Contact Us
Volunteers Needed
Contra Costa County HICAP
Health Insurance Counseling and Advocacy Program
Skip to content
HOME
Counseling
Counseling Locations
Welcome to Medicare Class
Welcome to Medicare – ONLINE VERSION
About HICAP
What HICAP Can Help You With
What to Bring to Your Appointment
Client Testimonials
About Medicare
Understanding Medicare
Medicare Premiums
Wellness / Preventive Care
Create a MyMedicare Account
Part B Late Enrollment Penalty
Guard Your Medicare Number
LGBT and Medicare
Medicare and the Affordable Care Act
Medicare and COBRA
End Stage Renal Disease and Medicare (ESRD)
Health Savings Accounts
2021 Medicare Plans
Medicare Plans Overview
Medicare Advantage (MAPD) Plans
Medigap Plans
Medicare/Medi-Cal Plans
Contra Costa County Health Services
Part D Prescription Drug Plans (PDP)
How to use Plan Finder
Drug Coverage
Drug Coverage Overview
Part D Prescription Drug Plans (PDP)
Choosing a Drug Plan (Plan Finder)
Part D Late Enrollment Penalty
Donut Hole and Part D
How to save money on prescription drugs
Programs that assist with insulin costs
Immediate Access to Insulin
Some drugs are cheaper without insurance
Part D Transition Rights
Low Income Help
Low Income Assistance Overview
Medicare Savings Programs
Extra Help for Part D
Medi-Cal Facts For Seniors
Eliminating Medi-Cal Share of Cost
Medicare/Medi-Cal Plans – for Full Duals
California 250% Working Disabled Program
Community Education
Contact HICAP Form
We can help you with Medicare. HICAP, the Health Insurance Counseling and Advocacy Program, provides free, unbiased education, counseling, and advocacy about Medicare and related health insurance.
Please use this form to submit a question or a request for assistance with
Medicare
. We will respond generally within 2 to 3 business days.
Complete the form below. An *asterisk indicates a required field. Do not put any personal information on this form, such as Medicare number or insurance member number.
Client's Name
*
First Name
Last Name
Client's Zip Code
*
Please enter your HOME Zip Code
Client's Year of Birth (example: 1947)
*
If you are contacting us on behalf of someone else, enter your name here.
Your Email Address
*
Enter Email
Confirm Email
Your Phone
*
Enter the best phone number to be reached on week days.
How do you prefer HICAP to contact you?
(check all that apply)
PHONE
EMAIL
If we need to contact you by phone, what are the best times to reach you.
(examples: "weekday mornings", or "after 3 pm")
Would you use ZOOM Video Conferencing to talk with a Counselor?
YES
Please tell us how HICAP can help you with your Medicare.
*
Please give us a brief summary of your questions or issues. A counselor will contact you for additional details. Do not include any personal information such as Medicare number.
PLEASE NOTE:
It may take 2 or 3 days for you to hear from us. Please
do not submit a second form
, or call our phone number. Multiple requests from the same person will slow down the response. Thank you for your cooperation.
Name
This field is for validation purposes and should be left unchanged.
Comments are closed.
In the NEWS!
Important Facts about the American Rescue Plan
Watch out for COVID Survey Scams!
For the Latest NEWS, follow us on Facebook
Other Resources
Medicare Fraud Alert
Dental, Vision and Hearing Resources
Federal Resources
State Resources
County Resources
Other Resources
Site Index