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

Yes, all 88 counties. The service is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Columbus, Cleveland, Cincinnati, Toledo, Akron, Dayton, Youngstown, Canton, 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 Ohio's programs like OSHIIP counseling from the Ohio Department of Insurance, the Medicare Savings Programs, the PASSPORT waiver, MyCare Ohio, and PACE, and gives you their direct phone, email, and text, so you never start over with a stranger in a call queue.

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. Ohio has no birthday rule and no year-round switching window, so after that window insurers can medically underwrite you. Ohio is also one of only a few states that does not require insurers to sell a Medigap policy to Medicare beneficiaries under 65 (a bill to change that, HB 24, was still in committee in 2026), so timing at 65 matters even more here. Because everything turns on that window, this is exactly where an advocate helps.

Those are Ohio Medicaid programs. PASSPORT is Ohio's Medicaid home and community-based waiver for adults 60 and older who need a nursing-facility level of care but want to stay home, and its consumer-directed options let you choose and hire your own caregiver, including a qualified family member. MyCare Ohio is the state's managed-care program that combines Medicare and Medicaid for dual-eligible adults. PACE (Program of All-Inclusive Care for the Elderly) bundles all care for dual-eligible adults 55 and older at a nursing-facility level, with Ohio centers in Cleveland and Cincinnati and a state expansion underway. 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.

OSHIIP (the Ohio Senior Health Insurance Information Program, reachable at 1-800-686-1578), is Ohio's free Medicare counseling service, run by the Ohio 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 OSHIIP counselors for enrollment-season plan comparisons.