Three doors, all worth knowing. For free counseling on plans, enrollment, and Medicare Savings Program applications, SHIINE (Senior Health Information and Insurance Education) at 1-888-854-5321. For local services such as in-home help, meals, caregiver support, and Structured Family Caregiving, Dakota at Home, South Dakota's aging and disability resource center, at 1-833-663-9673, which connects you with providers serving Oglala Lakota County, or the national Eldercare Locator at 1-800-677-1116. And for one dedicated advocate who does the ongoing work with you, bills, denials, appointments, and benefits, Understood Care, covered by Medicare for most members: call (646) 904-4027 or get started online.

Yes. Medicare has paid for professional healthcare navigation (Principal Illness Navigation and Community Health Integration services) since January 2024. Part B covers about 80% and a Medigap plan typically covers the rest. We check your coverage and tell you exactly what, if anything, you will owe before your first session.

Per CMS enrollment data for 2025, Oglala Lakota County had 1,403 Medicare beneficiaries: 78 on Medicare Advantage plans (5.6%) and 1,325 on Original Medicare, with about 460 dual-eligible for both Medicare and Medicaid. Understood Care advocates work with both: Original Medicare covers it, and we confirm Medicare Advantage coverage plan by plan before any work begins.

Per the US Census Bureau's American Community Survey, about 174 of Pine Ridge's 2,480 residents are 65 or older (7%), within a county of roughly 961 seniors (Oglala Lakota County). Most become Medicare-eligible at 65, and every one of them has the same federal benefits an advocate helps put to work.

No. Understood Care is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Pine Ridge as anywhere else in South Dakota's 66 counties. When the right specialist means hours on the road, an advocate you can reach without the trip is often the practical option; if leaving home is hard, that is exactly the situation the service is built for.

Advocates work virtually and are matched to you, not to a zip code. You get one dedicated advocate with their direct phone, email, and text (One Advocate, For Life), and they work with South Dakota's programs, free SHIINE counseling, the state's under-65 Medigap open enrollment, the Medicare Savings Programs, Medicaid home care through the HOPE Waiver, Structured Family Caregiving, and the local services that apply in Oglala Lakota County.

For in-home care through South Dakota Medicaid, the main path for older adults is the HOPE Waiver (Home and Community-Based Options and Person-Centered Excellence), for people 65 and older, or 18 and older with a qualifying disability, who need a nursing home level of care, within Medicaid's income and resource limits. Its Structured Family Caregiving service pays a stipend, with coaching, to a principal caregiver who lives with the participant. For people who do not qualify for Medicaid, the Department of Human Services' Division of Long Term Services and Supports offers state in-home services such as homemaker help, personal care, respite, and meals to people 60 and older, or 18 and older with a disability, who cannot get the same service through another program, including in Oglala Lakota County; a copay may apply. South Dakota has no PACE program. To start, call Dakota at Home at 1-833-663-9673. Families we serve in Winner, Rosebud & Pine Ridge use these programs. Our advocacy is billed through Medicare, so for dual-eligible families the split works well: you run the caregiving, and your parent's advocate handles the Medicare side.

In South Dakota we are in-network for Original Medicare (traditional fee-for-service Medicare). Together that covers roughly 64% of South Dakota's Medicare beneficiaries. Market-share data: 2024. Plan networks change, so we confirm exactly what your plan covers before any work begins.