Michigan 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 Michigan members pay $0. We confirm exactly what your coverage looks like before your first session, and there are no surprise bills.

Yes, all 83 counties. The service is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Detroit, Grand Rapids, Warren, Sterling Heights, Ann Arbor, Lansing, Flint, Kalamazoo, the Great Lakes Bay region, up north around Traverse City, and across the Upper Peninsula. 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 Michigan's programs and rules, the state's federal Medigap timing (Michigan has no birthday rule, so getting the one-time window right at 65 matters) and its narrow under-65 disability Medigap mandate, MMAP counseling (Michigan's SHIP), the Medicare Savings Programs that MDHHS runs with an income and asset test, and the paid-family-caregiving paths (the Home Help program and the MI Choice waiver), 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 Michiganders get caught. Michigan 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). Michigan does add one protection some states lack: insurers that also sell major medical coverage must offer at least Medigap Plan A and Plan G on a guaranteed-issue basis to beneficiaries under 65 who qualify through disability, though they may charge a higher premium and only a few carriers meet that trigger. Timing that one-time window, and knowing when underwriting applies, is precisely where an advocate helps.

Those run through MDHHS (Michigan's Medicaid) rather than Medicare. Michigan's Home Help program pays an authorized family caregiver, an adult child, another relative, or a trusted friend (but not a spouse), directly through MDHHS to provide personal care so a person can stay home. The MI Choice waiver is the broader home-and-community-based program for people who need a nursing-facility level of care, and its self-determination option can pay a spouse. 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 Medicaid paperwork, and your parent's advocate handles the Medicare paperwork.

MMAP (the Michigan Medicare/Medicaid Assistance Program, Michigan's SHIP, reachable at 1-800-803-7174) is the state's free Medicare counseling service, delivered through the Michigan Department of Health and Human Services, delivered through the state's Area Agencies on Aging 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 MMAP counselors for enrollment-season plan comparisons.

In Michigan we are in-network for Original Medicare (traditional fee-for-service Medicare); UnitedHealthcare Medicare Advantage plans (~26% of Michigan MA members); Humana Medicare Advantage plans (~20% of Michigan MA members); Priority Health Medicare Advantage plans (~18% of Michigan MA members). Together that covers roughly 78% of Michigan'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.