What does Understood Care do?

Understood Care provides one-to-one patient advocacy for Medicare members and caregivers, including help with benefits, appointments, care coordination, medical bills, insurance questions, denials, and paperwork.

How can a patient advocate help with North Carolina Patient Advocates | Covered by Medicare?

Understood Care advocates help with north carolina patient advocates | covered by medicare by explaining options, organizing paperwork, coordinating care, and helping families understand Medicare coverage and next steps.

Does Understood Care work with Medicare patients?

Yes. Understood Care focuses on Medicare patients and their families, with advocates who understand Medicare, Medicare Advantage, care coordination, coverage rules, billing issues, and appeal pathways.

Will I have a dedicated patient advocate?

Yes. This is Understood Care's first commitment: One Advocate, For Life. Every patient is matched at intake with one dedicated patient advocate and given that advocate's personal phone number, email, and text. Patients do not go into a call queue. The assignment is permanent: even after Understood Care has completed all tasks for a patient, they keep the same advocate. If a patient needs us again six months later, they will still have the same advocate.

How often will my Understood Care advocate communicate with me?

Understood Care follows a frequent-communication procedure with both active and follow-up patients. While the advocate is actively working on a patient's case, they communicate every 7 days by phone, text, or email with progress information. Once the patient has been helped with everything they needed, the case moves to a follow-up cadence: the advocate still checks in every month.

Does Understood Care use AI?

Yes. Understood Care is AI-supported. AI tools help every advocate surface programs, benefits, and services tied to where the patient lives, with the most up-to-date eligibility information. The result is that patients and advocates get the resources they need faster, while the human advocate stays in the loop on every patient's case.

North Carolina Patient Advocates | Covered by Medicare

Cities we serve

North Carolina Cities We Serve

The state's major metros and regional hubs, 54 cities across every corner of North Carolina, served virtually by the same advocates. Prefer the raw data? See North Carolina Medicare by the numbers.

Am I covered?

How Medicare Pays for Your Advocate in North Carolina

Original Medicare

Since January 2024, Medicare covers professional healthcare navigation (Principal Illness Navigation and Community Health Integration). Part B pays about 80%; a Medigap plan typically covers the rest, so most members pay $0.

Medicare Advantage

A majority of North Carolina's Medicare beneficiaries, 56.9% in 2025, are enrolled in a Medicare Advantage plan rather than Original Medicare. Acceptance varies plan by plan. Tell us which plan you have and we confirm what it covers before any work begins. No surprise bills, ever.

Not sure what you have?

That is a normal place to start. Read your red-white-and-blue card to us over the phone and we will explain your coverage in plain English, whether or not you sign up.

North Carolina is different

Four North Carolina Rules and Programs Worth Knowing

Medicare is federal, but the rules and assistance programs around it change at the state line. These four are specific to North Carolina, and your advocate works with them every week.

Medigap: one window at 65, plus a real under-65 right

Your six-month Medigap Open Enrollment Period begins the first month you are both 65 or older and enrolled in Part B, and it does not repeat. North Carolina has no birthday rule and no year-round switching, so miss that window and insurers can medically underwrite you. But North Carolina does something many states do not: state law (G.S. 58-54-45) requires insurers to offer Medigap Plans A, D, and G to beneficiaries under 65 who qualify through disability, a right that took effect January 1, 2020. Premiums for under-65 buyers can run higher, and a pre-existing-condition wait of up to six months may apply. Timing and plan choice are the whole game, which is exactly where an advocate earns their keep.

SHIIP: free state Medicare counseling in all 100 counties

North Carolina's State Health Insurance Assistance Program is the Seniors' Health Insurance Information Program (SHIIP), run by the NC Department of Insurance with trained, commission-free volunteers in all 100 counties. Statewide line: 1-855-408-1212. In 2024 SHIIP counseled more than 69,000 beneficiaries and saved them a combined $53 million. Great for one-off enrollment questions; we point our own members there during Open Enrollment.

Extra Help and the Medicare Savings Programs

Many North Carolinians qualify for federal Extra Help (the Part D Low-Income Subsidy) and for the Medicare Savings Programs, which NC Medicaid runs as QMB, SLMB, and QI to help cover Part B premiums and cost-sharing. Apply through your county Department of Social Services (DSS) or online at ePASS (epass.nc.gov). North Carolina expanded Medicaid in December 2023, which widened the door for many low-income seniors. Checking every one of these is standard advocate work, and most eligible seniors never claim them.

CAP/DA and PACE (Medicaid)

North Carolina's Medicaid alternatives to a nursing facility are CAP/DA (the Community Alternatives Program for Disabled Adults), a consumer-directed waiver that can pay a family member you choose, though typically not a spouse, to care for you at home, and PACE (Programs of All-Inclusive Care for the Elderly), which bundles Medicare and Medicaid for dual-eligible adults 55 and older near a provider site such as Wilmington or Asheville. Apply for CAP/DA through your county's CAP/DA case management entity (often the county DSS), and apply early: waitlists can run months to more than a year. These are Medicaid programs; for dual-eligible families we handle the Medicare side while you run the caregiving.

Go deeper

Medicare Help in North Carolina: SHIIP, CAP/DA, and PACE

The full, sourced guide to the North Carolina rules and programs your advocate works with.

How we work

Three Commitments, Kept in Writing

One Advocate, For Life

You are matched with one dedicated advocate and get their direct phone, email, and text. No call queue, no starting over. Even months after your case wraps up, the same person picks up.

AI-Supported, Human-Delivered

Behind your advocate, AI tools surface the North Carolina programs and benefits you actually qualify for, from the Medicare Savings Programs to county services, so answers come faster. A human stays in the loop on every case.

The 7-Day / 30-Day Cadence

While your case is active you hear from your advocate every 7 days. After it is resolved, they still check in every month. You are never left wondering what is happening.

North Carolina Questions, Answered

Does Medicare cover a patient advocate in North Carolina?

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

Do you serve all of North Carolina?

Yes, all 100 counties. The service is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Charlotte, Raleigh, Greensboro, Durham, Winston-Salem, Fayetteville, Wilmington, Asheville, and every rural county in between. There is no office to travel to.

Will my advocate actually be based in North Carolina?

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 North Carolina's programs like SHIIP, the Medicare Savings Programs, and the CAP/DA waiver and PACE, and gives you their direct phone, email, and text, so you never start over with a stranger in a call queue.

Can I switch my Medigap plan any time in North Carolina?

Not on your own timeline. Your one guaranteed six-month Medigap Open Enrollment Period begins the first month you are both 65 or older and enrolled in Part B, and it does not repeat. North Carolina has no birthday rule and no year-round switching window, so after that window insurers can medically underwrite you. Where North Carolina goes beyond the federal floor is for people who came onto Medicare early: state law (G.S. 58-54-45) requires insurers to offer Medigap Plans A, D, and G to beneficiaries under 65 who qualify through disability, effective January 1, 2020. Because everything here turns on timing, this is exactly where an advocate helps.

Can you help with CAP/DA, PACE, and paid family caregiving?

Those are North Carolina Medicaid programs. CAP/DA (the Community Alternatives Program for Disabled Adults) is a consumer-directed waiver that can pay a family member you choose to care for you at home instead of a nursing facility, and PACE bundles Medicare and Medicaid care for dual-eligible adults 55 and older near a provider site. 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 waiver caregiving, and your parent's advocate handles the Medicare paperwork.

What is the difference between Understood Care and SHIIP?

SHIIP, the Seniors' Health Insurance Information Program (1-855-408-1212), is North Carolina's free Medicare counseling service, run by the NC Department of Insurance with trained volunteers in all 100 counties, 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 SHIIP counselors for enrollment-season plan comparisons.

North Carolina Patient Advocates, Covered by Medicare

North Carolina Cities We Serve

Charlotte Metro

Research Triangle

Piedmont Triad

Eastern North Carolina

Coastal North Carolina

Western North Carolina

Sandhills