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Checklist: Questions to ask an advocate

Use these questions before you agree to work with any patient advocate. You decide who helps you and how much.

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Qualifications and experience

What training, certification, or background do you have?
How much experience do you have with problems like mine?
Can you describe a similar case, without sharing anyone's private details?

Who you work for

Who pays you? Do you work for a plan, hospital, or other company?
Will you act only on my behalf in this matter?
Do you get referral fees or commissions from anyone you might recommend?

Fees

How do you charge: by the hour, a flat fee, or a share of any savings?
What is included, and what costs extra?
Can I get the fees and the scope of work in writing before we start?

Permissions and privacy

Which forms will I sign so you can talk with my plan or providers?
How will you store and protect my records and personal information?
Can I limit what you do, or end the arrangement at any time?

Working together

How and how often will you update me?
Who makes the final decisions? (You should.)
What happens if the problem is not solved?

Related

This is general education. For decisions about your own plan, taxes, or legal rights, check your plan documents or a qualified professional.

Review status: Draft. Version 1. Sources retrieved: October 14, 2026.

Sources

Internal appeals HealthCare.gov (Centers for Medicare & Medicaid Services). Applies to: current page. Published or updated: Unknown. Retrieved: October 14, 2026.