My Coverage Plan

Name

My Coverage Plan

Legal name

My Coverage Plan, Inc.

Website

https://home.mycoverageplan.com

Company type

Private

Founded year

2010

Operating status

Operating

Headcount range

1–10 employees

Ownership category

akta.pro rank

Headquarters

HQ city

Madison

HQ country

United States

HQ region

North America

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. Healthcare Provider Software Subscriptions: Software-as-a-service solutions for healthcare providers and health systems, including FirstCheck Wisconsin and Advocus applications for patient eligibility screening and case management.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels5 records

Core offering

My Coverage Plan develops and sells web-based health benefits screening and counseling decision-support software to hospitals, clinics, and other healthcare providers. Its flagship suite includes FirstCheck Wisconsin for patient intake screening, Advocus for case and client coverage management, the FPL Calculator for Federal Poverty Level eligibility, and Gurulz for benefits-related education. Together the products help providers connect uninsured and vulnerable patients to appropriate coverage and mitigate medical debt.

Product overview

My Coverage Plan offers a suite of four integrated health coverage navigation tools. FirstCheck Wisconsin serves as the intake and screening entry point using a TurboTax-style interview approach; it feeds into Advocus, the flagship case and client management platform that ABC staff use to help patients identify and optimize healthcare coverage. The FPL Calculator is a standalone eligibility tool used by both consumers and benefits staff nationwide. Gurulz is a complementary learning management system that educates learners about health care coverage access through assessments and structured course content. Together, these products form a comprehensive medical debt mitigation ecosystem.

Differentiator

Problem solved

Functional benefit

Brands

• FirstCheck Wisconsin: A web application screening tool using decision support technology to help guide users through an intake interview about household, income, coverage, and demographics. Uses a TurboTax-style approach to expand low-income consumers' access to health insurance benefits.
• Advocus
• FPL Calculator
• Gurulz

Products and services

• FirstCheck Wisconsin Web application screening tool that uses decision support technology to guide users through an intake interview covering household, income, coverage, and demographics; uses a TurboTax-style approach to expand low-income consumers' access to health insurance benefits and to avoid certain medical debts. Targeted at hospitals, clinics, and benefits staff in Wisconsin and beyond.
• Advocus Flagship case and client management application that helps end-users identify and optimize patients' healthcare coverage and create a coverage roadmap that tracks and responds to changing life events. Used by ABC for Health, Inc. staff and healthcare providers to improve patient coverage outcomes and provider revenue.
• FPL Calculator Free online tool that determines an individual or family's standing relative to the current annual Federal Poverty Level based on income and family size, supporting calculations across annual, monthly, biweekly, and weekly values for years 2023-2026. Used by consumers and benefits staff nationwide for Medicaid, Marketplace Tax Subsidy, and SNAP eligibility determinations, attracting roughly 400,000 site visits and 150,000 unique users annually.
• Gurulz Emerging Learning Management System designed to educate learners about access to health care coverage with emphasis on patients vulnerable to health disparities. Built around a health benefits learning tool matrix (BLT) with content for four learner categories across 14 learning modules covering over 150 courses related to public benefits, private insurance, and legal and advocacy strategy.

Quantifiable outcome

• As of mid-2024, automated the FirstCheck Wisconsin referral process with end-user referrals dropping directly into Advocus, creating efficiency for users and partners.
• +1 more outcomes

Named customers3 records

Segments3 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

Feature6 records

Partnerships

One partnership is on record.

• ABC for Health, Inc.coreStrategic or Co-development Partner · 1 January 2010ABC for Health, Inc. is the parent nonprofit public interest law firm that spawned My Coverage Plan, Inc. For over 30 years, ABC for Health has helped clients impacted by health disparities due to income, race, or poverty connect to health care coverage and services in Wisconsin. My Coverage Plan operates as a technology development subsidiary, with Subject Matter Experts from ABC providing content and expertise for product development.

Scale indicators2 records

Recent moves6 records

Direct peers

• findhelp (formerly Aunt Bertha): findhelp operates a social/benefits-navigation platform that helps patients and caseworkers find and enroll in public benefit programs including Medicaid and other health coverage. It is a direct competitor to My Coverage Plan in the coverage-navigation and eligibility-screening category.
• Unite Us: Unite Us runs a coordinated social-care network connecting patients to benefits and community resources, with strong health-system relationships. It competes with MCP in helping providers screen patients for benefits eligibility and track outcomes.
• Healthify (now part of WellSky): Healthify provided SDOH screening and closed-loop referrals to community resources, including health coverage, for hospitals and health plans. It is a direct peer in benefits eligibility screening and patient navigation inside provider workflows.

Broad incumbents

• Waystar: Waystar is a large healthcare revenue-cycle management platform whose patient-access suite includes eligibility verification and benefits screening. It overlaps with MCP's coverage-eligibility tooling but as part of a much broader RCM portfolio.
• Experian Health: Experian Health offers patient eligibility, coverage detection, and financial-clearance tools used by hospitals. It is comparable to MCP's coverage-eligibility screening but operates at vastly greater scale and as part of Experian's broader data-services portfolio.
• Optum (Change Healthcare): Optum, through Change Healthcare, provides eligibility, claims, and patient-access solutions to providers and payers. It competes with MCP on healthcare eligibility and benefits determination as part of a much wider services platform.
• Epic Systems: Epic's EHR platform includes patient coverage and eligibility functionality that overlaps with MCP's decision-support tooling. While not a focused competitor, Epic could build or absorb comparable features natively, threatening standalone vendors.
• Oracle Health (Cerner): Oracle Health's Cerner platform provides eligibility and benefits screening within its EHR suite. As a broad incumbent in hospital IT, it represents the kind of large incumbent that could either partner with or displace niche coverage-navigation vendors.

Emerging players

• Cedar: Cedar offers a patient financial experience platform that includes eligibility checks, bill resolution, and coverage-related communications. It is comparable to MCP's mission of reducing medical debt and connecting patients to coverage, but is consumer-experience focused.
• AKASA: AKASA applies AI to healthcare revenue cycle operations including eligibility verification and coverage-related workflows for hospitals. It is comparable to MCP's eligibility and coverage-navigation value proposition, but at the RCM-automation layer rather than patient-navigation.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/mycoverageplan

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles4 records

Funding overview

Funding rounds

Investors

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 My Coverage Plan