What is Community Health Integration (CHI)?

Community Health Integration (CHI) is a Medicare-covered service for patients whose medical care is affected by everyday barriers like transportation difficulties, medication affordability, food access, social isolation, or difficulty navigating the healthcare system. A licensed clinician must determine that CHI is medically appropriate.

How do I know if my parent qualifies for CHI?

CHI starts with an Annual Wellness Visit, which is generally available at no cost under Medicare. During this visit, a licensed clinician assesses whether unmet social needs are affecting your parent's medical care. If the clinician determines CHI is medically appropriate, ongoing care coordination services may begin.

The standard Medicare Part B deductible and coinsurance generally apply to CHI services. Final costs depend on whether the patient has met their Part B deductible, has supplemental insurance, is enrolled in Medicaid, or has a Medicare Advantage plan with different cost-sharing rules.

Can't Afford Your Medications? Medicare Help Through CHI

Q: What CHI does not do

Important: CHI personnel must never independently tell you to stop, start, reduce, replace, or change a medication. Only your treating clinician can make medication changes. CHI does not pay for your medications, guarantee approval for assistance programs, or guarantee that a specific resource will

Q: How do I get started with medication help for my parent?

Call (800) 303-1766 to speak with our team. We can help verify Medicare eligibility and connect you with a licensed clinician who can determine whether CHI is appropriate for your situation.

Medication costs are one of the most common reasons Medicare patients struggle to follow their prescribed treatment plans. When you cannot afford your medications, you may skip doses, delay refills, or stop taking a medication entirely. This can worsen your medical condition and make it harder for your clinician to manage your care effectively.

If medication affordability is interfering with your medical care, Medicare-covered Community Health Integration, or CHI, may be able to help.

How CHI addresses medication affordability

If a licensed clinician determines that your medication cost barrier significantly limits their ability to treat your medical condition, CHI services may include:

Helping you communicate the affordability issue to your treating clinician
Navigating possible assistance resources and patient assistance programs
Helping you understand available options
Following up to determine whether the barrier has been addressed
Reporting continued barriers to your treating practitioner so the care plan can be adjusted

What CHI does not do

Important: CHI personnel must never independently tell you to stop, start, reduce, replace, or change a medication. Only your treating clinician can make medication changes. CHI does not pay for your medications, guarantee approval for assistance programs, or guarantee that a specific resource will be available. Each outside organization has its own eligibility rules and makes its own decisions.

An example of how CHI might work

Consider a patient who is not following their prescribed care plan because medication costs are unaffordable. CHI personnel may help the patient communicate the issue to the treating clinician, navigate possible assistance resources, understand available options, and follow up on whether the barrier has been resolved.

The treating practitioner remains responsible for all medication decisions. CHI personnel support the process but do not make clinical decisions about medications.

The connection to the Annual Wellness Visit

The CHI process often begins during a Medicare Annual Wellness Visit. During the AWV, the clinician reviews the patient's medications and may learn that cost is a barrier. If the clinician determines that the medication affordability issue significantly limits their ability to treat the patient, CHI may be recommended.

Consent is obtained before CHI services begin. The patient is told what CHI includes, that participation is voluntary, that Medicare Part B cost sharing may apply, and that they may revoke consent at any time.

Medication costs making it hard to follow your treatment plan? Call our team.

Call (800) 303-1766

Speak with our team during normal business hours. We can help verify your Medicare eligibility and connect you with a licensed clinician.