If you’re a Medicare patient living with a chronic or serious condition, you may qualify for extra support through Medicare’s Community Health Integration (CHI) or Principal Illness Navigation (PIN) programs. These programs are designed to help you manage care more effectively, address barriers to treatment, and connect with vital Medicare patient support services.
In this guide, we explain Medicare CHI eligibility, Principal Illness Navigation program benefits, and how Understood Care can make the enrollment process simple.
Community Health Integration is a Medicare-covered program for patients who face non-medical challenges that impact their ability to get proper treatment.
You may qualify for CHI if you have:
The Principal Illness Navigation program is for Medicare patients with one or more serious health or psychiatric conditions lasting at least three months, putting them at high risk of hospitalization, nursing home admission, or rapid health decline.
You may qualify for the Medicare PIN program if:
Medication-based qualifications may include high-risk prescriptions that require frequent monitoring, cause strong side effects, or carry a higher risk profile — such as blood thinners (Coumadin, Plavix, Eliquis), chemotherapy, epilepsy medications, or opioids.
Both programs give Medicare patients:
At Understood Care, our advocates specialize in helping Medicare patients determine if they qualify for CHI or PIN. We:
To make the most of your intake appointment for CHI or PIN:
Q: Are Medicare CHI and PIN programs covered?
Yes. Both programs are covered for eligible patients under Medicare.
Q: Can I qualify for both programs?
It depends on your needs and Medicare guidelines. An Understood Care advocate can help you determine the best fit.
Q: Do I need a referral to enroll?
Not necessarily. Your provider or an Understood Care advocate can confirm eligibility and start enrollment.
Adam J. Bonder, MD, MBA – Medical Director
Dr. Adam J. Bonder is the Medical Director at Understood Care, where he leads programs focused on Medicare patient support services. With expertise in clinical medicine and healthcare management, Dr. Bonder works to remove barriers to care and help patients get the most from their Medicare benefits, including CHI and PIN programs.
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Our caring team takes care of the paperwork, claims, and home care so you’re always supported.