Community health integration services
Medicare Part B (Medical Insurance) covers community health integration services if you meet certain conditions.
Description
Community health integration services help address non-medical factors that may be impacting your health. Some community health integration services include:
- An assessment to better understand your life story
- Care coordination
- Health education
- Patient self-advocacy training
- Health system navigation
- Social and emotional support
Coverage details
If your doctor or other health care provider gives you a social determinants of health risk assessment, they may find that social factors (like limited access to food or your living environment) are impacting your health or access to care. In these cases, Part B covers community health integration services to address your needs and help your health care provider diagnose or treat your medical conditions.
Provider requirements
Your provider or their staff can give you the community health integration services or refer you to other trained personnel (including community health workers) for the services.
Costs
After you meet the Part B deductible , you pay 20% of the Medicare-approved amount .
How often
You must have an initial office visit with your provider (separate from your yearly “Wellness” visit) before you can start getting community health integration services. You can get these services monthly after your initial visit.
Ask your doctor or healthcare provider how much your test, item, or service will cost.
Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.
Specific amounts you could owe depend on:
Other insurance you may have
How much your doctor charges
If your doctor accepts assignment
The type of facility
Where you get your test, item, or service