Cost and coverage
Start with a free call. Know the expected cost before care begins.
Medicare may cover navigation through Principal Illness Navigation or Community Health Integration if you qualify. With Original Medicare, the Part B deductible and 20% coinsurance apply. Other coverage may reduce your share. We check your coverage and explain expected costs before you decide.
Prefer to speak with someone? Call 628 234 2273 (NAV-234-CARE). Ask us to check coverage for yourself or a family member. The initial call is free, with no obligation.
By coverage type
How your coverage affects the cost.
These are general coverage rules, not a personal quote. Your eligibility, provider visit, navigation needs, and insurance determine the amount to check. Insurance premiums are separate.
Original Medicare without secondary coverage
Deductible, then 20%
For covered PIN or CHI services, you pay 20% of the Medicare-approved amount after meeting the Part B deductible. Ask about the initial provider visit and ongoing services separately.
Original Medicare + Medigap
Depends on your policy
Medigap helps with your share of covered Original Medicare costs, but benefits differ by plan. We check your specific policy rather than assume all deductibles and coinsurance are paid.
Qualified Medicare Beneficiary (QMB) program
No Medicare cost-sharing bill
Medicare providers cannot bill QMB members for Medicare deductibles, coinsurance, or copayments on covered services. A small Medicaid copayment may apply. Tell us you have QMB so we can check your records.
Medicare + other Medicaid assistance
Check your assistance
Your Medicaid eligibility and assistance category matter. QMB, SLMB, and QI do not pay the same costs. We check which help you receive and what it covers.
Medicare + retiree or employer secondary coverage
Check the plan
The secondary plan's terms determine which costs it pays. Ask how it coordinates with Medicare for the provider visit and monthly navigation services.
Medicare Advantage
Depends on the plan
Advantage plans set their own copays and may require in-network practitioners. We check your specific plan and tell you before anything starts.
The Part B deductible is annual. We check how much remains rather than assume earlier care has met it. Medicare's coverage and assistance sources are linked below.
Before services begin
Nothing starts until you say yes.
The free introductory call, provider assessment, and ongoing navigation are different steps. We explain each one.
- We check your Medicare coverage and any secondary insurance.
- We explain eligibility and the expected costs of the initial provider visit and ongoing services, including $0 when your coverage supports that estimate.
- We answer your questions, including the ones about what happens if coverage changes.
- We ask for your permission to begin. You can stop at any time.
Illustrative example
What 20% coinsurance means.
Suppose a covered service has a $100 Medicare-approved amount and your Part B deductible is already met. With Original Medicare and no secondary coverage, the calculation would be:
This is arithmetic, not Navigate Care's price or a monthly quote. An unmet deductible, additional services, other coverage, or Medicare Advantage rules can change what you owe. For the eligibility steps, read how Medicare covers navigation.
Questions about cost
Is Navigate Care free?
The initial call is free, with no obligation. Ongoing navigation may be covered through Principal Illness Navigation or Community Health Integration if you qualify. With Original Medicare, the Part B deductible and 20% coinsurance apply; other coverage may reduce your cost. We check your coverage and explain expected costs before services begin.
What does Medicare's navigation coverage pay for?
PIN helps eligible patients navigate care for a serious condition. CHI addresses nonmedical factors affecting health or access to care. Coverage of navigation does not automatically pay for transportation, groceries, housing, equipment, or hands-on care. Those services have separate rules.
What exactly is billed?
The provider assesses which covered navigation service fits your needs and explains how the initial visit and ongoing services are billed. PIN and CHI can be provided monthly after the required initial visit. Ask which service and provider names to look for on your Medicare or plan statements.
How do I find out my expected cost?
Ask us to check your coverage before services start. We explain the expected cost of the provider visit and ongoing navigation, answer your questions, and ask your permission to begin. Let us know if your insurance changes. If a later statement or bill differs from the estimate, contact us so we can help clarify it with the billing team.
Does the doctor’s visit cost extra?
It can. The free introductory call is different from the initial provider visit required for PIN or CHI. Ask which visit is needed and what you may owe for it before scheduling. Your coverage and the services provided affect the cost.
What if I only have Original Medicare and cannot afford the coinsurance?
Tell us before services begin. We can help you explore assistance and how to apply. QMB covers Medicare cost-sharing for covered services. SLMB and QI help with Part B premiums and do not, by themselves, remove navigation coinsurance. Your state determines eligibility, and other assistance may be available.
Check the coverage rules
Primary sources checked September 2026. These explain the general rules; your coverage still needs an individual check.
Guides
Read more about this
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.
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.
How much does a patient advocate cost?
Private advocates run $100 to $250 an hour, and nobody tells you that up front. Here's the real range, what drives it, what it's worth, and the versions that cost nothing.
Medicare Parts A, B, C and D, explained properly
Four letters, two systems, one very confusing set of choices. Here's what each part actually pays for — and the gaps nobody warns you about until a bill arrives.
Medicare Advantage vs Original Medicare: how to actually choose
One offers a spending cap and free extras. The other offers almost any doctor in the country. The catch is that switching back later isn't guaranteed — and nobody mentions that at enrollment.
How to read a Medicare Summary Notice
What Medicare paid, how Medigap claims are forwarded, and what to check before paying a provider’s bill.
Want to see what the Medicare statement will look like? We walk through it line by line. Or call 628 234 2273 (NAV-234-CARE).
Ask us the cost question first. We like that question.
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.