Are Health or Patient Advocate Services Covered by Insurance?

older clients discussing Medicare marketing messages and reviewing options

This is a question I get asked frequently:  If I hire a patient or health advocate, will my insurance cover the cost?

The answer might surprise you.  It’s yes – and it’s no – as follows, depending on who your advocate works for:

  • There are patient advocates who work for hospitals and insurance companies – not you. Yes, they might be helpful (and if they can help you – that’s great!) but remember, they are not objective, and they are covering the backside of the hospital or insurance company they work for. (Follow the Money)

    That said – no – if you seek the help of a patient advocate who works for an insurer or hospital, then you will not have to pay extra for those services. In effect, they are covered by your health insurance.
  • There are independent, private health and patient advocates who work for…. YOU!  They are the advocates you’ll find available through this AdvoConnection website.

    Because they are independent of the system, and because they work directly for you, their services are also paid directly by you. Their services are not paid for by an insurer – yours or anyone else’s.

Graphic: And that's the GOOD news!
And that’s the GOOD news!  Why?

Because the minute your advocate would be paid by someone else (like your insurer), she would be working for that insurer. That insurer could tell him what to do, and when to do it. That insurer could tell her she is not allowed to do something your doctor thinks is crucial. Your insurer would stand between you and what you really need.

If you think about it, isn’t that why there are so many problems with the healthcare system anyway?  Insurance is telling everyone what they can and cannot do.  Doctors can’t help you the way they think is best, because the insurer tells them no – unless you have an independent advocate to go to bat for you (and for your doctor, too.)

So, if you plan to hire a private patient or health advocate, be happy you won’t have to try to get blood out of the insurance turnip, and that you will benefit from the independence your advocate will use to help you – and only you.

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