Arizona Patient Advocates, Covered by Medicare

Yes. Since January 2024, Medicare pays for professional healthcare navigation through Principal Illness Navigation and Community Health Integration services. Medicare Part B covers about 80% of the cost, and a supplemental (Medigap) plan typically covers the rest, so most Arizona members pay $0. We confirm exactly what your coverage looks like before your first session, and there are no surprise bills.

Yes, all 15 counties. The service is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Phoenix, Tucson, Mesa, Chandler, Scottsdale, Glendale, Gilbert, the Sun Cities, Yuma, Flagstaff, Prescott, and every county in between. There is no office to travel to.

Advocates work virtually and are matched to you, not to a zip code. What matters is that your advocate is the same person every time (One Advocate, For Life), knows Arizona's programs and rules, the state's federal Medigap timing (Arizona has no birthday rule and no under-65 Medigap option, so getting the one-time window right at 65 matters), SHIP counseling from the Arizona Department of Economic Security, the Medicare Savings Programs that AHCCCS runs with no asset test, and the Arizona Long Term Care System (ALTCS), and gives you their direct phone, email, and text, so you never start over with a stranger in a call queue.

Not freely, and this is exactly where Arizonans get caught. Arizona has no Medigap birthday rule and no annual guaranteed-issue window, so it follows the federal rules: your one guaranteed six-month Medigap Open Enrollment Period starts when you are 65 and enrolled in Part B, and after it closes an insurer can use medical underwriting to raise your rate or turn you down (outside a few narrow federal guaranteed-issue situations). Arizona also does not require insurers to offer Medigap to beneficiaries under 65 who have Medicare because of a disability, and in practice no insurer sells under-65 Medigap in the state; those beneficiaries get a fresh guaranteed-issue window when they turn 65, and Arizona law bars charging them a higher premium for having qualified by disability. Timing that one-time window, and knowing when underwriting applies, is precisely where an advocate helps.

Those run through AHCCCS (Arizona's Medicaid) and its long-term care arm, the Arizona Long Term Care System (ALTCS). ALTCS is a managed long-term care program, and its Self-Directed Attendant Care option lets a member hire and direct a family caregiver, an adult child, sibling, or other relative, for attendant and personal care so a person can stay home instead of entering a facility; unlike some states, Arizona generally does not pay a spouse, and the caregiver has to work through a contracted agency and complete training. Our advocacy is billed through Medicare, so we focus on the Medicare side: bills, appeals, appointments, coverage questions. For dual-eligible families that split works well: you manage the caregiving and the ALTCS paperwork, and your parent's advocate handles the Medicare paperwork.

SHIP (Arizona's State Health Insurance Assistance Program, reachable at 1-800-432-4040) is the state's free Medicare counseling service, run by the Arizona Department of Economic Security (Division of Aging and Adult Services) with trained, commission-free volunteer counselors, and it is excellent for one-off questions. Understood Care is different: a dedicated advocate who does the work itself, makes the calls, files the appeals, untangles the bills, and stays with you month after month, covered by Medicare. The two are complementary, and we often point our own members to SHIP counselors for enrollment-season plan comparisons.

In Arizona we are in-network for Original Medicare (traditional fee-for-service Medicare); UnitedHealthcare Medicare Advantage plans (~48% of Arizona MA members). Together that covers roughly 73.5% of Arizona's Medicare beneficiaries. Market-share data: 2024-2025. Plan networks change, so we confirm exactly what your plan covers before any work begins - no surprise bills.