Patient Advocate Services in Arkansas, 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 Arkansas members pay $0. We confirm exactly what your coverage looks like before your first session, and there are no surprise bills.

Yes, all 75 counties. The service is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Little Rock, Fort Smith, Fayetteville, Springdale, Rogers, Bentonville, Jonesboro, North Little Rock, Conway, Hot Springs, Pine Bluff, Texarkana, 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 Arkansas's programs like Arkansas SHIIP counseling from the Arkansas Insurance Department, the Medicare Savings Programs that Arkansas DHS runs, the ARChoices in Homecare waiver, and the IndependentChoices paid-caregiver option, and gives you their direct phone, email, and text, so you never start over with a stranger in a call queue.

Partly, and the details matter. Federal law does not guarantee Medigap to people who qualify for Medicare under 65 through disability, but since July 2018 Arkansas requires every insurer that sells Medicare Supplement policies here to offer at least one plan to under-65 disability beneficiaries on a guaranteed-issue basis. Almost all insurers offer only Plan A (the most basic), and Arkansas does not require them to use the same premium as 65-year-olds, so the price is often much higher. When you turn 65, a fresh six-month Medigap Open Enrollment Period opens for every plan at standard rates, so timing that window is where an advocate helps most. Arkansas has no annual birthday rule, so there is no yearly do-over.

No. A handful of states (California, Oregon, and a few others) let you switch Medigap plans each year around your birthday with no health questions. Arkansas is not one of them. In Arkansas your guaranteed right to buy any Medigap plan without medical underwriting is essentially the one-time six-month Open Enrollment Period that starts when you are 65 and enrolled in Part B; after it closes, insurers can use medical underwriting on most applications. That makes getting the first decision right unusually important, and it is exactly the kind of deadline an advocate tracks for you.

Those are Arkansas Medicaid programs. ARChoices in Homecare is the state's Home and Community-Based Services waiver: it helps adults 21 and older who meet a nursing-facility level of care get personal care, homemaker help, respite, home-delivered meals, and home modifications so they can stay home instead of entering a facility. ARChoices has a waiting list in some counties, and your application date sets your place in line. IndependentChoices is the self-direction option: it lets the person receiving care hire and pay their own caregiver, including an adult child, sibling, other relative, or friend, though a spouse or legal guardian cannot be paid, and a financial management agency handles the payroll and taxes. Arkansas also has PACE (Program of All-Inclusive Care for the Elderly) for adults 55 and older at a nursing-facility level of care, but the footprint is limited, currently Northwest Arkansas PACE of the Ozarks (Washington Regional) in the Northwest Arkansas area, so it depends on living in a PACE service area. 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 your parent's advocate handles the Medicare paperwork.

Arkansas SHIIP (the Senior Health Insurance Information Program, reachable at 1-800-224-6330), is Arkansas's free Medicare counseling service, run by the Arkansas Insurance Department with trained, commission-free counselors, and it is excellent for one-off questions like comparing plans during Open Enrollment. 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 Arkansas SHIIP counselors for enrollment-season plan comparisons.

In Arkansas we are in-network for Original Medicare (traditional fee-for-service Medicare); UnitedHealthcare Medicare Advantage plans (~36% of Arkansas MA members); Aetna Medicare Advantage plans (~9% of Arkansas MA members). Together that covers roughly 75.3% of Arkansas's Medicare beneficiaries. Market-share data: 2024. Plan networks change, so we confirm exactly what your plan covers before any work begins - no surprise bills.