Medicare.gov

Community health integration services

Medicare Part B (Medical Insurance) covers community health integration services if you meet certain conditions.

  • Covered by Part B
  • You can get these services monthly

  • After the Part B deductible , you pay 20% of the Medicare-approved amount

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.