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

Yes, all 64 counties. The service is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Denver and the Front Range as it does in Colorado Springs and the Pikes Peak region, down in Pueblo and southern Colorado, up in the Boulder Valley and Northern Colorado, and out across the Western Slope, the mountain resort towns, and the Eastern Plains. 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 Colorado's programs and rules: the federal Medigap letter plans and Colorado's requirement that insurers also sell Medigap to people under 65 on Medicare because of a disability, free counseling from Colorado SHIP (housed within the Colorado Division of Insurance), the Medicare Savings Programs Health First Colorado runs, and CDASS, the self-directed path where a family member can be hired to provide care, and gives you their direct phone, email, and text, so you never start over with a stranger in a call queue.

Colorado uses the standard federal Medigap letter plans (Plans A, B, C, D, F, G, K, L, M, and N, plus high-deductible F and G), so every carrier's Plan G covers the same benefits and you can compare them on price and service. Your one guaranteed-issue window is the six months after you enroll in Medicare Part B at 65, when an insurer cannot turn you down or charge more for your health. Colorado has no birthday rule and no annual guaranteed-issue window, so a switch outside that window can be medically underwritten, which is why timing matters. Colorado does something many states do not: it requires insurers to sell Medigap to people under 65 who have Medicare because of a disability (premiums can be higher for under-65 enrollees, and the state regulates the rating), and it gives those beneficiaries a fresh six-month guaranteed-issue window when they turn 65. Knowing which plan fits your health and budget, and when you can move without underwriting, is exactly where an advocate helps. All of it is regulated by the Colorado Division of Insurance under Regulation 4-3-1.

Those run through Health First Colorado (Colorado's Medicaid program), not Medicare. Colorado's self-directed option is CDASS (Consumer-Directed Attendant Support Services): the member, or their authorized representative, is the employer and hires, trains, and pays their own attendants from an allocated budget, and in Colorado a family member such as an adult child can be hired and paid to provide that care. In-Home Support Services (IHSS) is the related self-directed model, and for adults 55 and older who need a nursing-home level of care there is PACE (InnovAge, Rocky Mountain PACE, TRU PACE, and Volunteers of America Senior CommUnity Care, in their service areas). 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 Health First Colorado paperwork through your Case Management Agency, and your parent's advocate handles the Medicare paperwork.

Colorado SHIP (Colorado's State Health Insurance Assistance Program, reachable at 1-888-696-7213) is housed within the Colorado Division of Insurance with trained, commission-free counselors at 17 local sites, and it is excellent for one-off questions; your Area Agency on Aging can point you to the nearest one. 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 Colorado SHIP for enrollment-season plan comparisons.

In Colorado we are in-network for Original Medicare (traditional fee-for-service Medicare); UnitedHealthcare Medicare Advantage plans (~47% of Colorado MA members); Aetna Medicare Advantage plans (~6% of Colorado MA members). Together that covers roughly 75.4% of Colorado's Medicare beneficiaries. Market-share data: 2025. Plan networks change, so we confirm exactly what your plan covers before any work begins - no surprise bills.