Phone scripts for a New York default enrollment letter: your plan, Medicaid Choice, HIICAP, Medicare

In short: only your plan can process the opt-out. HIICAP compares plans for free, New York Medicaid Choice explains the Medicaid side and can connect you to your plan, and 1-800-MEDICARE handles Medicare records. Below are the words for each call, with the numbers.

You have the letter. You know you should call someone. But which number, and what do you say so the person on the line can actually help? This post gives you the words for each call. Everyone other than your plan can explain, compare, or connect you. Nobody else can process the opt-out for you.

Who does what

Call	Can do	Cannot do
Your plan (number on the letter)	Confirm the start date. Check doctors and drugs. Take your opt-out by phone or in writing.	Give unbiased advice about other plans.
New York Medicaid Choice	Explain what happens to your Medicaid plan and home care. Connect you to your plan to opt out.	Process the opt-out itself.
HIICAP	Compare the D-SNP with Original Medicare plus a drug plan, for free, with no plan ties. Check Extra Help and Medicare Savings Program.	Enroll or disenroll you.
1-800-MEDICARE	Help with changes after the start date. Interpreters in any language, 24/7.	Cancel a default enrollment before it starts (that goes through the plan).
NYC HRA Medicaid Helpline	Confirm your Medicaid case is active, fix your address, answer renewal questions.	Anything about the D-SNP.

Before you dial

Put these on the table. Every call goes faster.

The letter, with the effective date and the opt-out deadline circled.
Your Medicaid card (the number on it is your CIN) and your Medicare card or Social Security award letter, if you have one.
A list of your doctors, your pharmacy, and your prescriptions.
A pen. You will write down the date, the person’s name, and any confirmation number, every time.

If English is not your first language: 1-800-MEDICARE says to “ask for an interpreter, 24 hours a day, 7 days a week.” HRA says free interpretation is available on its helpline. Social Security says press 7 for Spanish and stay on the line for other languages. New York Medicaid Choice and HIICAP do not publish an interpreter policy for their phone lines; ask as soon as someone answers.

Call 1: your plan (the number printed on the letter)

Federal rules say the plan must let you decline “up to and including the day prior to the enrollment effective date,” by phone or in writing, and must not talk you out of it. The same rules say the letter has to compare benefits and costs and explain your other Medicare options. Use the plan for facts about its own network and for the opt-out itself.

To check your doctors and drugs

“I got a default enrollment letter for your Medicare D-SNP with a start date of [date]. I want to check the Medicare network, not the Medicaid network. Is Dr. [name] in the D-SNP network? Is [pharmacy] in the pharmacy network? Is [drug] on the D-SNP formulary, and does it need prior authorization?”

To confirm which letter you got

“Does my letter say I stay in my current Medicaid plan under IB-Dual, or that I am moving to a Medicaid Advantage Plus plan? I want to be sure which one this is.”

To opt out

“I am declining the default enrollment into [D-SNP name] with the effective date of [date]. Please cancel it. What is the confirmation number for this request, and will you send me written confirmation? I am also writing down your name and today’s date.”

If the letter gives a mailing address for written requests, send a short signed letter too, with your name, date of birth, Medicaid number, and the sentence “I decline default enrollment into [D-SNP name] effective [date].” Keep a copy.

No rule requires the plan to mail you an opt-out confirmation, so ask for one and keep your own notes. If you opt out after the start date, the plan treats it as a disenrollment instead, and different timing applies.

If no letter came and Medicare is close

“My Medicare starts on [date] and I have not received a default enrollment letter. Is this plan doing default enrollment right now, or is it suspended on the state’s chart? If it is suspended, what happens to my Medicaid plan membership when Medicare starts, and do I have any voluntary option to keep it?”

Two New York City area plans have default enrollment suspended on the state’s 2026 chart, so this is a real question, not a lost-mail problem. Write down the answer and bring it to your HIICAP call.

Call 2: New York Medicaid Choice

Main line 1-800-505-5678 (TTY 1-888-329-1541), Mon–Fri, 8:30 a.m.–8:00 p.m.; Sat, 10:00 a.m.–6:00 p.m.. Medicaid Choice’s own website sends questions about integrated plans to its long-term care line, 1-888-401-6582. If the main line cannot answer, try that one. This is the state’s enrollment broker. It handles the Medicaid half of your situation.

To understand the Medicaid side

“I am in [Medicaid plan or HARP] and I got a default enrollment letter for the company’s D-SNP. If I opt out of the D-SNP, what happens to my Medicaid managed care plan? What does Medicaid fee-for-service mean for me day to day?”

If you get home care, or expect to

“I receive [personal care / CDPAP / home health] hours. Does my letter put me in IB-Dual or in a Medicaid Advantage Plus plan? If I opt out, would I need to join a Managed Long Term Care plan, and how would my hours continue without a gap?”

If you cannot reach your plan

“I want to opt out of default enrollment and I cannot get through to my plan. The state says you can connect me. Can you do that now, or tell me exactly how to reach the right department?”

Call 3: HIICAP

1-800-701-0501, Mon–Fri, 8:30 a.m.–5:00 p.m.. The recording asks for your ZIP code or your county (the state’s two pages describe it both ways), then routes you to your local program. In New York City, say your borough if asked for a county. Counselors are free and, in the state’s words, “not affiliated with any health plan.”

What to say

“I am on Medicaid managed care and got a default enrollment letter for a D-SNP starting [date]. Can you compare staying in the D-SNP with Original Medicare plus a drug plan, for my doctors and my prescriptions? Can you also check whether I should already have Extra Help and a Medicare Savings Program?”

For an in-person appointment in the five boroughs, call NYC Aging Connect at 212-244-6469 and ask for HIICAP, or email hiicap@aging.nyc.gov. Our borough pages list the community sites.

Call 4: 1-800-MEDICARE

1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day. Before the start date, Medicare mostly points you back to HIICAP and the plan. After the start date, it is the place to make changes. Medicare.gov says people with Medicaid or Extra Help “can make changes to your coverage once a calendar month,” taking effect the first of the next month.

What to say (the state suggests this wording)

“I got a letter saying I have Medicaid now and I am going to be eligible for Medicare. I want help with my Medicare choices.” Then, if needed: “I am already enrolled in a D-SNP and I want to move to Original Medicare and a drug plan using the monthly Special Enrollment Period. What is the effective date?”

Call 5: NYC HRA Medicaid Helpline (only if your case is the problem)

1-888-692-6116, Monday to Friday, 8 a.m. to 5 p.m. TTY users can dial 711. HRA runs Medicaid in all five boroughs. Call here if you are not sure your Medicaid is active, if you moved, or if a renewal is due. Default enrollment only works if your Medicaid stays active.

What to say

“Is my Medicaid case active, and what is my next renewal date? Is my mailing address correct? I am about to get Medicare and I want to make sure nothing lapses.”

Call 6: Social Security (only if you are not already getting benefits)

1-800-772-1213, TTY 1-800-325-0778, weekdays, 8:00 a.m.–7:00 p.m. (confirm on ssa.gov). If you already get Social Security or disability checks, Medicare starts on its own. If you do not, you must sign up, and New York Medicaid requires you to. The default enrollment letter cannot give you a Medicare start date you do not have.

What to say

“I turn 65 on [date] and I am not receiving benefits yet. I want to enroll in Medicare Part A and Part B so coverage starts the month I turn 65.”

Free public numbers used in this post

Keep a call log

One line per call is enough. Something like:

Date · Line called · Person’s name · What I asked · What they said · Confirmation # · Follow-up promised

If you opt out, keep the log with the letter and any written confirmation. If you stay, keep it with the D-SNP welcome packet. Either way, our first-7-days plan puts these calls in order, and the decision guide helps you decide what to say.

Sources

Official pages checked September 23, 2026. Your own notice and current official guidance control if anything here differs.

42 CFR 422.66(c), default enrollment rules (eCFR). Opt-out window and notice requirements; CMS Medicare Advantage Enrollment and Disenrollment Guidance §40.1.5.
NYS Department of Health, Integrated Care Plans for Dual Eligible New Yorkers. Who processes the opt-out; what happens to your Medicaid plan; the Integrated Plan Offerings 2026 chart with each plan’s default enrollment status (page revised July 2026; chart re-read September 23, 2026).
New York Medicaid Choice. Contact and integrated-plans pages.
NYS Office for the Aging, HIICAP. Free Medicare counseling, 1-800-701-0501; NYC Aging sites listing (December 2025).
Medicare.gov, Special Enrollment Periods. Also Medicare.gov “Talk to someone” and language pages; NYC HRA Medicaid helpline and ssa.gov contact pages. Numbers verified September 10, 2026.

Questions people ask

Can New York Medicaid Choice opt me out of the D-SNP?

No. The state says you opt out by calling your health plan or sending it a written request. Medicaid Choice can connect you with your plan and can explain what happens to your Medicaid coverage, but the plan processes the opt-out.

What is the deadline to opt out of default enrollment?

Federal rules require the letter to tell you that you can decline up to and including the day before the enrollment effective date. Your letter states the exact date and method. After the start date, a request is treated as a disenrollment instead.

What should I have ready before I call?

The letter with the effective date and deadline, your Medicaid card, your Medicare card or Social Security award letter if you have one, a list of your doctors and prescriptions, and a pen to record names, dates, and confirmation numbers.

What if I never got a default enrollment letter?

Call the plan number on your Medicaid card and ask whether the plan is doing default enrollment this year or is suspended on the state’s chart. Two New York City area plans are suspended for 2026, so no letter is often not lost mail. Then call HIICAP to compare your Medicare choices, because Medicare starts on its own either way.

Which lines offer interpreters?

1-800-MEDICARE says to ask for an interpreter in any language, 24 hours a day. The NYC HRA Medicaid Helpline offers free phone interpretation. Social Security offers Spanish by pressing 7 and other languages through an interpreter. Medicaid Choice and HIICAP do not publish a phone interpreter policy, so ask when someone answers.

Next step

Want these steps in writing for your own situation?

Answer five short questions and we will email you a plain-language summary. Optional callback. It does not enroll you in anything.

Get dual-plan help

You can also call HIICAP free at 1-800-701-0501. Free, unbiased, and they do not sell plans.