A bill arrives before your claim has finished processing. Or you're getting ready for surgery and aren't sure whether approval is in place. You can find plan information in Coupe's portal and app, but sometimes you'd rather talk it through with a person.
A 2023 KFF survey found that half of insured adults had difficulty understanding at least some aspects of their insurance coverage.
Tori M., Operations Supervisor at Coupe Health, hears questions like these regularly. She started her career at Coupe as a Health Valet, so she knows what happens after someone reaches out for help. She recommends you ask for help early in your care journey, before a question becomes urgent. Health Valets can help resolve concerns before they become large.
What happens when you contact a Health Valet?
Coupe Health Valets are real people who can help with nonclinical questions, provider searches, scheduling doctor appointments, and other day-to-day benefit-related needs. It's healthcare navigation in practical terms: finding out what you need, who can help, and what should happen next. There's no extra charge to talk with a Health Valet.
Tori explained that some members know exactly what's worrying them. Other members aren't sure where to begin. Either way, the first steps a Health Valet takes are listening, asking questions, and understanding the full picture. Sometimes that means explaining a benefit. Other times, it means talking with a provider, claims team, or pharmacy team on the member's behalf.
One familiar contact instead of starting over
If your question takes several conversations to resolve, you shouldn't have to repeat yourself. Tori explained that Health Valets generally follow a case from beginning to end, unless escalation is needed. Members can stay in touch with their Health Valet by phone or email.
As Tori explained, "Having a familiar contact means members don't have to retell their story over again."
Your Health Valet can keep track of what's already been checked, who they've contacted, and which questions still need answers. This takes the lift off you.
A real example: Waiting for surgery authorization
Tori recalled a member who was preparing for surgery but wasn't sure if authorization for the procedure was in place. The Coupe Health Valet team checked with the provider's office and prior authorization department, explained the process, and kept the member informed while the review continued.
HealthCare.gov explains that some services or prescriptions need health plan approval before they're covered. Prior authorization requirements are determined by the insurance carrier, not a Coupe Health Valet. A Health Valet can, however, help you understand which steps are complete, what's pending, and what may happen next, so you are aware.
If authorization is delayed or denied, a provider may be able to supply more documentation, pursue an appeal, or request a peer-to-peer review with the carrier's medical team, depending on the situation. These aren't guaranteed outcomes, but a Health Valet can help explain the possible next steps, so you don’t have to sort through the process alone.
Help with everyday questions, too
Not every call involves a major procedure. Say you're looking for a new doctor. A Health Valet can help you search for providers, understand provider ratings, and compare expected costs before booking a visit. If you'd rather look through the options yourself, a Health Valet can show you how to use the provider search tools in Coupe's member portal or app. For more on comparing costs as you choose care, see Coupe's price certainty guide.
“A provider's bill can arrive before an insurance claim finishes processing,” Tori said. That can leave you wondering what you may actually owe. A Health Valet can explain the timing and contact the provider when needed.
Coupe's Health Valets don't make clinical decisions or replace your doctor. They're there to help you understand your benefits, find the right resources, and help you navigate your next step.
When the answer takes more time
Some questions need research or another team's help. Tori explained that Health Valets can contact claims and pharmacy teams and follow up with providers. They can follow up with you by phone or email, whichever you prefer.
If the inquiry is related to services from a specialized vendor, your Health Valet may arrange a call transfer, introducing you to the right representative and staying on the line until you're connected.
Members can always rely on the member portal too. You can check plan summaries, pharmacy information, provider options, and Explanation of Benefits (EOBs), then ask a Coupe Health Valet for help if something is unclear.
You don't have to wait for a problem
Tori's advice applies to everyday questions, too. A Health Valet may be able to explain a process and what to watch for next. You don't need to wait until you're overwhelmed.
If you're considering Coupe during open enrollment, a Health Valet may be available to answer Coupe-related questions through your employer. For more help comparing your options, see Coupe's open enrollment guide.
A Health Valet can help you understand what's happening and what you can do next, whether your question is big or small. You don’t need to navigate your healthcare alone.
To learn more, visit the Coupe Member page.
About Tori
Tori M., Operations Supervisor at Coupe Health, started her career at Coupe as a Health Valet. She understands firsthand what happens after someone reaches out for support. With more than 10 years of experience in customer service and healthcare, Tori has built her career around helping members navigate complex healthcare situations and ensuring they receive the guidance they need. Her experience on the front lines as a Health Valet, combined with her current leadership role, gives her a unique perspective on how members can get the most out of their benefits.
Details matter. Coverage, costs, provider access, and eligibility may vary by employer and plan. This article is for general information purposes only. Coverage or costs are not guaranteed. Review your plan documents or contact a Health Valet with Coupe-specific questions.