Medicare 2026

Elk Grove Medicare help: how SHIP counselors and licensed agents differ

ELK GROVE, Calif. — If you live in Elk Grove and have a Medicare question, you have two very different kinds of local help available, and knowing the difference can save you time and confusion. One is free, unbiased counseling from trained volunteers through California's State Health Insurance Assistance Program (SHIP), known here as HICAP. The other is a licensed insurance agent or agency, who can walk you through specific plans and enroll you.

Elk Grove Medicare help: two very different doors to knock on

Both can be useful. They just do different jobs.

What SHIP (HICAP) is, and what it isn't

SHIP stands for State Health Insurance Assistance Program. Every state has one, funded by the federal Administration for Community Living. In California, it goes by HICAP — the Health Insurance Counseling and Advocacy Program.

HICAP counselors are trained and certified, but they do not sell insurance and do not earn commissions. They can:

• Explain how Parts A, B, C, and D fit together.
• Help you compare Medicare Advantage and Part D options side by side.
• Review a plan's Annual Notice of Change with you.
• Help you spot possible fraud or billing errors.
• Explain programs that help with costs, like Extra Help and Medicare Savings Programs.

What HICAP will not do is tell you which plan is "best." That is your call — but they will help you think it through.

Elk Grove residents are served by the Sacramento-area HICAP office. You can find your local counselor by calling 1-800-434-0222 or visiting cahealthadvocates.org/hicap.

What a licensed agent does

A licensed insurance agent is appointed by one or more insurance companies to sell Medicare Advantage, Part D, or Medigap plans. Good agents are knowledgeable and can be a real help, especially if you want someone to handle the paperwork and stay with you year after year.

A few things to keep in mind:

• Agents are paid by the insurance carriers whose plans they sell.
• Most agents are not contracted with every carrier in the market. Sacramento County has 10 carriers offering Medicare Advantage plans for 2027, and one agent may only represent some of them.
• By CMS rules, agents cannot cold-call you, show up uninvited, or pressure you.

Before you meet with an agent, it is fair to ask which carriers they represent and how they are paid.

How to choose which one to call first

If you are new to Medicare, feeling overwhelmed, or just want a plain-English explanation with no sales pitch, HICAP is usually the right first stop. If you already know what type of coverage you want and are ready to compare specific plans and enroll, a licensed agent can move quickly.

Many people use both — HICAP to learn the landscape, then an agent to complete an enrollment.

The Elk Grove market, at a glance

Elk Grove sits in Sacramento County, where roughly 243,370 residents are age 65 or older. For 2027, the county has 23 Medicare Advantage plans available from 10 carriers, according to CMS Plan Finder data. There are no stand-alone Part D prescription drug plans listed at the county level for 2027 in this data set, so if you have Original Medicare and want drug coverage, check medicare.gov for the plans available at your ZIP code.

Star Ratings, published by CMS, can be one tool to weigh quality, but they are just one input. A counselor or agent can explain what the ratings measure.

Key 2027 dates and numbers to know

• Annual Enrollment Period: October 15 – December 7.
• Medicare Advantage Open Enrollment: January 1 – March 31 (for people already in a Medicare Advantage plan).
• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027.
• Part D maximum deductible: $615 in 2026 and $700 in 2027.
• The old coverage gap ("donut hole") is gone as of 2025; Part D now has three phases.
• Medicare Prescription Payment Plan: an optional way to spread drug costs across the year in monthly payments.
• IRMAA (income-related surcharges) start above $109,000 in income for a single filer in 2026.