Care navigation in Pennsylvania
One dedicated navigator for your family in Pennsylvania. Medicare may cover it.
If you or a parent in Pennsylvania has Medicare and the practical side of care is getting hard, appointments, referrals, equipment, benefits, support at home, a Navigate Care navigator helps coordinate all of it with the doctors you already have.
Prefer to speak with someone? Call 628 234 2273 (NAV-234-CARE). Free initial call. No obligation.
What we help with
Your doctor recommends the care. We help you follow through.
Appointments and referrals
We help coordinate appointments, referrals, transportation and follow-ups so important care is not missed.
Medical equipment
We help you understand the steps for getting doctor-recommended walkers, wheelchairs and other medical equipment.
Benefits and assistance
We help identify Medicare benefits, Pennsylvania Medical Assistance programs and other assistance that may be available in Pennsylvania.
Support at home
We help find support that can make it safer and easier to manage your health at home.
Care coordination
We communicate with your care team, track the agreed next steps and help keep everyone on the same page.
Everyday needs affecting your health
When transportation, food, utilities, housing or lack of support makes it harder to follow your care, we help look for available resources.
Resources in Pennsylvania
What is different here, and who else can help.
Medicare is federal, so Navigate Care works the same way in every state. What changes is the Medicaid program, the rules Pennsylvania sets for its Medicare Savings Programs, whether PACE exists here, the free counseling program and the local aging network. Your navigator knows all of them and helps you use them.
- Medicaid in Pennsylvania
- Pennsylvania Medical Assistance
- If your parent has Medicare and Medicaid together, Medicaid usually pays the Part B coinsurance, which is why most dual-eligible patients pay $0 for Navigate Care.
- Medicare Savings Programs in Pennsylvania
- Federal limits: $9,950 in savings for one person
- Pennsylvania uses the federal resource limits, $9,950 for one person and $14,910 for a couple in 2026, not counting the home, one car or personal belongings. Income limits follow the federal baseline: $1,350 to $1,816 a month for one person in 2026, depending on the program. QMB pays the Part B premium and all cost-sharing, so a parent who qualifies pays $0 for Navigate Care; many eligible people never apply.
- PACE in Pennsylvania
- Available in parts of the state
- PACE wraps all of Medicare and Medicaid into one local team for people who qualify for nursing-home care but want to stay home. Programs cover defined ZIP codes; search yours.
- Free Medicare counseling
- PA MEDI (formerly APPRISE)
- Every state has a SHIP: trained counselors who explain Medicare choices for free. National line 1-877-839-2675.
- Area Agency on Aging
- Find yours through the Eldercare Locator
- Meals, rides, respite, home-safety programs and caregiver support in your county. 1-800-677-1116.
- Medicare itself
- 1-800-MEDICARE (1-800-633-4227)
- For coverage questions, claim status and the Medicare Summary Notice. Open 24 hours.
How it works
Getting started is simple. You keep your own doctors.
Navigate Care works alongside the care team you already have. We do not sell insurance, we do not replace your doctor, and you can stop at any time.
Tell us what is happening
Start with a free call. Tell us what you or your loved one needs help with. You do not need to know which program or service to ask for.
We check whether Navigate Care is a good fit
We review your needs, check your Medicare coverage and explain any expected cost. When appropriate, we arrange a phone or video visit with a healthcare provider.
Meet your dedicated navigator
Your navigator helps create a plan, coordinates the agreed services with your existing doctors and follows up on the next steps.
What families call about
The situations we help with in Pennsylvania.
Whatever is happening right now, there is a page that says exactly what a navigator would do about it.
Medicare may cover Navigate Care.
Medicare Part B covers Community Health Integration services for eligible patients when everyday challenges are affecting their health or access to care.
Questions from Pennsylvania families
Does Navigate Care serve Pennsylvania?
Yes. Navigate Care coordinates care for Medicare patients in Pennsylvania by phone and video, working alongside the doctors you already have. Where in-person support is available in your area we will tell you on the first call.
Does Medicare cover Navigate Care in Pennsylvania?
Medicare is federal, so the same rule applies in every state: Medicare Part B may cover Community Health Integration services for eligible patients when practical challenges are affecting their health or access to care. The Part B deductible and 20% coinsurance apply unless secondary coverage pays them. We check your coverage and explain any expected cost before services begin.
My parent has Medicare and Pennsylvania Medical Assistance. What will they pay?
Patients with both Medicare and Medicaid usually pay nothing for Navigate Care, because Medicaid covers the Part B coinsurance. We confirm this for your parent’s specific coverage before you start.
Does Pennsylvania have an asset limit for Medicare Savings Programs?
Yes. Pennsylvania uses the federal resource limits: $9,950 for one person and $14,910 for a couple in 2026, not counting the home, one car, personal belongings or a small burial fund. If your parent is close to the line, apply anyway; the programs are underused and PA MEDI (formerly APPRISE) will help with the form for free.
Is there a PACE program in Pennsylvania?
Yes, in parts of Pennsylvania. PACE (Program of All-Inclusive Care for the Elderly) is for people 55 and over who qualify for nursing-home level care but can live safely at home with support; it replaces Medicare and Medicaid with one local team, and is usually $0 for someone on both. Each program covers a defined set of ZIP codes, so check yours at Medicare.gov. If PACE is not available where your parent lives, or they do not qualify, a Navigate Care navigator coordinates the care they already have.
How is this different from PA MEDI (formerly APPRISE)?
PA MEDI (formerly APPRISE) offers free, unbiased counseling on Medicare choices: which plan, which enrollment window, how to appeal. It is excellent and we often refer families to it. Navigate Care does something different: a dedicated navigator who coordinates your actual care over time, making the calls and following up. Many families use both.
Do you sell Medicare insurance?
No. Navigate Care does not sell Medicare Advantage, Medigap or Part D plans and is not paid by any insurer. We help you understand the coverage you have and use it well.
Guides
Read more about this
Community Health Integration: help when daily life gets in the way of care
Food access, transport, or your living situation can make a care plan hard to follow. Medicare may cover coordination to help address those barriers.
Does Medicare cover a patient advocate?
Medicare covers navigation services for eligible patients. Here is how to check whether that help fits your situation, what you might pay, and how to get started.
Medicare Savings Programs and Extra Help: the benefits that pay your Medicare bills
Millions of older adults on a fixed income qualify for a state program that pays their Part B premium, and often every deductible and copay too. Most have never applied, because nobody told them it existed.
PACE: the Medicare program that keeps a nursing-home-eligible parent at home
One team, one building, one phone number for every medical and social need, with no copays and no deductibles. It is the best-kept secret in long-term care, and it is only available in some places.
Getting care at home through Medicare: who qualifies and how
Nurses, therapy and aides in the living room — Medicare's home health benefit is real, generous, and badly explained.
Caring for aging parents: the checklist to work through first
Most families start this in a crisis and improvise for months. Here's the order to do it in — documents, money, medical, home, help — so the next emergency finds you ready.
Other states
You don’t have to coordinate everything alone in Pennsylvania.
Tell us what is happening. We will listen, check whether Navigate Care can help and explain the next step.
Or call 628 234 2273 (NAV-234-CARE). Free initial call. No obligation.