Medicare Now Covers Health Navigation
What Every ShadowNurse Patient Should Know During Open Enrollment
Medicare now covers health navigation services, such as those provided by ShadowNurse.
For most people, Medicare coverage begins at age 65, though you may qualify earlier if you have a disability or certain chronic conditions. The key for both those eligible and their caregivers is knowing when and how to enroll, or review and renew coverage.
Some people receive Medicare automatically, typically those already receiving Social Security benefits before turning 65. For everyone else, enrollment must occur during specific windows throughout the year. Missing these open enrollment windows can mean delays in coverage and potential late enrollment penalties.
The current enrollment period, which began in early October, runs through December 7th, making it a critical time to learn about Medicare and what’s covered. Changes will take effect in the New Year.
Open enrollment isn’t just about signing up for coverage; it is also a time to switch coverage from Medicare (Parts A and B) to a Medicare Advantage Plan (Part C) or vice versa. In addition, it’s the time to join, switch, or drop Medicare (Part D), the prescription drug plan covered under Medicare.
It’s worth taking a moment to understand the covered services beyond just those provided by ShadowNurse.
Are You Eligible for Medicare?
For most people Medicare begins at age 65, but you may qualify earlier if you have ALS, also known as Lou Gehrig’s disease, or if you have end-stage renal disease.
For most other disabilities or chronic conditions, you must have already been receiving Social Security Disability Insurance for two years before you become eligible for Medicare. For those already receiving Social Security or others with benefits through the Railroad Retirement Board, enrollment is automatic.
For everyone else, you must actively sign up during open enrollment windows, such as the current period that ends on December 7th.
What’s New in Coverage
We already mentioned that Medicare expanded its benefits to cover “Principal Illness Navigation” or PIN services. That’s because people eligible for Medicare, those over 65 or those with chronic conditions or disabilities, often need expert support in managing care plans, keeping up with medications, arranging appointments, or coordinating between providers.
We built ShadowNurse and staffed it with an expert care team specifically to help people navigate the complexity of their own or a loved one’s care so that no one falls through the cracks or is left alone to face their health journey.
ShadowNurse & Medicare
Some of the services that ShadowNurse provides and are covered by Medicare include:
Medication and appointment reminders
Help scheduling and preparing for appointments
Care Plan support and follow-through
Resources and help coordinating other patient services
Our nurse-led navigation service helps seniors and families manage the details of healthcare both between visits and during visits when support is needed. ShadowNurse coordinates care plans, tracks follow-ups, and solves practical barriers so you can focus on living your life. Our goal is to make every step of your or someone you care for’s healthcare journey more straightforward, with less phone tag with doctors, fewer mixed messages, and more peace of mind.
Enrollment
First, confirm that you’re eligible. If you are and haven’t yet enrolled or need to make a change, visit Medicare’s Open Enrollment site.
Once you are there, you can review which plan works best for you or determine if you need to make a change to your current enrollment. You can also review what coverage is included beyond just Principal Illness Navigation. If you have questions, you can contact a licensed Medicare representative.
At ShadowNurse, we’re here to help you navigate your or a loved one's health journey. Our team can answer questions, or offer advice, or simply help ensure that you get the most out of your Medicare benefits.