Why Insurance Covers Solace Advocates

Yes, Solace Is Covered by Medicare—Here’s How

A quick Google search might’ve told you that Medicare doesn’t cover patient advocates. That confusion stems from one simple fact: there’s no billing code labeled “patient advocacy” in Medicare’s system.

But in practice, Medicare covers the work of Solace advocates in all 50 states and Washington, D.C.

How does that work?

Here’s the technical version: In 2024, Medicare introduced new billing codes—Community Health Integration and Principal Illness Navigation—that allow physicians to bill for trained staff who help patients manage complex care. That includes advocates like those at Solace.

Every patient journey at Solace starts with a short physician call—in part to match you with the right advocate, but also because those advocates work within a framework shaped by full-time Solace doctors. That’s a big reason Solace is covered: We’ve always recognized that doctors matter in patient support, even when medical treatment isn’t the focus.

Our physician team doesn’t just meet a requirement—they strengthen the model. And that structure is part of what makes Solace eligible for Medicare coverage.

New pathways for coverage under Medicare

Solace advocates work within these new CMS-approved pathways. That means the time they spend coordinating care—like finding specialists, securing prior authorizations, scheduling appointments, reviewing records, and resolving insurance issues—is reimbursed through Medicare Part B or your Medicare Advantage plan.

There’s no extra charge for you beyond your usual coinsurance or deductible.

What’s included—and what isn’t

Medicare doesn’t pay for in-person visits or medical procedures through Solace. But it does cover the time your advocate spends helping you navigate the healthcare system.

That includes:

• Coordinating care between doctors or facilities
• Getting equipment and treatment approved, crafting appeals, and resolving billing errors
• Helping you understand your treatment options after a complex diagnosis
• Finding the right specialists and scheduling appointments
• Helping you navigate local resources linked to your health, like food or housing

Advocates work remotely—by phone, video, and secure messaging—and can even join your doctor’s appointments by phone or video to ask questions and keep track of instructions.

What Solace Advocates Actually Do

Solace isn’t just covered by Medicare—it’s built for the real world of fragmented care, confusing paperwork, and patients stuck in limbo.

Your advocate is the person who keeps everything moving. You’ll set regular check-ins at a pace that works for you—but they’re also available in between, by text or email, whenever something comes up. If you need an unscheduled call, they’ll make it happen. Behind the scenes, they’re always working—tracking updates, nudging delays forward, and checking in with you even when you haven’t reached out.

At Solace, advocacy is an active partnership.

More than just answering questions

Solace advocates don’t just explain your insurance benefits. They take action to move your care forward:

• Scheduling and managing appointments with the right in-network providers
• Gathering, organizing, and sharing medical records with your entire care team
• Handling insurance paperwork and resolving denials or billing problems

When a prior authorization stalls, when two specialists don’t communicate, or when your plan says no to something it should cover—your advocate steps in and gets things back on track.

Support for the moments that go off-script

Most care delays aren’t emergencies. They’re quiet breakdowns that happen behind the scenes:

• Referrals that get lost, sent late, or misrouted
• Discharges with no follow-up—and no one to call
• Pre-approvals denied at the pharmacy window
• Confusing or conflicting instructions after a major diagnosis

Your advocate turns those breakdowns into progress. Whether you’re newly diagnosed, managing multiple specialists, or just worn out from navigating the system, they’re here to lighten the load—and make sure nothing falls through the cracks.

Why Do Insurers Cover Solace Patient Advocates?

For many patients, the healthcare system feels like something you’re constantly battling. Insurers deny care, delay decisions, and bury you in paperwork. So it's fair to ask: If insurers helped break the system, why would they cover the advocates helping to fix it?

The answer is complicated, but there's a clear logic behind it.

Solace works because—sometimes—what’s good for you is also good for your insurer. Not always. Not perfectly. But when patients avoid preventable crises, insurers save money. When care is better coordinated, outcomes improve and costs drop.

That alignment creates a rare situation where you get meaningful support—while Medicare and private insurers have a reason to keep covering it.

It’s a win-win model

Disorganized care is dangerous. It leads to missed diagnoses, botched medication lists, and unnecessary hospitalizations that could have been prevented with one well-timed conversation.

Solace helps to stop those breakdowns before they spiral. When care goes more smoothly for patients, it also works better for insurers. Everyone benefits when care is:

• Less fragmented, with fewer gaps between visits, tests, and treatments
• More efficient, with timely access to providers and follow-ups
• More successful, with higher treatment adherence and fewer preventable crises

From the insurer’s perspective, that means lower long-term costs. From yours, it means a safer, more manageable healthcare journey.

As Solace CEO and co-founder Jeremy Gurewitz puts it: “Advocacy is hyper-effective across the metrics the system cares about most: fewer hospital readmissions, better outcomes, and lower total cost of care. When you avoid the worst-case paths, you get something rare: a win-win-win for patients, providers, and payers.”

"Advocacy is hyper-effective across the metrics the system cares about most: fewer hospital readmissions, better outcomes, and lower total cost of care. When you avoid the worst-case paths, you get something rare: a win-win-win for patients, providers, and payers.”
‍—Jeremy Gurewitz, CEO and Co-Founder, Solace Health

Coverage Through Private Insurance and Employer Plans

Medicare has led the way in covering patient advocacy. But Solace currently serves patients through Medicare and Medicare Advantage plans—the latter of which are managed by private insurers.

That means many of our patients are already supported through private insurance—just within a Medicare context. And fully commercial coverage is very much on the horizon.

It’s Not Just Original Medicare

Original Medicare refers to the traditional government-run program—Medicare Part A (hospital insurance) and Part B (medical insurance). But it’s not the only option. Many people now get their Medicare benefits through private plans known as Medicare Advantage (Part C).

Many Medicare Advantage plans already include Solace in their coverage, including:

• UnitedHealthcare
• Humana
• Aetna CVS Health
• Cigna
• Blue Cross Blue Shield

Coverage varies by plan and location, but eligibility is widespread and growing. In all cases, the logic is the same: When people get the right care faster, everybody benefits.

Momentum is building for private insurance coverage

At Solace, we're already talking with private insurers about expanding access. For now, Solace won't cover patients with private insurance alone. But that will change.

For now, Medicare is leading the way. But as the benefits of advocacy become clearer, coverage is going to keep expanding.

How Solace differs from high-cost private advocacy

Solace started as a private-pay service. After working with countless patients and families navigating complex care, we saw firsthand how powerful advocacy can be—and how often cost gets in the way.

Today, Solace operates exclusively through insurance-covered models, making advocacy available to more people—not just those who can afford to pay out of pocket. High-quality, hands-on support should be a standard part of care, not a luxury.

Advocacy should be a standard part of care

This shift signals something bigger: a recognition that an advocate's support isn’t an "extra." It’s a core part of care—especially when patients are navigating a fragmented system, juggling multiple specialists, or recovering from serious illness.

Advocacy is moving to the center of care—not as a luxury, but as a necessity for making the system work better for everyone.

Are Solace Advocates Qualified Professionals?

If you’re trusting someone to help with your healthcare, you want more than a kind voice. You want someone who knows how the system works—and how to make it work for you.

Solace advocates are seasoned professionals

Our advocates aren’t call center staff or entry-level hires. They’re experienced RNs, social workers, care coordinators, and other healthcare professionals with years of hands-on experience supporting patients through complex care. Every advocate is selected for their expertise, empathy, and ability to solve real problems.

Trained for today's healthcare landscape

Before working directly with patients, Solace advocates complete an intensive training program focused on communication, documentation, insurance navigation, Medicare processes, care transitions, and more. They’re prepared to handle the tangled realities of modern care—prior authorizations, denied claims, scattered records, conflicting instructions—and to do it all with clarity and compassion.

Backed by doctors, supported by a team

Advocates don’t work alone. They’re supported by Solace’s clinical team of physicians and healthcare leaders, who help guide complex decisions and provide ongoing oversight. And because we believe great care means continuous learning, our advocates stay current through regular education and case-based training.

With Solace, you’re not just getting help—you’re getting a healthcare professional on your side.

How to Check Your Coverage and Get Started With Solace

You don’t need a referral. You don’t need to wait on hold. And you definitely don’t need to figure this out alone.

Getting started with Solace is fast, remote, and completely personalized. Whether you’re at home, in a care facility, or helping someone from afar, the process is designed to meet you where you are—and get you the right support quickly.

Step 1: Confirm your eligibility

You don’t need to call your insurer or dig through paperwork. Just visit find.solace.health, answer a few quick questions, and we’ll check your coverage for you—usually within seconds.

Step 2: Talk with a Solace physician

This isn’t a medical appointment—it’s a short intake call to understand your needs, preferences, and goals. During the conversation, our physician will help identify what kind of support you’re looking for and help match you with the right advocate. It usually takes about 20 minutes.

Step 3: Get paired with your advocate

We provide you with an advocate who fits your needs and goals—someone whose background and expertise make them a strong match for where you are in your care journey. With hundreds of advocates on our team, we can pair you with someone who brings specialized experience in the specific challenges you're facing.

No travel, no phone tag

Everything happens remotely. You can talk to your advocate by phone or video, message them through our secure platform, and set up check-ins on a schedule that works for you. If something comes up, you can also reach them in-between scheduled check-ins.

Ready to get started?

Visit find.solace.health to check your coverage and take the first step. You’ll answer a few quick questions, and we’ll guide you through the rest.

The Bottom Line: Solace Is Covered Because It Works

Solace is covered because it works. It’s a structured, practical way to make healthcare safer, more connected, and less overwhelming. By preventing delays, reducing confusion, and helping patients get the right care at the right time, Solace improves outcomes for everyone involved. That’s why Medicare and other insurers cover it—and why it can make such a difference in your care.

If you’re eligible, there’s usually no cost after any deductible and coinsurance.

It starts with just one call—which you can schedule now.

Frequently Asked Questions About Solace Advocates and Insurance Coverage

Does Medicare cover Solace advocates?

Yes. Solace is covered under Medicare and many Medicare Advantage plans through updated billing codes that were approved in early 2024—namely, Community Health Integration and Principal Illness Navigation. If you qualify, you typically pay nothing beyond your standard deductible or coinsurance.

What’s the difference between insurance-covered and self-pay advocacy?

Some advocacy services are only available through private-pay arrangements, meaning you cover the cost out of pocket—often at a high hourly rate. Solace is different. Because our model includes physician involvement and operates within structured insurance frameworks, qualifying Medicare patients can work with an advocate for little or no cost.

What if I have commercial insurance or an employee benefit plan?

Currently, Solace advocates work with patients who have Medicare and Medicare Advantage coverage. Here's an important nuance: Medicare Advantage plans—while still Medicare—are administered by private insurers instead of the government. So they’re commercial plans, but still fall under Medicare. While we don’t yet serve people with non-Medicare commercial plans, Solace is actively working to expand into private insurance coverage in the future.

What do Solace advocates actually do?

Your Solace advocate is your strategist, your care coordinator, and your voice in the system. Advocates provide personalized, ongoing support—scheduling appointments, coordinating care between specialists, helping with insurance denials, managing medical records, and more. They can also join your doctor's visits by phone or video, secure approvals for important equipment, and work behind the scenes to prevent gaps or delays.

Can I keep the same advocate over time?

Yes. Solace prioritizes continuity. We match each patient with one advocate based on their needs, communication style, and care goals. With hundreds of advocates on our team, we can often pair you with someone who brings specialized experience in the issues you're facing—such as mobility challenges, chronic illness, or long-term care transitions. You can work with your advocate for as long as you need them. And if you take a break or need support again later on, you’re always welcome to come back and work with the same advocate.

What if I’ve already been doing my own self-advocacy?

If you’ve been scheduling your own appointments, organizing records, fighting denials, and chasing down providers, you’ve already been doing the work of a healthcare advocate. But you shouldn’t have to do it all yourself. Solace provides an expert who can lighten your burden. That being said, you're always in charge. Your advocate is your partner in care. If there’s something you want to handle yourself, they’ll follow your lead—and step in where you want help.

How do I check my coverage and get started?

Just visit find.solace.health, answer a few short questions, and we’ll check your eligibility instantly. If you’re covered, you can schedule a short intake call with a Solace physician. During that call, the physician will get to know your needs and help match you with the right advocate—usually right then and there. Most patients meet their advocate quickly, sometimes the very same day.

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