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 Helping you understand your benefits — Understood Care?

Understood Care advocates help with helping you understand your benefits — understood care 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.

Understood Care is a virtual patient-advocacy service for Medicare members. Unlike case management or brokers, our advocates cover claims, appeals, and care. Compared to helplines, it is one-to-one.

Helping you understand your benefits

Video · 2:33 · hosted by Deborah Hall

Watch on YouTube Subscribe

Transcript

Auto-generated from the video, lightly edited for readability.

Not everybody knows. Do you know what your deductible is?

What your co- insurance rate is? If you have regular Medicare, normally the Medicare annual deductible goes up every single year.

And what that means is that if you have traditional only, you have to pay that amount. I believe it's $200 and something dollars first every year before Medicare will then pick up and pay the 80%. Medicare is considered what they call an indemnity plan, meaning it's it pays on an 80% 20% basis.

However, that is not 20% of the provider's build rate. They don't build your insurance the amount that they're going to get reimbursed. What they bill is called the build rate. the difference between those two amounts if it is a Medicare provider gets adjusted off and you are not responsible to pay that.

So you're only responsible to pay 20% of what the provider is paid. And a lot of people don't know that.

What we do at Understood care, we compare a bill you may get with your explanation of benefits or the things you get from your insurance company that say this is not a bill. We compare the two. Then we take over. We call the doctor's office. We explain why you don't owe that amount and then make sure that it's adjusted off so no further action is taken.

For Medicare Advantage plans, a lot of times you have a co-ay which is a set amount like if you go to your primary care, it could be zero, it could be $10, it could be $20. Now, a lot of these plans also have a deductible and a co insurance amount for services outside of a physician's office.

What we do, we call or we go on to your insurance's online portal and we look up your benefits for whatever service you're interested in and then we break it down for you into a language that's easily understandable so that the next time you have to go get a test done or go to your doctor's office, you know exactly what your coverage is. So, you're not going to come across any surprises when you're at that facility.

We help break down your benefits and make sure that you're receiving what you're supposed to based on your coverage, but also that you're not getting build or paying for something you're not supposed to. >>

← All videos

Helping you understand your benefits

Transcript

More on this topic