California Patient Advocates
A California patient advocate is a trained professional who handles the coordination, paperwork, and phone calls around your care, covered by Medicare. Careway advocates work with patients throughout California by phone and video, from Los Angeles and San Diego to the Bay Area and the Central Valley.
What is different about getting help here
California has rules other states do not
California gives Medigap policyholders an annual window around their birthday to switch to another policy with equal or lesser benefits without new medical underwriting. It is written into state insurance law, and most people who could use it have never heard of it.
- Explains how the birthday rule works and when your window opens
- Reviews what your current supplemental coverage actually pays for
- Never recommends or sells a specific plan, which is not what an advocate is for
Medi-Cal changes what you pay
People who have both Medicare and Medi-Cal cannot be billed for Medicare cost-sharing. If you have both Medicare and Medi-Cal, you pay $0 out of pocket. Many Californians who would qualify for Medi-Cal have never applied.
- Screens for Medi-Cal and the Medicare Savings Programs
- Helps assemble and submit the application
- Explains how having both programs works in practice
Staying at home, with help that already exists
California funds in-home care through In-Home Supportive Services and coordinated care through PACE in many counties. Both keep people out of facilities, and both require someone to navigate an application.
- Explains what In-Home Supportive Services provides and who qualifies
- Checks whether a PACE program serves your county
- Connects families to their local Area Agency on Aging
Large systems, long distances
California care ranges from tightly integrated systems to a scattering of independent practices, and in much of the state the nearest specialist is a long drive. Coordination and transportation are the recurring problems.
- Moves records between systems that do not share them
- Finds specialists who are genuinely accepting new Medicare patients
- Arranges transportation and telehealth where distance is the obstacle
Programs your advocate helps you reach
These are run by California and its counties, not by Careway. Your advocate helps you find out whether you qualify and works through the applications with you.
HICAP (Health Insurance Counseling and Advocacy Program)
California's free Medicare counseling program, offering unbiased help with coverage questions, appeals, and comparing options.
Official site ➞Medi-Cal
California's Medicaid program. People with both Medicare and Medi-Cal cannot be billed for Medicare cost-sharing.
Official site ➞In-Home Supportive Services (IHSS)
Pays for help with daily activities at home for people who qualify, so they can remain in their own homes.
Official site ➞PACE (Program of All-Inclusive Care for the Elderly)
Coordinated medical and social care for people who need a nursing-home level of care but want to stay at home. Available in many California counties.
Official site ➞Where California patients get their care
Records do not move between these on their own. When your doctors are in more than one, your advocate is the one making sure each has the current picture.
- Kaiser Permanente
- Sutter Health
- UCLA Health
- UCSF Health
- Cedars-Sinai
- Dignity Health
- Providence
- Sharp HealthCare
Advocates across California
Los Angeles
Patient advocates for Los Angeles seniors, covered by Medicare. Help navigating Cedars-Sinai, UCLA, Kaiser, and county care across LA County.
Read more ➞San Diego
Patient advocates for San Diego seniors, covered by Medicare. Help navigating Sharp, Scripps, UC San Diego, and Kaiser care.
Read more ➞San Jose
Patient advocates for San Jose seniors, covered by Medicare. Help navigating Kaiser, Stanford, and county care in Santa Clara County.
Read more ➞San Francisco
Patient advocates for San Francisco seniors, covered by Medicare. Help navigating UCSF, Sutter, Kaiser, and city aging services.
Read more ➞Fresno
Patient advocates for Fresno seniors, covered by Medicare. Help navigating Community Health System and Kaiser care in the Central Valley.
Read more ➞Questions from California
Yes. Medicare's care management programs are Medicare-covered services available to eligible patients in California. If you have a Medigap policy or Medi-Cal, your standard coinsurance may be fully covered.
If you have both Medicare and Medi-Cal, you pay $0 out of pocket. Federal and California rules prohibit billing people with both programs for Medicare cost-sharing.
Not necessarily, and it rarely matters. Your advocate works with you by phone and video, and is familiar with the coverage rules, programs, and health systems in your state. There is no office to travel to.
California law gives people with a Medigap policy an annual window around their birthday to switch to another policy with equal or lesser benefits without new medical underwriting. An advocate can explain how it applies to you, and does not sell or recommend policies.
An advocate can explain what In-Home Supportive Services provides, tell you whether you are likely to qualify, and help you work through the application and follow up on it.
It makes an advocate more useful, not less. Much of the work is finding clinicians who are accepting new Medicare patients, arranging telehealth where it is appropriate, and organizing transportation when a visit has to happen in person.
Talk to someone who can take this on
Checking whether you qualify takes a couple of minutes. If we are not the right fit, we will tell you plainly.
Covered by Medicare. If you have a supplemental policy (Medigap) or Medicaid, your standard coinsurance may be fully covered.