Health Insurance Counseling Project

For District of Columbia residents with Medicare, or who are 60 years or older, HICP provides

  • Telephone Help Line
    • Leave confidential messages 
    • Calls returned during business hour
  • Legal Representation
    • Office Visits (by appointment)
    • Home Visits (as needed)
  • Community Education Programs
    Our information sessions help you understand Medicare, Medicaid, and private health insurance. Please call us to set an appointment to have sessions held at your schools, churches, senior centers, government agencies, and community groups

For further information, please call: 202-994-6272.

HICP is a part of The George Washington Law School, and charges no fees for its services. HICP gratefully accepts tax-deductible donations.

Additional Information

Insurance and Prescription Drug Coverage

Hospital Insurance

  • Part A covers in-patient hospital stays, short-term care in skilled nursing facilities, hospice care, and some home health care. Part A is free if a person has paid into the Social Security trust fund for 40 quarters, or 10 years

Medical Insurance

  • Part B covers outpatient hospital care, doctor’s visits, laboratory fees, durable medical equipment, and some preventive care like mammograms.  There is a monthly fee for Part B, called a premium
  • Both Part A and Part B have co-payments and deductibles which are the  patient’s responsibility to pay.  A deductible is the amount the patient pays at the start of each year, before Medicare provides coverage.  A co-payment is the amount left for the patient to pay after Medicare pays for a service

Long-Term Care Insurance

  • Medicare does not cover most long-term care, whether in a nursing home, assisted living, an adult day care center, or in your own home.  Private long-term care insurance companies provide coverage to help pay for these services
  • Long-term care policies can differ in important ways.  Not everyone should buy long-term care insurance

Medigap (Supplemental Medicare Insurance)

  • Medigap insurance fills some of the gaps in Medicare coverage, paying for some health care costs that Medicare does not pay.  The more gaps that a Medigap plan covers, the more expensive the policy is to buy
  • Eligibility for Medigap policies can vary.  Plans must offer “guaranteed enrollment” for new Medicare beneficiaries who are turning sixty-five years of age:  the plan cannot refuse to enroll a beneficiary, even if he or she is injured or sick.

Prescription Drug Coverage

  • Part D prescription drug coverage is provided by private insurance companies, subsidized by Medicare.  Coverage ranges from basic to extensive and from low-cost to more expensive. 

Medicare, Medicaid, and Medigap

Facts about Medicare

  • Medicare covers people aged 65 and older, some people with disabilities, and people with end-stage renal disease
  • Medicare is a federal health insurance program administered by CMS (Centers for Medicare and Medicaid Services)
  • Medicare has several different parts, covering different types of services

Medicare Managed Care

Part C, or Medicare managed care, allows beneficiaries to enroll in comprehensive health insurance through private companies. These programs replace the standard Part A, Part B, and Part D coverage, usually by expanding the types of services that are covered. Most Part C plans charge a monthly premium in addition to the Medicare Part B premium. Most plans require patients to use a limited network of providers.

Medicaid

Medicaid is a government program that provides full coverage for health care costs for Medicare beneficiaries with low incomes, and substantial coverage for Medicare beneficiaries with moderate incomes and few assets.

Full Medicaid benefits cover the cost of most medical services, including visits to the doctor, hospital treatment, medical tests, physical therapy, home health care, and glasses.  Prescription drugs for Medicaid beneficiaries are now covered by Medicare prescription drug plans.

People with Medicare may be able to get help from Medicaid with very high medical bills that Medicare will not pay.  The Medicaid “spend-down” program helps people to pay catastrophic medical bills they could otherwise not afford.  Medicaid also covers many nursing home and community-based care services.

Medigap (Supplemental Medicare Insurance)

Medigap insurance fills some of the gaps in Medicare coverage, paying for some health care costs that Medicare does not pay. The more gaps that a Medigap plan covers; the more expensive the policy is to buy. 

Eligibility for Medigap policies can vary.  Plans must offer “guaranteed enrollment” for new Medicare beneficiaries who are turning 65 years old: the plan cannot refuse to enroll a beneficiary, even if he or she is injured or sick.

Limited Income and Assets

Medicare beneficiaries who are over the income limit for Medicaid may still be eligible for a program called, "Qualified Medicare Beneficiaries” (QMBs). This coverage pays for Medicare Part B premiums and some medical costs, and pays for premiums and reduces co-payments for prescription drug coverage under Part D.  It also provides prescriptions for only a few dollars each.  

If you are single and your monthly income is lower than $2,950, you should contact HICP at: 202-994-6272.  You also may contact the District of Columbia Medicaid Program at: 202-724-7491 for an application and the location of a Medicaid office near you.

Community Outreach

HICP comes to neighborhoods across the city to help District of Columbia seniors understand Medicare, Medicaid and private health insurance.  We make presentations at senior centers, churches, libraries, schools, health fairs, among other locations.  

We also can provide individual assistance to people with Medicare, their families, friends, and caregivers, at convenient locations.  We provide training for professionals who help people with Medicare.  

If you would like more information, please call HICP at 202-994-6272.

Contact

Health Insurance Counseling Project
Jacob Burns Community Legal Clinics
The George Washington University Law School
650 20th Street, NW 
Washington, DC 20052

Phone: 202-994-6272
Fax: 202-994-6441

Online Resources

The Centers for Medicare and Medicaid Services (CMS)
Administers the Medicare program and this site

The DC Healthcare Alliance 
Gives both uninsured individuals and families an opportunity for better health care

District of Columbia Office on Aging 
Develops and carries out a comprehensive and coordinated system of health, education, employment, and social services for the District's elderly population, who are 60 years of age and older

The Department of Human Services
Provides information on Medicaid and other services provided in the District of Columbia

Health Assistance Partnership
A helpful tool for patients to understand their insurance needs as well as giving updates on changes in insurance policies.

Medicare
Helps Medicare beneficiaries understand their Medicare coverage as well as signing up for prescription drug coverage