In her long career as a Health Insurance Counseling & Advocacy Program (HICAP) Program Manager in Northern California, Tatiana Fassieux became an experienced troubleshooter who could penetrate government and corporate bureaucracies to find healthcare solutions for Medicare beneficiaries.

Now, in an encore to that work, Fassieux serves as a training specialist for California Health Advocates, an education and watchdog organization that provides Medicare education, policy research, advocacy and investigations to support California seniors navigating the Medicare system.

Fassieux and other CHA trainers have provided critical instruction to prepare hundreds of people to work as staff and volunteer counselors for California’s 26 regional HICAP networks. Those networks cover California’s 58 counties, help seniors obtain Medicare coverage and intervene on their behalf to resolve coverage denials and ensure they receive care.

“Our mission is to have seniors understand it so that they’re not afraid of Medicare.”
Tatiana Fassieux
Training and Education Specialist, California Health Advocates

CHA’s training regimen reinforces the work of HICAP networks with meticulous instruction on all aspects of Medicare coverage, claims and the appeal process to equip staff and volunteers in advocating on behalf of people who are often confused and overwhelmed by the Medicare and health system.

As a result of that training, Fassieux says, older adults are both satisfied that counselors have been able to resolve problems with their coverage and enlightened about how the system works.

“Our mission is to have seniors understand Medicare so that they’re not afraid of it,” she says.

Marcie Gugenheim, one of Fassieux’s recent trainees through the CHA program, stepped up to join that mission. A former journalist, computer systems supervisor and a manager for higher education technology firms, Gugenheim had been seeking out volunteer opportunities in retirement.

Gugenheim quickly mastered demands of the Medicare system as she rounded up documentation of recent employer group coverage for her husband and herself to avoid late-enrollment penalties for Medicare Part B health coverage and Part D prescription drug coverage.

She was inspired to sign up for the CHA training after a positive encounter with a volunteer counselor at the Santa Clara County HICAP. She’d called HICAP with a question about how to submit her paperwork and realized she’d found a new opportunity.

Gugenheim, who says she viewed her career in journalism as a public service, decided to now join the volunteer ranks.

“I realized I’m a pretty good advocate for myself, but a lot of people aren’t going to be as persistent,” Guggenheim says. “I’m also really good at reading nuance. When I see something, I read all of it. And if there’s a phone number for someone to call, I will make a call.”

Guggenheim trained through California Health Advocates, as well as through the national State Health Insurance Assistance Program (SHIP) technical center. Now, she’s preparing for an internship, the first step to becoming a HICAP volunteer. She will join community-based networks that have helped tens of thousands of California seniors to access the Medicare system, resolve medical coverage claims and file appeals to protect their rights as Medicare beneficiaries.

That work has been a life’s calling for Fassieux, a former board chair for CHA and a member of the organization since 1996.

Fassieux served as a HICAP Program Manager with Passages Health Insurance Counseling and Advocacy Program, which advocates for seniors in Butte, Colusa, Glenn, Plumas and Tehama counties. She’s intervened on behalf of clients misled by salespeople pitching Medicare Advantage plans. She’s also cut through red tape and archaic billing procedures to ensure that Medicare recipients could access needed care with local hospital groups and other medical providers

And in 2008, Fassieux testified before the United States Senate to reform the Medicare system itself. Appearing before the Special Committee on Aging, she illuminated the case of someone who had been improperly enrolled in a Medicare Advantage plan due to incorrect information provided by customer representatives for Medicare Advantage’s hotline.

Fassieux told the Senate panel that Medicare’s “credibility has been shaken” due to misinformation being provided to seniors about their health plan coverage.

“What troubles us is the difficulty of resolving hard cases,” she said during the hearing.

Fassieux’s testimony led to improved training and new scripts for Medicare customer service representatives. Now, she’s training a new generation of HICAP staffers and volunteers such as Gugenheim to support people in getting Medicare and the healthcare system to resolve those hard cases. Trainees receive an average of 38 hours of instruction through California Health Advocates.

“Tatiana’s stories were really interesting,” says Gugenheim, who recently completed an instructional program led by Fassieux that illuminated examples of how HICAP networks advocate on behalf of Medicare recipients. “She was focused on real-world solutions.”

Gugenheim adds that the instruction covered changes in Medicare under President Donald Trump’s new budget act, H.R. 1, and how those changes will affect coverage in 2027 and beyond.

“Medicare is the quintessential thing in a retired person’s life,” Gugenheim says. “Everyone has to sign up for it. Everyone has to pay attention to it, and it’s really complicated. If I can help demystify it a little for someone, that would be good.”