Frequently Asked Questions
Have questions? Find answers in our patient advocacy FAQs. If you have questions about Medicare coverage of patient advocacy, read more in our Medicare FAQs.
Patient advocates are also called health advocates, care managers, or health navigators. These individuals have deep healthcare expertise and can help you navigate the healthcare system to get the best healthcare possible. They stand up for you, fighting for your rights and representing your interests with doctors, hospitals, health plans, and other parts of the healthcare system.
Patient advocates provide a variety of services and specialize in different health problems and patient populations. There is a patient advocate who is an expert in just about every healthcare problem out there.
Advocates can help you get a clear diagnosis or a second opinion, coordinate care across multiple healthcare providers, and make sure you’re getting the care you need. Advocates can also help you choose health insurance, understand your coverage, request coverage, or appeal an insurance denial. If you get a large medical bill, an advocate can review it and help you find errors, or work with the provider to negotiate it down or into a manageable payment plan. Learn more about how a patient advocate can help.
Original Medicare pays for patient advocacy services subject to any coinsurance. If you have an Original Medicare plan, tell us more about you and we can see if you qualify.
At this time, other health insurance plans do not cover patient advocacy services. This is because most insurance plans are designed to cover direct medical treatments and procedures rather than advocacy services. Additionally, since independent patient advocates work specifically for your interests—not for hospitals, doctors, or insurance companies—there can be a conflict of interest from the insurance company's perspective in covering services that may challenge their decisions or policies.
Umbra patient advocates can also be secured through private pay and are typically paid by the patient or the patient’s loved ones. Sometimes, companies will pay for advocacy services for their employees, members, or other groups.
You may encounter a patient advocate in a hospital or a member advocate employed by your health plan. These advocates may be helpful but remember, they work for the entity that hired them. That doesn’t mean they don’t care about you, but it does mean their first loyalty will be to the hospital or health plan. To make sure you have an advocate whose sole loyalty is to you, hire an independent advocate.
If you have original Medicare, Umbra can bill Medicare for your services. You would only pay coinsurance, if applicable. Find out if you qualify.
If you are paying privately, advocate rates vary widely depending on their services, expertise, and location, among other factors. Advocates typically charge between $100-$400 per hour. Some advocates charge hourly; others will offer a package price for a specific service or to resolve a specific issue.
At Umbra, you pay set fees for specific services, like help navigating a new diagnosis or reviewing a medical bill to find opportunities to negotiate. You can also buy blocks of time for an advocate to help with more complicated issues. Read more about Umbra patient advocate costs.
A great advocate can come in many forms. Some advocates are nurses or doctors, social workers, pharmacists, or other clinicians. Others may have had jobs in doctors’ offices, hospitals, or health plans dealing with medical bills and insurance claims. Still other advocates are people who have personal experience managing care for themselves or a loved one.
The thing all independent advocates have in common is that they work for you, the individual. Your needs and interests are their primary concern.
Patient advocates have many different credentials such as
- Board-certified Patient Advocate (BCPA)
- Certified Case Manager (CCM)
- Care Manager, Certified (CMC)
- Certified Geriatric Care Manager (CGCM)
- Registered Nurse (RN)
- Medical Doctor (MD or DO)
- Lawyer (JD)
- Social Worker (MSW)
- Doctor of Osteopathy (DO)
- Chiropractor
- Nurse Practitioner (NP)
- Aging Life Care Expert
- Senior Care Manager
Based on what you need help with, Umbra Health Advocacy will match you with the advocate that has the right experience and credentials.
There are two ways to work with Umbra Health Advocacy to get help from a patient advocate:
- Let us match you to a patient advocate. Tell us what you need help with, and we’ll match you to an advocate with the right expertise for your situation. We’ll introduce you to the advocate we think will be a great fit for you. You can decide to move forward with them or ask us to find someone else.
- Search for an advocate in our directory. We have a national network of advocates for you to choose from. Search for an advocate based on your needs and priorities, like where they are, what they specialize in, or what their background is. You contact the advocates you’re interested in and decide whether or not they can meet your needs.
The right advocate for you will be someone with the right qualifications and experience to help you address your issue and someone who meets your other priorities. Does meeting them in person matter to you? Do you care what gender they are? Do you feel you need someone with specific credentials? Those are all factors you might include in your search criteria. Read more about how to choose an advocate.
Some advocates will visit patients in the hospital or go with patients to doctor visits. If that’s a service you need, it will be important to find a local advocate. But most of the work advocates do can be done remotely. You may have a specific issue with a specific healthcare provider where a local advocate could be extra helpful, but in most cases, you should feel free to hire an advocate who knows how to tackle the specific issue you’re facing, wherever they may be.
We’d hate for you not to be happy with your advocate through Umbra. Most of our clients LOVE their advocates. While we can’t guarantee any specific outcome, if you’re not happy with your advocate, let us know and we’ll do everything we can to make it right.
Some people want us to do the leg work for them. Others prefer to do their own research. If that's you, search our Umbra Health Advocacy Directory to find advocates that might work for you. You can reach out to advocates right from the Directory or call them for more information. If you need help finding or selecting an advocate, we can help too. Just fill out a Help Request form or call us and we can make a match.
We are here to help! And we've tried to make it easy for you to get the help you need. Here are some options:
- If you want to search for your own advocate, visit our Directory and search for the service/s you need.
- If you would like us to do the research and find the perfect advocate, please submit a Help Request or call us at 332-699-6778.