Fortuna Health

What Fortuna Health does

Fortuna Health is a private, New York-based health technology company founded in 2023 that operates an AI-powered Medicaid navigation platform designed to streamline eligibility screening, enrollment, and renewal for Medicaid beneficiaries. The platform integrates with state Medicaid systems to provide automated data pre-fill, eligibility checks in as little as 30 seconds, and guided multi-step workflows across 11+ U.S. states. It supports multilingual access in 8+ languages in-app and 180+ languages via phone, manages a virtual mailbox for state Medicaid correspondence, and—since March 2026—offers a Voice AI capability for automated renewal outreach. A specialized NY Nursing Home Medicaid & Asset Planning service combines application handling with an integrated elder law attorney partner network for legal and asset strategy.

The company operates exclusively through a B2B2C distribution model: services are accessible only through partner Managed Care Organizations and healthcare providers (hospitals, health systems, primary care, mental health, dental, kidney care, maternity, and geriatrics practices), with consumers gated by partner codes. Reported partner outcomes include a 95% application approval rate, 5x faster enrollment, 15% renewal rate lift, 53%+ enrollment lift for provider partners, and a 27% reduction in uncompensated care for hospital partners (per the Alomere Health case study, which cites $2,700 per patient recovery and 10x ROI). Revenue is generated through performance-based contracts with health systems—where clients pay only for patients actively managed and progressing toward coverage—and likely subscription or per-member-per-month arrangements with health plans. The platform is HIPAA-compliant, hosted on AWS with Aptible-managed containers, and includes partner-facing modules such as provider portals and health plan dashboards with closed-loop reporting.

Fortuna Health has raised approximately $22 million across two rounds: a $4 million seed in November 2023 led by Andreessen Horowitz Bio + Health with BoxGroup and Y Combinator, and an $18 million Series A in July 2025 led by Andreessen Horowitz, earmarked for nationwide expansion, AI workflow enhancement, and policy adaptation. Strategic alliances include a co-development partnership with Unite Us for cross-sector member coordination and a network of elder law and Medicaid planning attorneys for NY long-term care. With 1-10 employees and operations across 11+ states targeting the 90M+ U.S. Medicaid beneficiary population, Fortuna is in an early scaling phase.

Name

Fortuna Health

Legal name

Fortuna Health, Inc.

Website

https://fortunahealth.com

Company type

Private

Founded year

2023

Operating status

Operating

Headcount range

1–10 employees

Short description

Fortuna Health is an AI-powered Medicaid navigation platform that helps consumers complete eligibility checks, enrollment, and renewals, distributed exclusively through partner health plans and healthcare providers across 11+ U.S. states.

Ownership category

akta.pro rank

Product category

Medicaid Navigation Software

NAICS

Services for the Elderly and Persons with Disabilities (62412)

SIC

Hospital & Medical Service Plans (6324), Services-Prepackaged Software (7372)

akta.pro primary industry

Care Navigation, Referral & Digital Front Door Platforms (HLALABAH)

Keywords

• Medicaid navigation platform
• Healthcare eligibility software
• AI-powered enrollment
• Medicaid renewal automation
• Health plan member engagement

Headquarters

HQ city

New York

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Infrastructure, Operations, Marketing or Sales

Revenue model

1. Performance-Based Healthcare Navigation: Fortuna charges health plans and health systems based on patient outcomes - Alomere Health case study indicates they pay only for patients actively managed and progressing towards coverage. This creates alignment between Fortuna's success and client outcomes.
2. B2B2C Platform Subscription: Health plans and providers partner with Fortuna to offer Medicaid navigation services to their members/patients. Revenue likely derived from per-member-per-month arrangements or platform licensing fees with partner organizations.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels5 records

Core offering

Fortuna Health operates an AI-powered digital Medicaid navigation platform that helps consumers complete eligibility checks, enrollment, and renewal for government health coverage in under a minute. The platform delivers 24/7 multilingual live navigation support, a virtual mailbox for managing state Medicaid correspondence, and closed-loop partner reporting, and is offered exclusively through partnerships with health plans (MCOs) and healthcare providers who refer their members and patients via partner codes.

Product overview

Fortuna Health offers a unified AI-powered Medicaid navigation platform consisting of a core enrollment and renewal system, Voice AI capabilities for automated member outreach, and specialized services for nursing home Medicaid. The platform integrates eligibility screening, application submission, multilingual support across 170+ languages, and continuous renewal management into a single consumer-facing experience. Partner-facing tools include provider portals for patient enrollment support and health plan dashboards with closed-loop reporting. The company also provides state-specific Medicaid guidance pages covering 14 U.S. states with eligibility calculators.

Differentiator

Problem solved

Functional benefit

Products and services

• Fortuna Medicaid Navigation Platform AI-powered digital platform enabling consumers to complete Medicaid eligibility checks, enrollment, and renewal in under a minute. Provides 24/7 multilingual support via chat, SMS, and phone with licensed navigators handling end-to-end processes for health plan members and provider patients.
• Fortuna Voice AI for Medicaid Renewals AI-powered voice capability for automated Medicaid renewal outreach and member engagement. Enables health plans and states to scale renewal reminders and support calls while reducing call center load and caseworker burden.
• NY Nursing Home Medicaid & Asset Planning Specialized Medicaid navigation service for New York nursing home residents combining application handling with elder law and Medicaid planning attorney partnerships for coordinated legal and asset strategy. Includes end-to-end application services, document collection, application submission, dedicated case management, and legal document drafting for asset protection.

Quantifiable outcome

• 95% application approval rate
• +5 more outcomes

Named customers2 records

Segments4 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability6 records

Feature6 records

Partnerships

Five partnerships are on record, tiered strategic, core and supporting.

• Unite UsstrategicStrategic or Co-development Partner · 27 February 2026Fortuna Health and Unite Us partnered to support Medicaid members with people-first digital engagement and real-time coordination across health, benefits, and human services systems. Collaboration helps residents stay informed, enrolled, and supported.
• Managed Care Organizations (MCOs)coreChannel Partner/ Reseller/ DistributorFortuna partners with health plans and MCOs to provide Medicaid navigation services to their members, helping reduce churn and improve renewal rates. Services are offered through partner health plans.
• Healthcare Providers and Health SystemscoreChannel Partner/ Reseller/ DistributorHospitals, health systems, and provider practices partner with Fortuna to help uninsured and underinsured patients enroll in Medicaid, reducing uncompensated care. Services available only through partnered providers.
• Elder Law and Medicaid Planning AttorneyssupportingImplementation/ SI/ Consulting PartnerFortuna partners with licensed elder law and Medicaid planning attorneys for NY nursing home Medicaid services. Attorney partners handle legal strategy, document drafting, and asset protection while Fortuna manages the application process.
• Hudson Valley Estate Planning PLLCsupportingImplementation/ SI/ Consulting PartnerPartner attorney firm led by Kylan Johnson specializing in estate planning and Medicaid qualification for families entering nursing homes in Westchester County, NY.

Scale indicators16 records

Recent moves6 records

Expansion highlights6 records

Broad incumbents

• Waystar: Waystar is a healthcare payments and revenue cycle platform serving hospitals and health systems with eligibility verification and patient access workflows. It is comparable to Fortuna as it addresses Medicaid eligibility screening and uncompensated care reduction for providers, though at much broader enterprise scale.
• Benefitfocus (now Voya Financial): Benefitfocus operates a benefits administration platform serving health plans, employers, and consumers with enrollment and decision-support tools. It overlaps with Fortuna's digital enrollment/renewal capabilities, though at a much broader scale and serving commercial benefits as well as government programs.
• Maximus: Maximus is a large government services contractor that operates state Medicaid eligibility and enrollment contact centers, as well as health insurance exchange platforms. It is comparable to Fortuna as both serve as the operational and technical layer between Medicaid agencies and beneficiaries, though Maximus does so as an incumbent BPO/IT vendor at massive scale.
• Conduent: Conduent provides government healthcare services including Medicaid eligibility, enrollment, and health insurance exchange technology (inheriting hCentive and other platforms). It competes with Fortuna in the Medicaid administration market but as a diversified incumbent offering broader government BPO services.

Direct peers

• HealthSherpa: HealthSherpa is a leading ACA marketplace enrollment platform that helps consumers find, compare, and enroll in Marketplace and Medicaid coverage. It is a direct peer in consumer-facing government health coverage navigation, with overlapping technology and distribution models.
• GetInsured: GetInsured is a health insurance marketplace platform that powers state-based ACA exchanges and supports Medicaid eligibility screening. It is directly comparable to Fortuna as a technology platform enabling consumers to enroll in and renew government health coverage, including Medicaid.
• Stride Health: Stride Health provides a benefits navigation platform helping consumers enroll in ACA, Medicaid, and Medicare coverage, often via partnerships with employers and health plans. It is directly comparable to Fortuna in target market (underserved/Medicaid-eligible consumers), business model (B2B2C), and technology approach (digital navigation).

Emerging players

• Talkiatry: Talkiatry is a mental health provider network that works with health plans and partners to deliver in-network psychiatric care, often to Medicaid beneficiaries. It is comparable to Fortuna as a venture-backed digital health company partnering with MCOs and health systems to serve Medicaid populations.
• Zipari: Zipari is a health insurance customer experience platform serving payers with member engagement, enrollment, and retention tools. It is comparable to Fortuna as a technology partner to health plans focused on member retention and engagement, including in Medicaid lines of business.
• Unite Us: Unite Us is a social care coordination platform connecting health, human, and social services. Fortuna has a strategic partnership with Unite Us, making it both a peer (in Medicaid member coordination) and a partner, as both serve Medicaid populations needing cross-sector support.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/fortuna-health
• Xx.com/hifortunahealth
• Facebookfacebook.com/fortunahealth

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds2 records

Investors3 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Fortuna Health