A Hillsborough woman seeking help for suspected Medicare fraud recently called the San Mateo County office of the Health Insurance Counseling and Advocacy Program, or HICAP, in San Mateo. She was almost in tears.

Hours earlier, she had started her telephone search for information at 1-800-Medicare and found herself in a whirlpool of agency voice mail and frustration.

Finally, somebody in her chain of calls suggested that she call HICAP. She had never heard of the program, but in one conversation she received targeted advice, was directed to gather paperwork and given an appointment with a counselor — at no charge.

Who doesn’t understand the relief she must have felt?

For Medicare beneficiaries of all income levels and their caregivers who are confused about any aspect of health insurance, HICAP is a reliable source of free, personalized counseling and information about all aspects of health care.

The topics covered by agency counselors include long-term care, Medi-Cal (the state’s low-income insurance program) and Medicare (the federal health insurance program for people 65 and older). They also cover regulations, changes in law, co-pays, deductions, drug prices, fraud, differences in policies, fees, how to avoid being scammed, what to do if you are scammed, who to see and what do to. No wonder business is brisk.

It continues to grow. Since the introduction of the convoluted Medicare Part D prescription drug program in 2006, HICAP counselors have spent extra hours each winter advising seniors on ways to maneuver within the world of this complex piece of legislation. (November through December is the only time seniors may change such policies if they choose.)


Now, under a new state law, low-income seniors on Medi-Cal will be required in 2009 for the first time to pay their monthly Medicare premium that Medi-Cal had previously paid. Unchanged since last year, the premium for 2009 is $96.40.

This law affects people whose income is less than about $1,600 per month and who have assets of less than $2,000, not including a home.

“Now they are being asked to pay $96.40 per month. That’s a big portion of their income,” said Bob Fucilla, community partnership liaison for Health Plan of San Mateo, which provides health insurance for low-income county residents. The agency has a close partnership with HICAP.

The task of explaining and counseling is done by trained HICAP volunteers, who receive 30 hours of training, plus 20 hours of internship, six hours a day, two days a week for three weeks. At successful completion, they are registered as HICAP counselors with the state of California.

“Counseling for HICAP is a challenging volunteer job,” said Barbara Kammerlohr, program manager since July, who started as a volunteer. “It’s complicated to get into Medicare, but knowing rules and regulations and how to understand them to help other people can be satisfying. When the volunteers get into it, they really want to stay.”

Kammerlohr has replaced longtime program manager Diana Gray, who left in April.

A new training program for volunteer counselors starts Jan. 20, with special focus on Half Moon Bay, East Palo Alto and Daly City.

HICAP places volunteers in their own communities, at senior centers and Social Security offices, with home visits, if necessary.

“People want to stay in their home area for counseling, so HICAP needs volunteers from the community,” said Christina Kahn, community outreach coordinator.

In February, HICAP representatives will explain “Medicare Changes for 2009 and General Enrollment Period Jan. 1 through March 31″ at two meetings. The meetings will take place at 11:45 a.m. Feb. 18 at Fair Oaks Senior Center, 2600 Middlefield Road, Redwood City; and 11 a.m. Feb. 24 at Senior Coastsiders, 535 Kelly Ave., Half Moon Bay.

To volunteer or otherwise contact HICAP in San Mateo County, call 650-627-9350 or 800-434-0222.

HICAP is the name in California for the federally mandated State Health Insurance Assistance Programs, which provide counseling to Medicare beneficiaries and caregivers.

Source: www.insidebayarea.com

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