If a Medicare notice confuses you or an agent is pushing a plan switch, Texas HICAP, the state's free Medicare counseling program, can help at 800-252-9240.,, Texas HICAP is the name Texas uses for its State Health Insurance Assistance Program (SHIP), the federally funded program that gives free local Medicare counseling.,

In This Guide

What Is Texas HICAP?

Texas HICAP is Texas's version of the State Health Insurance Assistance Program (SHIP), a national program of the Administration for Community Living (ACL) that helps people with Medicare, their families, and caregivers. The Texas Health and Human Services Commission (HHSC) states plainly that in Texas, SHIP is called the Health Information, Counseling and Advocacy Program (HICAP). ACL notes that your local SHIP may go by another name depending on where you live, but the support it provides is the same. So when a Texas doctor's office or a neighbor says "call HICAP," they mean the Texas SHIP.

Here's how the program is put together in Texas. HHSC's Office of Area Agencies on Aging (AAAs) applies for two grants funded by ACL: the SHIP grant and the Medicare Improvement for Patients and Providers Act (MIPPA) grant. HHSC says both grants serve Medicare beneficiaries in all 254 counties across Texas, that the SHIP grant has existed since 1992, and that the MIPPA grant was implemented in 2008 to support the SHIP efforts. In practice, a rural Texan and a Houston resident are served by the same statewide program, with benefits counselors working in coordination with local Area Agencies on Aging.

Texas HICAP counseling is free because Texas HICAP is a SHIP. Medicare's official appeals guide defines a SHIP as a state program that gets money from the federal government to give free local health insurance counseling to people with Medicare. ACL's conflict-of-interest guidance for SHIP programs likewise states that SHIPs provide free, in-depth, unbiased, one-on-one health insurance counseling and assistance to Medicare beneficiaries, their families, and caregivers. For how SHIPs work nationally, see our guide to free Medicare counseling through your SHIP, and for the wider picture of Medicare in the state, see Medicare plans and coverage in Texas.

Who Can Get Help, and Who Does Texas HICAP Focus On?

Texas HICAP is not limited to the person on the Medicare card. HHSC states that SHIP/HICAP services support Medicare beneficiaries, their families and caregivers. That means an adult daughter trying to sort out her father's drug plan can call Texas HICAP herself.

HHSC also names groups the program pays special attention to. According to HHSC, SHIP/HICAP services support Medicare beneficiaries, their families and caregivers, especially beneficiaries with limited incomes, beneficiaries under the age of 65 with disabilities, and people who are dually eligible for Medicare and Medicaid. Read these groups as priorities, not entry rules.

HHSC describes the goal of SHIP in Texas in practical terms. The goal is to improve access to care and affordability of benefits by giving Medicare and Medicare-eligible beneficiaries and their caregivers accurate information and person-centered counseling on public and private health benefits and community-based services. "Medicare-eligible" matters here: a Texan who is about to turn 65 and has not yet signed up is part of the audience HHSC names.

What Can a Texas HICAP Counselor Help With?

A Texas HICAP counselor helps with the part of Medicare that trips people up after enrollment, not just with choosing a plan. ACL states that SHIP can assist with navigating access to providers, correcting billing issues, and filing complaints and appeals. That makes Texas HICAP a reasonable first call when a bill or a Medicare Summary Notice doesn't match what you expected.

Appeals are a good example of where a counselor earns their keep. Medicare's appeals guide tells people to call their SHIP for free, personalized health insurance counseling, including help with appeals. Our guide on how to appeal a Medicare denial explains the appeal levels themselves, and a Texas HICAP counselor can help you work out which one applies to your notice.

Texas HICAP counselors can also deal with Medicare for you when you want them to. ACL states that, with your permission, SHIP will work with Medicare directly to help solve problems on your behalf. That permission step keeps you in control of your own coverage.

Texas benefits counselors also cover more than Medicare. HHSC's Texas Benefits Counseling Program page says benefits counselors provide information, counseling, assistance, and advocacy to older people and their Medicare-eligible families and caregivers about their benefits, entitlements, and legal rights. If your question runs from Medicare into other benefits, say so on the first call.

How Do Texas Benefits Counselors Work?

HHSC's grants page ties the benefits counselors to the Area Agencies on Aging. It says that, in coordination with the Area Agencies on Aging, benefits counselors provide education and assistance to Texans, with targeted outreach to specific groups. HHSC's separate Texas Benefits Counseling Program page then explains how those Area Agency on Aging benefits counselors are organized.

HHSC's Texas Benefits Counseling Program page describes two kinds of benefits counselor in Texas. Both provide the same core help; what differs is who employs them and who trains whom:

Regional benefits counselor Volunteer benefits counselor
Who employs them An Area Agency on Aging (AAA employee) Serves as a volunteer
What they provide Information, counseling, assistance, and advocacy on benefits, entitlements, and legal rights Information, counseling, assistance, and advocacy on benefits, entitlements, and legal rights
Training Regional counselors train volunteers Trained by regional benefits counselors

HHSC's stated aim is broad access to trained people. HHSC says it wants all Texans aged 60 and older, as well as Medicare-eligible people with disabilities of any age, to have ready access to trained and certified benefits counselors. The same HHSC page lays out certified counselor levels (Certified Benefits Counselor I and II) and says each local Area Agency on Aging customizes its job descriptions to suit the skill and knowledge level a position needs. So the exact role of the person you reach can vary from one region of Texas to another.

Legal problems are handled by referral. HHSC lists, among the duties of noncertified volunteer benefits counselors, assisting older people in applying for and maintaining insurance and entitlement benefits, and referring more complex cases and cases requiring legal intervention to the appropriate sources. For a Certified Benefits Counselor II, HHSC lists providing information and referral on probate, guardianship, protective services, powers of attorney, and other matters requiring legal intervention. If your situation needs legal help, expect a Texas benefits counselor to refer you to the appropriate source.

Is What You Tell a Counselor Confidential?

Yes, and HHSC puts it in writing. HHSC's Texas Benefits Counseling Program page states that all client information will be treated as confidential and will not be shared with anyone outside the Benefits Counseling Program without the client's consent. HHSC's Texas Benefits Counseling Program page also says all Texas benefits counseling clients have the right to remain anonymous throughout the counseling process.

There is one situation where you may choose to give up some of that privacy. HHSC says a client may sign a "consent to release" form for appeal and representation cases when the counselor acts, at the client's request, on his or her behalf. That form is the Texas side of the arrangement: it lets your counselor share what's needed to work your case.

Medicare has its own forms for letting someone else in. Form CMS-10106, "Authorization to Disclose Personal Health Information," is how a person with Medicare gives 1-800-MEDICARE written permission to share their personal health information with someone else, and CMS says that by law this permission must be in writing. For an appeal, Medicare's appeals guide says you can appoint a representative, such as a family member, friend, advocate, attorney, or doctor, using the "Appointment of Representative" form (Form CMS-1696) or a written request with the required elements. If you're unsure which form you need, ask your counselor.

Can Texas HICAP Help You Pay Less for Medicare?

Yes, helping people save money is part of Texas HICAP's stated work. HHSC says the Medicare Improvement for Patients and Providers Act (MIPPA) grant, implemented in 2008 to support the SHIP (HICAP) efforts in Texas, expands, extends and enhances outreach to beneficiaries, caregivers and their families to help them save money on health care costs through three routes:

HHSC says Texas benefits counselors, working in coordination with the Area Agencies on Aging, give targeted outreach to people who are low-income with limited resources, live in rural areas, are members of American Indian, Alaskan Native, or Native Hawaiian communities, are people with disabilities under age 65, or speak English as a second language. If that describes you or the parent you're helping, ask a Texas HICAP counselor about these savings programs on the first call.

To check whether income and assets fit, see our guide to Texas Medicare Savings Programs for Texas's own figures, and Medicare Extra Help for the drug-cost side.

How Do You Reach Texas HICAP?

Texas HICAP has one statewide number and a few other ways in. Here they are in the order most people should try them:

1
Step 1

Call 800-252-9240

The Centers for Medicare & Medicaid Services (CMS) contacts directory lists Texas HICAP as a State Health Insurance Assistance Program offering personalized health insurance counseling at toll-free (800) 252-9240, and HHSC's Aging page says to call 800-252-9240 for AAA and Medicare services.

2
Step 2

Use TDI's benefits counselor directory

The Texas Department of Insurance (TDI) page "Insurance Resource for Medicare Beneficiaries" links to a directory to find a benefits counselor in your area for help with public and private benefits.

3
Step 3

Use the national SHIP locator

ACL's SHIP flyer tells people to find their local SHIP at shiphelp.org or 1-877-839-2675, which is useful if you're helping a parent who lives in another state.

4
Step 4

Call 1-800-MEDICARE for Medicare itself

CMS lists 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) as the route for an Original Medicare question, and tells people with a Part D or Medicare Advantage question to call their plan first, using the number on the member ID card.

The difference between the first and last steps is worth holding onto. Texas HICAP counsels you about your options and, with your permission, works with Medicare on your behalf, while 1-800-MEDICARE is the official Medicare contact line run by CMS., You may end up using both.

What Will Texas HICAP Not Do for You?

Texas HICAP is bound by a federal conflict-of-interest rule. Federal law (42 U.S.C. 1395b-4) requires a state's SHIP grant plan to assure that staff members, including volunteer staff members, have no conflict of interest in providing the counseling. ACL's SHIP volunteer policy says no person with a personal, philosophical, or financial conflict of interest may serve as a volunteer, and it gives anyone who receives compensation for enrolling beneficiaries in a specific insurance plan as one example of an inherent conflict. Because HHSC applies for the SHIP grant in Texas and SHIP is called HICAP in Texas, that federal rule applies to Texas HICAP. Our comparison of a SHIP counselor and a Medicare broker walks through how each is paid.

Checking an insurance agent's license is a job for TDI. In its Medicare supplement guide, TDI says you can verify company and agent licenses, and learn a company's complaint history, by calling the TDI Help Line at 800-252-3439, and that you can file a complaint with TDI if you believe an agent or company engaged in unfair and illegal practices. The same TDI guide points readers who want help comparing plans and costs to the Texas SHIP at 800-252-9240.

TDI's Medicare supplement guide lists sales practices that break the law when agents or companies sell Medicare Supplement (Medigap) policies in Texas. Those practices include:

  • Twisting, meaning knowingly misleading you to drop a policy and buy a replacement from another company
  • High-pressure tactics using force, fright, or threat
  • Cold lead advertising that hides that an agent may try to sell you insurance
  • Mailings made to look like mail from the government
  • Acting as a representative of Medicare or a government agency
  • Selling a Medigap policy that duplicates coverage you already have
  • Suggesting that you falsify an answer on an application

If a caller claiming to be "from Medicare" pushes a Medigap policy, TDI's list gives you the words to describe what happened when you report it. Texas's Medigap buying rules are covered in our Texas Medicare Supplement guide.

How Should You Prepare for a HICAP Session?

Timing matters most in the fall. Medicare Open Enrollment runs from October 15 through December 7 each year, and during it you can join, switch, or drop a Medicare Advantage Plan or a Medicare drug plan, or switch between Original Medicare and Medicare Advantage. For Medicare Open Enrollment, a health or drug plan must get your enrollment form by December 7, and if you switch to a new health or drug plan, your new coverage starts January 1. Booking a Texas HICAP session early in that window leaves room to act on what you learn. Our Medicare Open Enrollment guide covers the choices in more depth.

A little preparation makes a session far more useful. Have your Medicare card, your plan's member ID card, and the notice or letter you're asking about in front of you. Write down your prescriptions and doctors if you're comparing plans. If you're calling for a parent, decide in advance whether the counselor needs to speak with Medicare on your parent's behalf, since Texas counselors act on a client's behalf at the client's request and Medicare shares information with someone else only with written permission.,

How Can You Volunteer With Texas HICAP?

Texas benefits counseling relies partly on volunteers, and HHSC says how to start. HHSC's Texas Benefits Counseling Program page tells anyone interested in becoming a volunteer benefits counselor to contact their local area agency on aging at 1-800-252-9240. HHSC also says the Texas Benefits Counselor Training Manual is available on the Texas Legal Services Center's website.

Volunteers are held to the federal conflict-of-interest rule described above. ACL's SHIP volunteer policy says volunteers do not promote any personal or business interest while doing their SHIP assignment. For other Texas programs for older adults and the people who care for them, see our guide to caregiver programs in Texas.

Frequently Asked Questions

Is Texas HICAP only for people 65 and older?

No. HHSC says Texas HICAP pays particular attention to Medicare beneficiaries under age 65 with disabilities, and HHSC wants Medicare-eligible people with disabilities of any age to have access to trained benefits counselors.

Can a Texas HICAP counselor help with Medicaid, SSI, or food stamp questions?

Some can. For a Certified Benefits Counselor I in Texas, HHSC lists knowledge of Medicare, Medicaid and private insurance, Social Security and Supplemental Security Income (SSI) disability, appeals for Medicare, Medicaid and SSI, food stamps, pensions, money management, and debtor's rights. Because each Area Agency on Aging customizes its job descriptions, ask on the first call whether your counselor handles the benefit you need.

Why does the Texas HICAP number also reach Area Agency on Aging services?

HHSC's Aging page says to call 800-252-9240 for both Area Agency on Aging (AAA) and Medicare services, and HHSC says Texas benefits counselors work in coordination with the Area Agencies on Aging., So the same number serves both.

Can a Texas HICAP counselor represent me at a hearing?

For a Certified Benefits Counselor II, HHSC lists assisting older adults, their families and caregivers in obtaining advocacy and representation in matters that require review, waiver reconsideration or hearings before administrative agencies, and it says cases requiring legal intervention are referred to the appropriate sources. Ask whether your counselor can help you find representation.

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. MedicareMedicare Plans and Coverage in TexasMedicare in Texas for 2026: Parts A and B, Medicare Advantage, Part D, Medigap, free HICAP counseling, and the Medicare Savings Programs that lower your costs. 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. MedicaidTexas Medicare Savings Programs: Help Paying Medicare CostsTexas Medicare Savings Programs 2026: QMB, SLMB, and QI income and resource limits, what each pays, automatic Part D Extra Help, and how to apply through HHSC. MedicareHow to Appeal a Medicare DenialA Medicare denial isn't final. Here's how to appeal one through all five levels, with 2026 deadlines, dollar thresholds, and the fast track for urgent care. CaregiverArea Agencies on Aging: How to Find and Use YoursAn Area Agency on Aging is your state-designated local front door to help for an aging parent. What yours does, who it serves, and how to find it today.

Find personalized help sorting out Medicare counseling options in Texas at brevy.com, or chat with Brevy's care navigator.

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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