What is Health Advocate?
Health Advocate is the nation’s leading healthcare advocacy and assistance company, serving some of the nation’s largest companies and more than 40 million people. Health Advocate provides unlimited, confidential access to a dedicated consultant (known as a Personal Health Advocate) to help you resolve healthcare and insurance-related issues.
How does it work?
During your first call, you will be assigned a Personal Health Advocate who will begin helping you right away. When asked for the associated company, you can tell them Justworks. Personal Health Advocates are typically registered nurses who are supported by medical directors and benefits and claims specialists. They'll help cut through the red tape and get to the heart of your issue. Personal Health Advocates can assist you with issues, such as:
- Finding and booking specialists,
- Understanding how certain types of care are covered under your plan,
- Finding eldercare,
- Filing and negotiating claims,
- Negotiating fees for non-covered services, and more.
Why is Justworks offering this service for free?
At Justworks, we know that navigating your healthcare and insurance can be tough and we’re on a mission to make it as easy as possible for employees. Justworks has partnered with Health Advocate to complement your Aetna health plans with a dedicated advocate to help you understand your coverage and get the most out of your benefits.
Who is covered?
Health Advocate is available to all health insurance eligible employees at companies offering access to health insurance through Justworks. Health insurance eligible employees are defined as full-time employees, owners, and part-time employees working over 30 hours per week. The easiest way to determine if you meet these criteria is to log in to Justworks and visit Your Benefits. You will be eligible for this benefit even if you decline health insurance coverage through your company.
If you are eligible for Health Advocate, your spouse or domestic partner, dependent children, parents and parents-in-law can also access this benefit.
Do I need to sign-up for Health Advocate or activate my membership before I use it?
No, you do not need to sign up for Health Advocate. If your company is offering Aetna health plans through Justworks, you automatically have a Health Advocate membership and you can access the service by dialing 1-866-695-8622 or emailing them at email@example.com. When asked for the associated company, you can tell them Justworks.
When can I contact Health Advocate?
Health Advocate is available 24 hours a day, 7 days a week. If you are having a medical emergency, you should contact 911 instead.
Can my family reach out to Health Advocate directly?
Yes. Your spouse or domestic partner, dependent children, your parents and parents-in-law, regardless of whether they are on your health plan, can all call Health Advocate for help. In order for your family members to access the service, they’ll need to share your name, the name of your company and their relationship to you.
Will my issues be kept private and confidential?
Health Advocate’s staff is specially trained to follow strict protocols that comply with all governmental privacy standards to ensure that members’ medical and personal information is fully protected. As with all health and assistance programs sponsors, your employer does not receive or have access to any of your confidential information.
How do I contact Health Advocate?
To contact Health Advocate, please log into Justworks and visit Your Benefits. There, you will be able to find the different services offered by Health Advocate and the best ways to contact Health Advocate. When asked for the associated company, you can tell them Justworks.
Can Health Advocate help me with my dental questions?
Yes, Health Advocate assists with dental issues as well.
Who are the personal Health Advocates?
Personal Health Advocates are trained professionals, typically registered nurses, who have a number of years experience working in health insurance-related jobs. Health Advocate carefully screens their staff to make sure they have both the necessary professional credentials and communications skills to resolve your health-related issues swiftly and with compassion. For mental health services, Health Advocate requires a minimum of 5 years of post-licensure experience. For Medical Bill Saver, Health Advocate requires a minimum of 3-5 years of negotiating experience.
Can Medical Bill Saver be used for in-network bills?
Medical Bill Saver can be used for in-network and out-of-network bills. However some states do not allow negotiations on balances related to coinsurance, deductible, or copays. In those states, Medical Bill Saver can not be used for those balances. Other states allow negotiations on all balances and are not restricted in this way. To find out if a particular bill can be negotiated under your state’s laws please call Health Advocate and they can advise you directly.
Medical Bill Saver can always negotiate on a non-covered service regardless of whether the provider is in-network or out-of-network. Medical Bill Saver can always negotiate on out-of-network balance billed amounts.
Can Medical Bill Saver negotiate on bills received prior to me becoming a member of Health Advocate
Medical Bill Saver can attempt to negotiate on balances related to services that were received prior to HA going live.
Are there any co-pays or additional costs for the three in-person mental health sessions?
There are no co-pays or additional costs for the three mental health sessions after you have been referred to a provider by Health Advocate.
If I have already had three sessions for one mental health issue can I still have in-person sessions for a different issue?
The in person sessions are “per person, per issue, per year” so if it is truly another issue you will get 3 more sessions! Unlimited telephonic support is available as well at any time.
What type of issues can Health Advocate address?
Health Advocate staff serve as a liaison for clients with health insurance providers, insurance plans and other health-related community resources. This means they can address nearly any medical question and issue from finding primary care, specialist physicians and medical institutions to resolving claims and billing errors. Health Advocate also helps members access community resources, including senior care services that fall outside traditional healthcare coverage.
Will I be able to speak to the same person each time I call Health Advocate?
Yes. When you call Health Advocate for the first time, you will be assigned your very own Personal Health Advocate (PHA) who will remain with you until your issue is resolved. However, if you contact Health Advocate outside usual business hours and your assigned PHA is not available, your inquiry may be handled by other members of the staff..
Can Health Advocate make appointments on my behalf?
Yes, Health Advocate can make appointments on your behalf. If your condition requires an urgent appointment, your Personal Health Advocate can attempt to call your specialist or physician and schedule an earlier appointment..
Will Health Advocate help me fight a bill?
If you receive a bill that you would like to dispute, it is best to contact your health provider directly. However, if the bill is related to insurance coverage and you need further assistance, your Personal Health Advocate can review the bill on your behalf and, if necessary, contact the provider on your behalf to correct any errors.
Will Health Advocate share my information with my employer?
Health Advocate will never share your confidential healthcare information with anybody without your explicit consent, including your employer.
Are there issues I should *not* call Health Advocate for?
You can call Health Advocate with almost any questions about your health insurance coverage, claims and medical bills. However, if you have a question about your health insurance premium billing or other billing issues linked directly to your paycheck, please reach out to our internal support team instead. You can reach Justworks at firstname.lastname@example.org or 1-888-534-1711.
Does Health Advocate cost me any money?
Access to Health Advocate is free for eligible Justworks members. If you have questions, please don’t hesitate to contact our support team at email@example.com
This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, legal or tax advice. If you have any legal or tax questions regarding this content or related issues, then you should consult with your professional legal or tax advisor.