It never hurts to be at the right place at the right time, and Medicaid navigation platform Fortuna Health just landed $18M of Series A funding in the wake of one of the biggest shakeups the safety net coverage program has ever seen.
Medicaid is complicated. Each of the 56 Medicaid programs in the U.S. has its own evolving eligibility rules, documentation standards, and renewal timelines – none of which are easy for anyone to keep track of.
- Fortuna consolidates these programs into a single interface for patients and members, allowing them to manage their eligibility and applications while getting guided through the obstacle course.
- For anyone with some time to spare for an exhaustive overview of Fortuna and the broader Medicaid market, look no further than HTN’s stellar interview with CEO Nikita Singareddy.
“TurboTax for Medicaid.” That’s the basic pitch to Fortuna’s payor and provider customers.
- Managed care plans and payors get a way to offload backend compliance work and “become invaluable to their members” by putting a Medicaid navigator in their pocket.
- Health systems and other provider orgs get a way to maximize revenue / retention by helping more patients get (and stay) enrolled in Medicaid or navigate their way to financial support from partners like Cedar.
Over 71M people are currently covered by Medicaid, and One Big Beautiful Bill just reshuffled the rulebook for all of them.
- OBBB includes roughly $1T in cuts to safety net coverage, as well as new proof-of-work restrictions, documentation requirements, and more frequent eligibility checks.
- The CBO expects 10M people to lose coverage by 2034 as a result, and Fortuna plans to use its Series A to scale nationwide (it’s currently in 10 states) and invest in AI features that will help respond to the policy shifts.
The Takeaway
As long as Medicaid exists, there’s a place for software that makes enrolling easier. Medicaid infrastructure is long overdue for a healthy dose of AI modernization, and an extra $18M certainly won’t hurt Fortuna’s chances of being the company that makes it happen.
