What Is a Beneficiary

A beneficiary is someone who receives healthcare benefits through an insurance plan, including Medicare, Medicaid, private health insurance, or another healthcare program. This can include policyholders, dependents, or individuals enrolled in government health programs.

Why does beneficiary status matter?

• Determines eligibility: Being a beneficiary decides what medical services, medications, and financial assistance you can receive.
• Impacts coverage and costs: Beneficiaries must understand their plan’s benefits, out-of-pocket costs, and renewal requirements.
• Affects decision-making: In some cases, a legal representative (such as someone with power of attorney) may make healthcare decisions on behalf of a beneficiary.

Types of beneficiaries

• Primary Beneficiary: The main person entitled to benefits under a policy.
• Dependent Beneficiary: A spouse, child, or family member covered under a health plan.
• Medicare Beneficiary: An individual enrolled in Medicare, eligible for hospital and medical benefits.

How Solace can help

A Solace advocate can help beneficiaries understand their coverage, confirm eligibility for additional benefits, and resolve issues with claims or denied services.

What to do next

Not sure what benefits you're entitled to? Find an advocate today.