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

Yes, all 92 counties. The service is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Indianapolis, Fort Wayne, Evansville, South Bend, Carmel, Fishers, Bloomington, Gary, Hammond, Muncie, 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 Indiana's programs like SHIP counseling from the Indiana Department of Insurance, the Medicare Savings Programs, the PathWays to Aging Waiver, Indiana PathWays for Aging, and PACE, and gives you their direct phone, email, and text, so you never start over with a stranger in a call queue.

Now, yes, which is new. Your one guaranteed six-month Medigap Open Enrollment Period still begins the first month you are both 65 or older and enrolled in Part B. But as of January 1, 2025, Indiana law (Senate Enrolled Act 215) gives Medicare beneficiaries under 65 who qualify through disability or ESRD a guaranteed-issue right to buy a Medicare Supplement policy, which Indiana did not broadly offer before. Plans A, B, and D must be sold at the same premium a 65-year-old pays in their guaranteed-issue period; other plans can cost more. Indiana has no year-round switching and no birthday rule, so the windows still matter, which is exactly where an advocate helps.

Those are Indiana Medicaid programs. Indiana PathWays for Aging is the state's managed long-term services and supports program for Hoosiers 60 and older on Medicaid, including people who also have Medicare, and it launched July 1, 2024. Its home-and-community services run through the PathWays to Aging Waiver (the successor to Indiana's Aged & Disabled Waiver), and the Structured Family Caregiving option can pay a qualified family caregiver who lives with the person. PACE (Program of All-Inclusive Care for the Elderly) bundles all care for adults 55 and older at a nursing-facility level, with Indiana centers around Indianapolis, Fort Wayne, Lafayette, and Northwest Indiana. 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.

SHIP (Indiana's State Health Insurance Assistance Program, reachable at 1-800-452-4800), is Indiana's free Medicare counseling service, run by the Indiana Department of Insurance with trained, commission-free 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 Indiana we are in-network for Original Medicare (traditional fee-for-service Medicare); UnitedHealthcare Medicare Advantage plans (~30% of Indiana MA members); Humana Medicare Advantage plans (~24% of Indiana MA members); Anthem Blue Cross and Blue Shield (Elevance) Medicare Advantage plans (~20% of Indiana MA members); Aetna Medicare Advantage plans (~6% of Indiana MA members). Together that covers roughly 90% of Indiana'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.