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

Yes, all 77 counties. The service is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Oklahoma City, Tulsa, Norman, Broken Arrow, Edmond, Lawton, Enid, Stillwater, Muskogee, Ardmore, 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 Oklahoma's programs like SHIP counseling from the Oklahoma Insurance Department, the Medicare Savings Programs SoonerCare runs, the ADvantage Waiver, and PACE, and gives you their direct phone, email, and text, so you never start over with a stranger in a call queue.

Yes, and this is where Oklahoma is more generous than many states. Since 1994, Oklahoma has required Medigap insurers to offer at least one Medicare Supplement policy (in practice, Plan A) to beneficiaries under 65 who have Medicare through disability, during a six-month open enrollment period that starts when you enroll in Part B. Since 2017 the premium for that under-65 plan cannot be set higher than the highest age-65 rate for the same plan. On top of that, Oklahoma has had a Medigap birthday rule since September 2023: every year, a 60-day window that begins on your birthday lets you switch to a policy of equal or lesser benefits with no medical underwriting, as long as you have not had a coverage gap longer than 90 days. Getting that timing right is exactly where an advocate helps.

Those are SoonerCare (Oklahoma Medicaid) programs. The ADvantage Waiver helps Oklahomans 65 and older who meet a nursing-facility level of care get personal care, home-delivered meals, skilled nursing, and other support so they can stay at home instead of in a facility. Its self-direction route, Consumer-Directed Personal Assistance Services and Supports (CD-PASS), lets you become the employer of record and pay a qualified relative such as an adult child or sibling as your personal services assistant (a spouse or legal guardian only in narrow, documented exceptions). PACE (Program of All-Inclusive Care for the Elderly) bundles all care for adults 55 and older at a nursing-facility level, with Oklahoma centers run by Valir PACE in Oklahoma City and Shawnee, Cherokee Elder Care in Tahlequah, and LIFE PACE in Tulsa. 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 (Oklahoma's Senior Health Insurance Counseling Program, reachable at 1-800-763-2828), is Oklahoma's free Medicare counseling service, run by the Oklahoma Insurance Department 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 Oklahoma we are in-network for Original Medicare (traditional fee-for-service Medicare); UnitedHealthcare Medicare Advantage plans (~51% of Oklahoma MA members); Humana Medicare Advantage plans (~25% of Oklahoma MA members). Together that covers roughly 90.3% of Oklahoma'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.