Medicare    Patient Advocacy Services

Yes! As of 2024, Medicare covers Principal Illness Navigation (PIN) and Community Health Integration (CHI) services under new billing codes. Umbra Health Advocacy can now bill Medicare directly for these comprehensive advocacy services, so the navigation support you need is covered like any other Medicare-covered service.

No referral needed! Umbra Health Advocacy has doctors and nurse practitioners who can meet with you to understand your needs. If you’re eligible, We’ll match you with a dedicated patient advocate who can help you navigate your healthcare headaches.

We handle everything in-house—first we verify your Medicare eligibility, then you'll have an appointment with one of our supervising providers, and finally you'll be matched with a dedicated advocate.

Medicare covers a wide range of navigation services. If you have a serious medical condition, or other barriers to getting the care you need, we can help you with things like:

• Coordinating your care
• Communicating with your doctors
• Scheduling and preparing for appointments
• Managing medications
• Resolving insurance issues and medical bills
• Connecting you with community resources to help with food, housing, transportation, and other needs 
• And more!

We can provide covered navigation services if you have Original Medicare (Parts A and B) and have been diagnosed with a serious, high-risk medical condition or if you’re facing barriers (like issues with housing, food, or transportation) that make it hard to manage your health or get the care you need. Schedule an initial visit with one of our doctors to find out if you’re eligible for navigation services.

If you are in a skilled nursing facility, nursing home, or dementia care facility, we can’t provide Medicare-covered services. But, you can still hire our team of private advocates if you need help navigating any of those settings. Those with multiple serious conditions can receive navigation services for each condition.

After you meet your Medicare Part B deductible, you pay 20% of the Medicare-approved amount. If you have a Medigap (Supplement) plan, you may not pay anything at all.  We bill Medicare and any supplement plan you may have and bill you only what Medicare requires.

Even if you do not qualify for Medicare-covered patient advocacy services, we can still connect with you with a private advocate that can assist with all of the same things. These advocates charge around $150-$200 per hour depending on case complexity.

During this visit with one of our doctors or other healthcare providers, we'll review your medical history, learn more about your current health challenges, and assess your needs for advocacy services. This visit establishes your eligibility for Medicare-covered navigation services and lets us match you with a patient advocate who will help you with a personalized plan to resolve your healthcare challenges.

After your first visit with us, we match you with a patient advocate who specializes in navigating the healthcare system. Your advocate will work with you to help you get the care you need. Your advocate will support you as long as you need them.

Absolutely! Medicare's Community Health Integration (CHI) benefits specifically cover help with  things like food insecurity, housing issues, utility assistance, transportation problems, and other daily life challenges that can get in the way of your healthcare. Your advocate can help you apply for programs and resources to address these needs.

Yes! Your advocate can support you with comprehensive medication management. They can make you an up-to-date medication list, explain what each medication does, organize dosing schedules, track refill dates, identify potential side effects, and provide tips for remembering to take medications properly.

Your advocate can go with you to medical appointments by phone or video. They can take notes, help translate medical terms, make sure all your questions get answered, and give you recaps in plain English so you understand exactly what happened and what your next steps are.

You can get advocacy services for as long as you need them. If you stay with your advocate for a full year, we’ll schedule another visit with the doctor you met at first so they can confirm that the services still make sense for you. 

At this time, we are only working with Original Medicare. But we are adding new plans all the time, so if you have Medicare Advantage, still let us know. We’ll see if we can work with your plan. 

Yes! Your advocate can review medical bills for errors, explain what Medicare and any other insurance covers, help file appeals for denied claims, track paperwork through resolution, and make sure you're getting all the benefits you're entitled to.

Absolutely! Your advocate can help you set up and learn to use patient portals, telehealth applications, blood pressure monitors, wearable devices, and other health technology. We'll also troubleshoot technical issues and make sure you're comfortable using these tools on your own. But we’ll stand by to support you if you need us.

Call us at 332-699-6778 or request a free consultation. 

We'll verify your Medicare eligibility, schedule your visit with one of our doctors or other healthcare providers, and then match you with an advocate who specializes in navigating the healthcare system.