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Navigating Medicare: 5 Allies Who Can Help


Enrolling in Medicare for the first time or starting coverage under a new plan? It might bring you back to that first day starting a new job. You knew some of the basics, but you also knew there was a lot more to learn. More than likely, you got help from colleagues who have been around for a while and helped show you the ropes.

Don’t worry. With Medicare, you have the same kind of knowledgeable support. You’ve got a team on your side that can help make navigating the health care system easier. Goodbye hassles, hello helpers.

Here are five allies in your corner:

1. Your Primary Care Physician (PCP). This physician is the “go-to” doctor who provides guidance on your health care needs, taking the time to really get to know you, your medical history, and your health goals. Think of your PCP as the “quarterback” of your medical team – someone who can take charge of knowing the ins and outs of your health status and help drive decisions to get you on the right track and keep you there.

2. A caregiver. Perhaps the “unsung hero” of your health care team, caregivers are the ones you know you can count on – the ones you know are there to offer support and care for you, whenever you need it. Whether a family member, neighbor, friend or professional assistant, these are the people in your life who help you along the way. Their assistance can span everything from bringing you to appointments or getting prescriptions filled to making meals or offering emotional support.

3. Your pharmacist. This team member keeps an eye on the medications you take – prescription and over-the-counter – to make sure they work safely together. Your pharmacist is a great person to talk with about how medications are making you feel and answer any questions you have on topics including what side effects to expect, what to do if you miss a dose, or how to store your meds.

4. An insurance agent. Original Medicare. Medicare Supplement. Part D. Medicare Advantage. There are many options and decisions to make when it comes to your Medicare coverage, and a licensed insurance agent can help you find the right plan, or plans, for you. Once you’ve selected a plan, you can also always call your agent to ask questions if your heath or coverage needs change or if your plan changes from year to year. Agents provide their services at no cost to you so check out licensed agents in your area.

5. Your insurance company. Within your insurance company, there are more people than you likely realize who are working hard on your behalf to ensure you get the medical care and support you need. Insurers can offer tools, resources and support that can help you live a healthier life. UnitedHealthcare’s Navigate4Me program, for instance, shows how a company can be a valued team member and ally, invested in your health.

Exploring Navigate4Me(TM)

Introduced by UnitedHealthcare last year, Navigate4Me is a program that provides individualized support to Medicare Advantage members facing complex health issues, including congestive heart failure or diabetes, or multiple chronic conditions, as well as those who experience sudden health events like a hip or knee replacement.

The program partners eligible individuals with a health navigator who serves as their single point of contact to provide personalized, one-on-one guidance. By empowering the navigator to take charge of complicated care situations, people can focus their time and energy on their health.

Health navigators spend time talking with individuals, their families and caregivers to fully understand all of the factors that play a role in someone’s overall health, asking questions on subjects such as:

  • Medical needs: What ongoing conditions do they have? What doctors do they see and what services are they receiving? What else do they need to help improve or maintain their health?
  • Social support: Who do they interact with on a daily basis? Do they have family members or friends around? What support do they have in their community?
  • Emotional support: How are they feeling? Are they happy, concerned, lonely? Are they showing signs of depression?
  • Financial resources: Do they have the money to pay for their medications and food? Do they qualify for programs that can provide these items at lower cost?

Using this information, navigators develop a personalized care plan for each person, and keep in touch with them and their caregivers to address any concerns, monitor progress and identify issues along the way. Navigators also have an interdisciplinary team of experts behind them, ready to step in when needs change or questions arise that may be best addressed by an expert such as a behavioral health specialist or pharmacist.

In addition to being the contact point for medical and social support needs, health navigators help people with administrative issues, from resolving questions about claims to identifying additional resources for which members may be eligible.

“People with complex health needs don’t need to face the health care system alone,” said Dr. Efrem Castillo, chief medical officer of UnitedHealthcare Medicare & Retirement. “With their health navigator, they have a partner and trusted resource who makes it easier for them to get the care and support they need.”

Navigate4Me is already making a positive impact on the lives of the 140,000 people already enrolled in the program. Many have provided feedback on how much they value their relationship with their navigator and the support they provide.

UnitedHealthcare intends to expand Navigate4Me to support additional health conditions and unexpected health events, helping to simplify the process of navigating the health care system for even more people – when they need it most.


Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan’s contract renewal with Medicare.

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