How is Solace covered by Medicare? Here's what you need to know.

If you’re confused about what your Medicare plan does (or doesn’t) cover, you’re not alone. In fact, a recent study discovered that 65% of Medicare beneficiaries find their coverage confusing and difficult to understand. U.S. healthcare often seems like it was designed to be intentionally frustrating—and when you’re experiencing health concerns, the last place you want to be is struggling to understand where to even start.

So—where should you start? 

Our insurance coverage story starts with First Lady Jill Biden.

“When you have someone by your side who knows the system and is with you every step of the way, it changes everything. But for too long, these navigation services weren’t available to many Americans.

Together, we’re building a world where [...] patients and their families have a trusted navigator by their side.”

- First Lady Jill Biden

In late 2023, the Biden administration recognized the gaps in the healthcare system—and recognized the significant, irrefutable benefits of health advocacy and navigation as the solution. 

How exactly does this work? 

Read on to learn about Medicare’s coverage of healthcare advocates, how Solace’s services fit in, and what it all means for you.

I thought Medicare didn’t cover patient advocacy. What’s changed?

Until recently, Medicare did not cover advocacy. Since our founding in 2022, Solace advocates offered purely out-of-pocket services—but we know just as well as you do that healthcare in general is expensive, and additional costs are prohibitive to most people. 

In 2024, new regulations went into effect stating that advocacy services can now be reimbursed directly through Medicare. Because of these new regulations, the majority of Solace patients pay nothing out of pocket. 

I haven’t been pre-approved. Am I still eligible for Solace?

Yes! Solace is federally covered by Medicare in all 50 U.S. states.

To pair you with the healthcare advocate who can help you best, you’ll first meet with a friendly, licensed Solace physician. 

This appointment is easy, can be done over the phone, and only takes about 30 minutes. We'll check directly with Medicare and let you know instantly, before you book, whether your specific insurance plan qualifies you for Medicare-covered advocacy.

During this visit, we'll use the health information you share to match you with the qualified advocate who's the best fit for you, and you'll work directly with that person for as long as you need. Plus, our platform is entirely HIPAA compliant, so you can trust that your confidential health information stays protected.

Does that include Medicare Advantage plans?

Solace is credentialed with many Medicare Advantage plans, with many more on the way. We know patient advocacy is crucial and are working hard to expand our coverage every day. 

Curious if your plan is currently covered? You can give our US-based support team a call at (240) 693-3281.

Are you sure this is covered? How does billing work?

Solace bills Medicare and other insurance plans directly—so you'll never receive a surprise bill from us that hasn't gone through your insurance first. No sneaky fees or unpleasant surprises here! During sign-up, we'll work with our insurance clearinghouse partner behind the scenes to 100% confirm your eligibility before you schedule your first visit. If you have a deductible remaining for the year, advocacy services will hit that deductible before coverage kicks in.

Most Solace patients pay little to nothing out of pocket, but if you have questions, give us a call. We're happy to help.

Why is Medicare coverage for advocacy important?

The U.S. healthcare system has become too complicated and confusing for most patients to navigate alone. Having a healthcare advocate is like having a nurse in the family—someone who knows how to work inside the system, and make it work for you.

Numerous studies have shown the benefits of working with a healthcare advocate. Solace advocates communicate with doctors, break down complex information, and empower patients to take control of their health.

“Today, I’m excited to announce that the Biden Administration is putting in place billing codes that health insurers—including Medicare—can use to pay for patient navigation services.
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This means that more Americans will benefit from the critical support that patient navigators provide.”

- First Lady Jill Biden

Who can benefit from a patient advocate?

In short, everyone can benefit from a healthcare advocate—and we hope in the future, every American will be able to work with an advocate as a critical part of their care team. Whether you’re practicing preventative care, navigating a new phase of health, or need help overcoming a particularly complicated diagnosis, a Solace advocate can make all the difference in your care journey and give you the dignity, respect, and confidence you deserve. 

You wouldn’t go to court without a lawyer, so why visit a doctor without an advocate on your side? 

With this new legislation, we’re one step closer to making patient advocacy available for everyone who needs it. If you’re ready to experience your healthcare in a new, better way, give us a try. It’s our mission to empower and improve the health outcomes of everyone we serve.