How to prepare for a HIICAP appointment in New York: what to bring and what to ask

Statewide: call 1-800-701-0501. The state Office for the Aging's page says callers are prompted to state their county and are then routed to the local HIICAP program. Some counties counsel on the spot, some schedule a callback, some book an in-person visit. Say which you prefer.

New York City: call Aging Connect at 212-244-6469 and ask for HIICAP. NYC Aging runs the program in the five boroughs and publishes a list of community counseling sites where you can meet a counselor by appointment. Sites and hours change, so confirm before you go.

If English is not your first language, ask for an interpreter when the call connects. If you use a TTY or need large print, say so at the start.

Counselors can cover a lot in one session, but the useful ones start by asking, "What made you call today?" Decide your answer before you dial. Common ones:

• I got a letter and do not understand it.
• I want to know if I can get help with the Part B premium or drug costs.
• My drug plan is changing and I need to compare plans.
• I am turning 65, or my spouse is, and I do not know when to sign up.
• I got a bill I thought Medicaid or Medicare would cover.
• I am helping my parent and do not know where to start.

Write that sentence on the top of a sheet of paper. Everything else on this page hangs off it.

Bring the actual paper, not a memory of it. If the appointment is by phone, put the documents on the table in front of you before you call.

Every appointment

• Your red, white, and blue Medicare card, or the Social Security letter with your Medicare start date if the card has not arrived.
• Any Medicaid card, Medicare Advantage card, drug plan card, or Medigap card.
• A pen and the sheet with your one question.
• Your date of birth, address, and the last four digits of your Social Security number, which offices use to find your case.

If you are asking about the Medicare Savings Program or Extra Help

The counselor will want a rough monthly income figure to see whether an application is worth filing. New York's 2026 MSP limits are $1,836 a month for a single person and $2,489 for a couple for QMB, and $2,474 and $3,355 for QI, before a $20 disregard. There is no savings test for either. Have:

• Your Social Security benefit amount (the December letter, or the amount that lands in your bank account, plus the Part B premium if it is being deducted).
• Any pension, wages, or other income, with how often it is paid.
• Any health premium you pay other than Medicare, such as a retiree plan or Medigap policy. New York subtracts these before comparing your income to the limit.
• If you want to file on the spot: the state's form DOH-4328 asks for a copy of your Medicare card, proof of date of birth, proof of address dated within six months, and proof of income. Our MSP documents checklist has the full list.

If you are comparing drug plans or Medicare Advantage plans

• Every prescription you take, with the dose and how often. The bottles work. Plan comparisons on medicare.gov are built from the exact list, and a missing drug changes the answer.
• Your pharmacy name and address.
• The names of the doctors and hospital you want to keep.
• The plan's Annual Notice of Change if you received one in September, and the Extra Help rider if you have Extra Help.

If you got a letter you do not understand

• The whole letter, including the back page where appeal rights and deadlines are printed.
• The envelope, because the postmark date sometimes matters.
• Any earlier letter it refers to.

Our decoder for Medicaid renewal and Extra Help letters explains the common ones if you want to read before you call.

If you are new to Medicare or still working

• Your employer or union coverage details and the date it ends.
• Any Social Security letter about Part B enrollment.
• The month you turned, or will turn, 65.

If you are helping a parent or spouse

• Everything above, for the person on Medicare.
• The person themselves, at least for the first few minutes of the call. Counselors will usually want to hear from them directly.
• If they cannot join, any paper that shows you are allowed to act for them: a power of attorney, or Medicare's authorization form (see below).

You will not need all of these. Pick the block that matches your one thing.

About costs and programs

1. Based on what I told you about income, which programs are worth applying for: QMB, QI, Extra Help, or EPIC?
2. Where does my application go, HRA, my county, or NY State of Health, and which form?
3. What documents will they ask for, and how recent do they need to be?
4. If approved, when does the Part B premium stop coming out of my check, and can any past months be refunded?
5. Do I need to renew every year, and who will send the renewal?
6. Would applying for the MSP affect my SNAP or anything else I get?

About a letter

1. Is this letter asking me to do something, or just telling me a number?
2. What is the deadline, and what happens if I miss it?
3. Can I appeal, and does asking for a hearing keep my coverage in place while I wait?
4. Who sent this, and what number do I call about it?

About drug plans

1. With my exact drug list, which plans cost the least over the whole year, counting copays and the deductible as well as the premium?
2. Are all my drugs covered, and do any need the plan's approval first?
3. Is my pharmacy in the plan's network?
4. If I have Extra Help, which plans have a $0 premium for me?
5. Can I change plans now, or do I have to wait for a set period?

About Medicare Advantage vs Original Medicare

1. Will my doctors and hospital take this plan?
2. What would I pay for a hospital stay or a specialist visit under each option?
3. If I have Medicaid or an MSP, how does that change what I would pay?
4. If I try a plan and do not like it, when can I switch back?

About signing up for Medicare

1. Do I need Part B now, or can I delay it because of my job coverage?
2. Is there a late penalty in my situation, and can an MSP remove it?
3. What is my enrollment window and when does coverage start?

Always, at the end

1. What are my next steps, in order?
2. Is there a case number or form number I should write down?
3. Can I call you back, and how?

Medicare, Social Security, and the plans will not discuss a person's case with a family member unless the person is on the line or has given written permission. HIICAP counselors are more flexible, but the offices they help you call are not. Two things to arrange ahead:

• Medicare's authorization form. Form CMS-10106, "1-800-MEDICARE Authorization to Disclose Personal Health Information," lets the person on Medicare name someone Medicare can talk to. CMS says it can be submitted online through a Medicare.gov account, by mail, or by fax, and it stays in effect until the person cancels it or until an end date written on the form.
• The person's own presence. For Medicaid, HRA, and NY State of Health, the simplest route is for the person to be on the call to give verbal permission, or to name a representative on the application itself. The DOH-4328 form has a signature line for a representative and asks for that person's relationship and address.

If you hold a power of attorney, have a copy handy. Do not send originals to anyone.

HIICAP can explain any letter, compare plans on medicare.gov with your drug list, tell you which office decides your case, fill out the MSP or Extra Help application with you, and help you file an appeal. The state's page lists Medicare, Medicare Advantage, Part D, Medigap, Medicaid, the low-income programs, employer coverage, and long-term care insurance as topics counselors cover.

HIICAP cannot approve Medicaid, an MSP, or Extra Help. Those decisions belong to HRA or your county, NY State of Health, and Social Security. A counselor also cannot enroll you in a plan for you; they show you the comparison and you enroll through medicare.gov, 1-800-MEDICARE, or the plan. If a counselor's answer is "that is up to the Medicaid office," that is the honest answer, not a brush-off.

• Write down every case number, form number, and date the counselor gave you, on the same sheet as your one question.
• Put deadlines on a calendar the day you get home.
• If you were told to mail something, make a copy first and note the date you mailed it.
• If the counselor is expecting a callback from you, call. Cases go quiet when the person does.

Counselors handle hundreds of these a year. The people who get the most out of them are the ones who arrive with the paper and leave with the next step written down.

• Calling without the letter in hand and describing it from memory.
• Listing "my blood pressure pill" instead of the drug name and dose.
• Forgetting a health premium you pay, which can move you across the MSP income line on paper.
• Having an adult child call alone about a parent, with no authorization form and no parent on the line.
• Asking which plan to pick without bringing the drug list and doctor names the answer depends on.
• Not asking what happens next, then waiting for a letter that was never coming.

Do I need an appointment, or can I just call HIICAP?

Call first. The statewide number, 1-800-701-0501, routes you by county, and the local program tells you whether they counsel on that call, schedule a callback, or book an in-person visit. In New York City, Aging Connect at 212-244-6469 can book you at a community site; NYC Aging publishes the list of sites by borough.

Is HIICAP really free, and does the counselor sell anything?

Yes, it is free, and no. HIICAP is New York's State Health Insurance Assistance Program (SHIP), funded through federal and state aging agencies. The national SHIP program describes the counseling as objective and says there is no cost to consumers. Counselors are not paid by any plan and do not enroll you in a plan.

What if I am helping my mother and she cannot come to the phone?

Bring proof you can act for her. For Medicare itself, form CMS-10106 lets her name you as someone Medicare can talk to; it can be filed online, by mail, or by fax. For a Medicaid or MSP application, she can name you as her representative on the form. A power of attorney also works. A HIICAP counselor can talk with you in general terms without any of this, but the offices that decide her case cannot.

How much income detail do I need to bring?

A rough monthly figure is enough for a first conversation. The counselor compares it to the published limits to see whether an application makes sense. If you decide to apply on the spot, the state's MSP form wants proof: pay stubs covering four weeks, a pension statement, a tax return, or the award letter for Social Security or any other benefit.

Can HIICAP tell me whether I will be approved?

No. HIICAP counselors can say whether your numbers are inside the published bands and can help you file. The decision comes from HRA or your county, NY State of Health, or Social Security, in a written notice. Anyone who promises approval in advance is not HIICAP.