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

Yes, all 95 counties. The service is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Memphis and West Tennessee as it does in Nashville and Middle Tennessee, over in Knoxville and East Tennessee, down in Chattanooga and the southeast, and up in the Tri-Cities of Northeast Tennessee. 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 Tennessee's programs and rules: the federal Medigap letter plans and the fact that Tennessee, unlike Alabama and many states, does require insurers to sell Medigap to people under 65 on Medicare because of a disability, free counseling from TN SHIP (the Tennessee State Health Insurance Assistance Program, administered by the Tennessee Department of Disability and Aging), the Medicare Savings Programs TennCare runs with income and asset limits, and CHOICES Consumer Direction, the self-directed path where a family member such as an adult child 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.

Tennessee uses the standard federal Medigap letter plans (Plans A, B, C, D, F, G, K, L, M, and N, plus high-deductible F and G), so every carrier's Plan G covers the same benefits and you can compare them on price and service. Your one guaranteed-issue window is the six months after you enroll in Medicare Part B at 65, when an insurer cannot turn you down or charge more for your health. Tennessee has no birthday rule and no annual guaranteed-issue window, so a switch outside that window can be medically underwritten, which is why timing matters. Tennessee is more protective than many states in one way: under a 2011 state law, any insurer that sells Medigap to people 65 and older must also offer the same plans to people under 65 who have Medicare because of a disability, with the same six-month open-enrollment window (though insurers may charge the under-65 group higher premiums). Knowing which plan fits your health and budget, and when you can move without underwriting, is exactly where an advocate helps. All of it is regulated by the Tennessee Department of Commerce and Insurance.

Those run through TennCare (Tennessee Medicaid), not Medicare. Tennessee's self-directed option is CHOICES Consumer Direction, the self-directed model within TennCare CHOICES: the member becomes the employer of their own workers (with Consumer Direct Care Network Tennessee acting as the fiscal employer agent), and in Tennessee a family member such as an adult child, sibling, or parent can be hired and paid to provide that care, though a spouse cannot be hired through the self-directed pathway. For adults 55 and older who need a nursing-home level of care there is PACE, but in Tennessee the only PACE program is Ascension Living Alexian PACE in Chattanooga, which serves Hamilton County only, not the whole state. 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 TennCare paperwork through your Area Agency on Aging and Disability, and your parent's advocate handles the Medicare paperwork.

TN SHIP (the Tennessee State Health Insurance Assistance Program, reachable at 1-877-801-0044) is administered by the Tennessee Department of Disability and Aging through the state's 9 Area Agencies on Aging and Disability, with trained counselors who take no commissions and sell nothing, and it is excellent for one-off questions; the statewide line at 1-866-836-6678 can point you to the nearest counselor. 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 TN SHIP for enrollment-season plan comparisons.

In Tennessee we are in-network for Original Medicare (traditional fee-for-service Medicare); UnitedHealthcare Medicare Advantage plans (~31% of Tennessee MA members); Aetna Medicare Advantage plans (~2% of Tennessee MA members). Together that covers roughly 64.4% of Tennessee's Medicare beneficiaries. Market-share data: 2025. Plan networks change, so we confirm exactly what your plan covers before any work begins - no surprise bills.