Free Medicare counseling in NY: how HIICAP works (and when a broker is optional)

HIICAP is New York's State Health Insurance Assistance Program, funded through federal and state aging agencies and run by the New York State Office for the Aging. The state's page describes it this way: "More than 700 trained HIICAP counselors located in local offices for the aging across the state are available to answer New Yorkers' questions about Medicare, Medicare Advantage programs (managed care), Medicare prescription drug coverage, Medigap, and other health and long term care insurance."

The same page lists what counselors cover: the Medicare program itself, Medigap policies, Medicaid, Medicare Advantage plans, long-term care insurance, Low-Income Subsidy programs (that is Extra Help and the Medicare Savings Programs), employer-sponsored insurance, and other health insurance programs. In practice that means a counselor can read a letter with you, compare drug plans for your actual prescriptions on medicare.gov, explain what QMB or QI would do to your Social Security check, and help you fill out an application.

Counselors are trained volunteers and staff. They do not sell insurance, they are not paid by any plan, and they do not have a stake in what you choose.

Statewide: 1-800-701-0501. The recording asks for your county and routes the call to the local program. Hours as published are Monday through Friday, 8:30 a.m. to 5 p.m. If you live in New York City, say the borough name or the county name; the two are the same place, but the county names trip people up. Brooklyn is Kings County, Manhattan is New York County, Staten Island is Richmond County, and the Bronx and Queens share their county names.

In New York City: Aging Connect, 212-244-6469, and ask for HIICAP. NYC Aging, the city's Department for the Aging, runs the program inside the five boroughs. The main HIICAP unit is at 2 Lafayette Street in lower Manhattan, weekdays by appointment, and it can also be reached by email at hiicap@aging.nyc.gov.

In person, by appointment. NYC Aging publishes a citywide listing of community counseling sites in every borough: Parkchester and East 172nd Street in the Bronx; Homecrest, Coney Island, and downtown Brooklyn; the main unit, Eldridge Street, a Friday library program on Fifth Avenue, and West 66th Street in Manhattan; Jamaica, Corona, Astoria, and Sunnyside in Queens; and St. George on Staten Island. Sites and hours change, so call Aging Connect before going. Our borough pages under /locations list the sites with phone numbers as published.

Outside New York City. The statewide number routes to your county's Office for the Aging, which either counsels directly or schedules an appointment at a local site.

A little preparation turns a 40-minute call into a 15-minute one. Have these within reach:

• Your red, white, and blue Medicare card, or the Social Security letter that gives your Medicare start date if the card has not arrived.
• Any Medicaid card and any recent letters from HRA, your county Department of Social Services, Social Security, or a health plan. The letter is usually the reason for the call, so have the actual paper, not a memory of it.
• A list of your prescriptions with doses, or the bottles themselves. Drug plan comparisons are built on the exact list.
• The names of your regular doctors and your pharmacy.
• A rough monthly income figure (your Social Security amount, any pension, any wages). Counselors use it to see whether the Medicare Savings Program or Extra Help is worth pursuing; they do not decide eligibility, the program offices do.
• A pen. The counselor will give you a case number, a form number, or a next step.

If English is not your first language, ask for an interpreter when the call connects. If a family member is helping, the counselor will usually want to speak with the person on Medicare directly at least briefly. For a fuller checklist by situation, plus a list of questions to ask, see our guide to preparing for a HIICAP appointment.

HIICAP can explain, compare, and help you apply. It can walk through a Medicare Savings Program application and tell you where to send it, which in New York City is HRA and elsewhere is the county DSS. It can help you apply for Extra Help with Social Security. It can compare drug plans and Medicare Advantage plans on medicare.gov without steering you toward any of them.

HIICAP cannot approve a Medicaid, MSP, or Extra Help application; those decisions belong to HRA, the county, and Social Security. It is a knowledgeable, neutral guide, not a fast track.

People also hear from licensed insurance agents and brokers, sometimes by mail, sometimes through a pharmacy or a community event. It is worth being clear about what that role is, without naming anyone.

A licensed broker is paid a commission by insurance companies when a person enrolls in one of the company's Medicare Advantage or drug plans. Federal Medicare marketing rules govern what brokers may say, how they may contact you, and what disclosures they must make, including telling you that they do not represent every plan in your area. A broker can enroll you in a plan directly, which HIICAP does not do; HIICAP shows you the comparison and you enroll yourself through medicare.gov, 1-800-MEDICARE, or the plan.

A broker cannot enroll you in a Medicare Savings Program, Extra Help, or EPIC. Those are government applications that go to HRA or the county DSS, to Social Security, and to the state EPIC program respectively. Some brokers will point you toward those programs; some will not mention them. The applications are free either way, and HIICAP will help you with them for free.

So when is a broker optional? If your questions are about cost programs (MSP, Extra Help, EPIC, Medicaid), HIICAP covers the whole territory and no broker is needed. If you have decided you want a specific plan and want someone to submit the enrollment for you, a broker can do that. If you want a plan comparison that is not tied to anyone's commission, HIICAP is the free alternative and it sells nothing. Many people use HIICAP first and decide afterward whether they want anyone else involved.

A plain disclosure about this site. This site is not HIICAP and is not a government site. It is an educational site that explains how New York's cost programs work. If you use a contact form here, your information is held by this site and is not sent or sold to any broker, plan, or agency. The free public numbers below are always the first call we suggest.