we are happy to help as often as needed. Some are once a year for Annual Open Enrollment and others can be daily, weekly, or monthly depending on the issue at hand. Our team is empathetic and we understand the importance of every phone call to HICAP. Give us a call Monday thru Friday from 8am to 5pm at (559) 224-9117 for assistance with all things Medicare.


HICAP values all outreach opportunities and is able to provide in-person or virtual presentations upon request. HICAP shares a monthly digital newsletter with both clients and community partners. If you are interested in receiving this newsletter please email HICAP Program Manager, Jennifer Webb at jwebb@valleycrc.org and she will happily subscribe you.


Are you interested in making a difference in the lives of many? Contact our HICAP Volunteer Coordinator, Laura Robinson at lrobinson@valleycrc.org to inquire about our Volunteer Program. We are always accepting applications!

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