Patient Advocate Services in Minnesota, 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 Medicare supplement (Medigap) plan typically covers the rest, so most Minnesota members pay $0. We confirm exactly what your coverage looks like before your first session, and there are no surprise bills.

Yes, all 87 counties. The service is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Minneapolis and St. Paul as it does in Rochester and southeastern Minnesota, up in Duluth and the Northland and the Iron Range, over in St. Cloud and central Minnesota, down in Mankato and the south, and out in Moorhead and the Red River Valley. 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 Minnesota's programs and rules: the fact that Minnesota is one of only three states that designs its own Medigap plans (a Basic or Extended Basic plan you build up with riders, not the federal letter plans) and grants the six-month Medigap open enrollment to people under 65 on Medicare because of a disability, free counseling from the Senior LinkAge Line (Minnesota's State Health Insurance Assistance Program, run by the Minnesota Board on Aging), the Medicare Savings Programs the Minnesota Department of Human Services runs with income and asset limits, and CDCS and CFSS, the self-directed paths where a family member, including a spouse, 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.

Minnesota is unusual: it is one of only three states (with Massachusetts and Wisconsin) that received a federal waiver to standardize Medicare supplement insurance its own way. Instead of the federal letter plans (A through N), Minnesota sells a Basic plan and an Extended Basic plan that you build up with optional riders, plus Medicare SELECT network versions; versions of Plans K, L, M, N, and high-deductible F are also available. Your core guaranteed-issue window is the six months after you enroll in Medicare Part B, and Minnesota is more protective than most states here: that window is granted to anyone who enrolls in Part B regardless of age, so people under 65 who have Medicare because of a disability get it too, with a second six-month window at 65. Minnesota has no birthday rule and does not currently allow year-round switching, though a 2023 state law adds an annual fall guaranteed-issue window (aligned with the October 15 to December 7 Medicare Open Enrollment) that is taking effect in 2026. Because every Minnesota plan starts from the same Basic design, comparing carriers is really about riders and price, which is exactly where an advocate helps. All of it is regulated by the Minnesota Department of Commerce.

Those run through Medical Assistance (Minnesota Medicaid), not Medicare. Minnesota's self-directed options are Consumer Directed Community Supports (CDCS) and, since October 1, 2024, Community First Services and Supports (CFSS), which replaced the old PCA and Consumer Support Grant programs: you get a budget and hire your own workers, and in Minnesota that worker can be a family member, and unlike many states that includes a spouse or the parent of a minor. A financial management services provider handles the payroll and taxes. Minnesota does not currently have a PACE program (a 2024 law directs the state to build one); for dual-eligible seniors it instead runs Minnesota Senior Health Options (MSHO), integrated Medicare and Medical Assistance plans. 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 Medical Assistance paperwork through your county or Area Agency on Aging, and your parent's advocate handles the Medicare paperwork.

the Senior LinkAge Line (Minnesota's State Health Insurance Assistance Program, reachable at 1-800-333-2433) is run by the Minnesota Board on Aging through the state's seven Area Agencies on Aging, with trained counselors who take no commissions and sell nothing, and it is excellent for one-off questions and plan comparisons 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 the Senior LinkAge Line for enrollment-season plan comparisons.

In Minnesota we are in-network for Original Medicare (traditional fee-for-service Medicare); UnitedHealthcare Medicare Advantage plans (~11% of Minnesota MA members); Aetna Medicare Advantage plans (~4% of Minnesota MA members). Together that covers roughly 49% of Minnesota'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.