California HICAP gives free one-on-one Medicare counseling, and you can reach it statewide at 800-434-0222. The California Health Insurance Counseling & Advocacy Program (California HICAP) counsels people 65 and older who are eligible for Medicare, people under 65 with a disability who are eligible for Medicare, and people who will soon be eligible. So if someone told you to "call HICAP" and you're not sure what that gets you, here's what California HICAP counselors actually do, who can use them, and how the program is paid for.

In This Guide

What Is HICAP, and How Does It Relate to SHIP?

The California Department of Aging (CDA) describes the Health Insurance Counseling & Advocacy Program (HICAP) as a consumer-oriented program providing Medicare and related health insurance counseling and education.

The national State Health Insurance Assistance Program (SHIP) network is explained in Brevy's guide to free SHIP counseling. The federal Administration for Community Living (ACL) says your local SHIP may go by another name depending on where you live, and the support it provides is the same. CDA's HICAP program narrative lists federal SHIP funds from ACL as one of California HICAP's funding sources, so in California, the SHIP you're looking for is HICAP.

Brevy's California Medicare hub gives the short version of HICAP alongside California's premiums, plans and Medigap rules. This page is the longer answer: everything a HICAP counselor can take on, and how to get the most out of the call.

What Can a HICAP Counselor Help You With?

CDA lists four HICAP services, and the range is wider than most people expect. HICAP isn't only for comparing plans in the fall. It also takes on problems, like a drug your plan won't cover or a hospital bill that doesn't look right.

HICAP service What CDA says it covers
Community education about Medicare Medicare-related health insurance, long-term care insurance, and long-term care planning
Individual health insurance counseling about Medicare Medicare Parts A and B, Medigap plans, Medicare Advantage and Prescription Drug Plan comparisons, Medicare Savings Programs, and Extra Help with medication costs
Informal advocacy on Medicare-related issues Enrollment, disenrollment from Medicare Advantage or Medicare Prescription Drug Plans, claims, appeals, prescription drug exceptions, questions about hospital bills, and other related insurance coverage issues
Legal assistance or legal referral Help for individuals with legal questions related to their Medicare benefits

That individual counseling line touches most of the decisions a new or returning Medicare enrollee faces. A California HICAP counselor can walk you through Medicare Parts A and B, Medigap (Medicare Supplement Insurance) plans, and side-by-side comparisons of Medicare Advantage and prescription drug plans. CDA's list also names the two main cost-help programs: the Medicare Savings Programs and Extra Help with medication costs.

The advocacy line is the part people tend to miss. CDA says HICAP's informal advocacy covers disenrollment from Medicare Advantage or Medicare Prescription Drug Plans, claims, appeals, prescription drug exceptions, and questions about hospital bills. For SHIPs nationally, ACL says a certified counselor gives one-on-one guidance based on your situation, and that SHIPs can help with navigating access to providers, correcting billing issues, and filing complaints and appeals.

Who Can Use California HICAP?

CDA says California HICAP counseling is provided to three groups:

  • Individuals aged 65 or older who are eligible for Medicare
  • Individuals younger than 65 with a disability who are eligible for Medicare
  • Individuals soon to be eligible for Medicare

CDA also says HICAP education events are available for individuals of any age. That matters if you're in your early 60s and planning ahead, or if you're an adult child trying to get up to speed before a parent's decisions come due.

Families count too. ACL says SHIP provides unbiased help to Medicare beneficiaries, their families, and caregivers. And the CA.gov listing for California's Medicare counseling service says HICAP's volunteers counsel older adults and their families on complex Medicare and health insurance issues.

Is HICAP Really Free and Unbiased?

Yes on free, and the unbiased part comes down to who pays HICAP. The CA.gov listing says HICAP's volunteers provide free one-on-one information and counseling.

CDA's program narrative lists four funding sources for California HICAP: federal SHIP funds through ACL, the State Insurance Reimbursement Fund, the State HICAP Fund, and the California Department of Insurance. Nationally, ACL says SHIP is supported through state and federal partnerships that are not reimbursed by private health insurance plans or entities, and that SHIP is not paid per enrollment.

Federal law adds a guardrail. Under 42 U.S.C. 1395b-4, a state's SHIP grant plan has to provide assurances that the program's staff members, including volunteer staff members, have no conflict of interest in providing counseling. ACL's conflict-of-interest guidance for SHIP volunteers gives one example of a person with an inherent conflict of interest: anyone who receives compensation for enrolling beneficiaries in a specific insurance plan or plans.

How the counselor gets paid is the real difference between HICAP and a broker, and Brevy's SHIP counselor vs. broker comparison walks through how each one is compensated.

How Do You Reach California HICAP?

Call 800-434-0222, the statewide number CA.gov lists for California's Medicare counseling service. The California Department of Aging contracts with partners that coordinate HICAP, and those partners' volunteers provide the one-on-one counseling. CDA's Medicare Counseling page is the state's official starting point online.

Who will you be talking to? ACL says SHIP counselors are members of the local community who have been screened, trained, and certified as Medicare experts, and that many are volunteers.

What Won't HICAP Do?

HICAP's help has edges, and knowing them saves you a wasted call. California HICAP's advocacy is what CDA calls "informal advocacy" on Medicare-related issues. CDA lists California HICAP's legal help for legal questions related to your Medicare benefits, and CDA describes that help as "legal assistance or legal referral," so on a legal question the help may be a referral elsewhere.

Medicare's own website and phone line are a different kind of help. In CDA's words, "The Medicare website and toll-free number are helpful consumer resources, but do not substitute for HICAP services." Medicare's own line is 1-800-MEDICARE (1-800-633-4227), and TTY users call 1-877-486-2048. For a problem with a Medicare Advantage or Part D plan, the Centers for Medicare & Medicaid Services (CMS) tells beneficiaries to contact the plan first, using the phone number on the plan member ID card.

When Is the Best Time to Call HICAP?

Two windows stand out. The first is your Medicare Initial Enrollment Period, the 7-month window that starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after it. California HICAP counsels people who are soon to be eligible for Medicare, so you can call before that window opens.

The second is the fall Medicare Open Enrollment Period, which runs October 15 through December 7 each year. During Medicare Open Enrollment, you can join, drop, or switch Medicare Advantage Plans, switch between Original Medicare and Medicare Advantage, join, drop, or switch a Medicare drug plan if you're in Original Medicare, or keep your current coverage. A plan must get your enrollment form by December 7, and new coverage chosen during Medicare Open Enrollment starts January 1.

If you've reviewed your options and you're happy with your current Medicare coverage, you don't need to do anything, because the coverage continues automatically; any changes to that plan's benefits or costs for the new year also start January 1. That's a reason to call California HICAP early in the October 15 to December 7 Medicare Open Enrollment Period rather than on December 6, since plan comparisons are part of HICAP's individual counseling and the plan must get your enrollment form by December 7., Raise one caution with a counselor before switching: someone who drops a Medigap policy to join a Medicare Advantage Plan may not be able to get the same Medigap policy back later, depending on their state's Medigap enrollment rules and their situation.

Can You Call HICAP for a Parent?

You can. ACL says SHIP helps Medicare beneficiaries' families and caregivers, and that with the person's permission, a SHIP will work with Medicare directly to help solve problems on their behalf.

Permission matters on Medicare's side, too, and there are two different forms for two different jobs. The first lets Medicare talk to you. By law, your parent must give 1-800-MEDICARE permission in writing before 1-800-MEDICARE can share any of your parent's information with you or anyone else. Form CMS-10106, "Authorization to Disclose Personal Health Information," is the form your parent uses to give 1-800-MEDICARE that permission to share their personal health information with you. Your parent can submit Form CMS-10106 online through their secure Medicare.gov account, or mail a completed and signed copy, and your parent has the right to change or cancel that authorization at any time.

The second form lets you act for your parent in an appeal. If your parent wants help filing a Medicare appeal, your parent can appoint a representative, and that representative can be you or another family member, a friend, an advocate, an attorney, a doctor, or someone else who acts on your parent's behalf. Your parent can appoint you as their representative for a Medicare appeal with Form CMS-1696, "Appointment of Representative," or with a written request that includes the required elements. A Form CMS-1696 appointment is valid for one year from the date the form is signed by both your parent and you as the appointed representative. Brevy's guide to helping a parent with Medicare covers the rest of the paperwork, and the Medicare appeals guide explains each appeal level.

Frequently Asked Questions

Can HICAP help me appeal a denied Medicare claim?

California HICAP's informal advocacy covers claims and appeals, according to the California Department of Aging, along with prescription drug exceptions and questions about hospital bills. If you want someone formally named to act for you in a Medicare appeal, Medicare's appeals guide says that representative can be a family member, friend, advocate, attorney, doctor, or someone else.

Does HICAP help if I have both Medicare and Medi-Cal?

California HICAP's individual counseling covers the Medicare Savings Programs and Extra Help with medication costs, according to the California Department of Aging. People who have both Medicare and full-benefit Medicaid are called dual eligibles, and for them Medicare pays first and Medicaid pays last, per Medicare.gov. In California, Medicaid is Medi-Cal, and the Medicare Savings Programs are one place the two programs meet: Medicaid.gov says that through the Medicare Savings Programs, Medicaid pays Medicare premiums, deductibles, and/or coinsurance costs for beneficiaries eligible for both programs.

Who should I call first if my Medicare Advantage or Part D plan won't cover a drug?

For a problem with a Medicare Advantage or Part D plan, the Centers for Medicare & Medicaid Services tells beneficiaries to call the plan first, using the phone number on the plan member ID card. If the plan call doesn't settle it, California HICAP's informal advocacy covers prescription drug exceptions, according to the California Department of Aging.

Does HICAP cover long-term care insurance?

The California Department of Aging lists long-term care insurance and long-term care planning among California HICAP's community education topics.

Learn More

MedicareFree Medicare Counseling: What SHIP Is and Whether It's Really UnbiasedSHIP gives free Medicare counseling. Federal law requires its counselors to have no conflict of interest, and ACL bars licensed insurance agents. Find yours. MedicareSHIP Counselor vs. Medicare Broker: Who Actually Pays Each OneA SHIP counselor and a Medicare broker are both free to you, but one is paid by the government and one by the insurer. See who pays each and when to use which. MedicareMedicare Plans and Coverage in CaliforniaMedicare in California for 2026: Part A, Part B, Medicare Advantage, Part D, Medigap and the birthday rule, plus programs that help pay your costs. MedicareCalifornia Medicare Supplement (Medigap) and the Birthday RuleCalifornia Medicare Supplement (Medigap) guide: the 60-day birthday rule to switch with no underwriting, Plan G vs N, closed C and F plans, and who regulates. MedicareMedicare Open EnrollmentMedicare open enrollment runs October 15 to December 7. What you can change depends on your coverage now, and doing nothing keeps your plan for January 1. MedicareMedicare Enrollment PeriodsWhen to sign up for Medicare without a lifelong penalty: the 7-month Initial Enrollment Period, working past 65, the GEP, and what each late penalty costs.

Find personalized help getting ready for your California HICAP call at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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