Healthcare IT · Medicaid enrollment
Fortuna Health
A consumer app for getting onto Medicaid and staying on it, paid for by the hospitals and health plans that lose money when coverage lapses. Eleven states, $22 million raised, and a federal work requirement landing January 1, 2027.
A card in a waiting room
The testimonial Fortuna Health puts on its own home page starts in a clinic. A parent had known for years that her adult child, who has learning difficulties and is on the autism spectrum, should be enrolled in Medical Assistance, which is what Minnesota calls Medicaid. She kept putting it off. Then she picked up a card with a QR code.
“I got a Fortuna QR code from my clinic. I thought I’d give it a shot! IT WAS AWESOME. All done on my cell... 100% would recommend.”
That is a marketing page and should be read as one. The mechanics behind it are the business. A provider or health plan hands a patient a link. The patient lands in a web app shaped by the state, the program and the household. Fortuna keeps the notices, the deadlines and the uploads, and a licensed navigator picks up the phone when the software runs out.
The patient pays nothing. The clinic does.
Fifty six programs, none of them alike
Medicaid is not one payer. It is 56 programs across the states, the District of Columbia and five territories, each with its own eligibility rules, documentation standards and renewal calendar. Fortuna says 44 states run eligibility systems more than a decade old and 13 keep two platforms running at once, figures that are the company’s own.
What that costs people is not in dispute. When the pandemic era continuous enrollment rule ended in April 2023, states spent fifteen months redetermining eligibility for everyone on the rolls. KFF counted more than 25 million people disenrolled and more than 56 million renewed. Of those disenrolled, 69 percent lost coverage for paperwork or procedural reasons, not because anyone found them ineligible.
That is the market Fortuna was built for, and the company’s uncomfortable fact: the friction is the opportunity.
Three operators and a Crown Heights apartment
Nikita Singareddy, Cydney Kim and Ben Wesner started the company in 2023 out of an apartment in Crown Heights, Brooklyn. Singareddy interned on Capitol Hill, ran population health at Oscar Health, led special projects at Truepill building pharmacy services for community health centers, and spent two years as an investor at RRE Ventures. She was born on public assistance and has been on Medicaid herself. Kim came from consulting and had scaled a health tech company from seed to Series C as general manager and VP of operations. Wesner was the first software engineer at Juniper, a behavioral health revenue cycle startup in Y Combinator’s Winter 2021 batch.
They went through Y Combinator in Summer 2023 pitching TurboTax for Medicaid. That November they raised $4 million led by Andreessen Horowitz Bio + Health, with BoxGroup, Y Combinator and angels including Zocdoc founder Cyrus Massoumi, PillPack founder Elliot Cohen and the musician John Legend.
The timing looked perfect and was not. Singareddy has since said the company was too early: it was small, the product was not built, and rather than chase sales during the largest coverage disruption in Medicaid history the team spent the period learning state rules. Her summary: in Medicaid almost every case is an edge case.
The bill that changed the arithmetic
On July 4, 2025 the reconciliation law called the One Big Beautiful Bill Act, H.R. 1 and the Working Families Tax Cut legislation was signed. Its Section 71119 created a Medicaid community engagement requirement, and CMS issued the interim final rule implementing it on June 1, 2026.
From January 1, 2027, non pregnant adults aged 19 to 64 in the Medicaid adult group must show 80 hours a month of work, community service, a work program or half time education, or earn at least 80 times the federal minimum wage, which CMS puts at $580 a month in 2026. CMS says 43 states and the District of Columbia must implement it, and renewals for most of those adults move from annual to every six months. CMS models a 15 percent disenrollment rate for the adult group, about 6.4 points of it procedural: people who do not return forms in time.
Seventeen days after the law was signed, Fortuna announced an $18 million Series A led by Andreessen Horowitz. Forbes put total funding at $22 million and the company at eight states. Fourteen months later the home page says eleven.
What is proven, and what is still claimed
| Evidence | What the record shows | Source type |
|---|---|---|
| SEC Form D | Filed Aug 28, 2025, CIK 0002080965. Delaware corporation, incorporated 2023. Equity offering of $18,275,489, all sold. First sale Jul 18, 2025. Six investors. Rule 506(b). | Public record |
| Board on file | Nikita Mary Singareddy (executive officer and director), Minji Cydney Kim, Benjamin Wesner and Julie Yoo, the a16z general partner who led both rounds. No independent director is named. | Public record |
| The 2023 seed | $4 million announced Nov 2023, no Form D for it on EDGAR. A full text search for the company name returns one document, the August 2025 filing. Raises under Section 4(a)(2) need no Form D, so the gap proves nothing. | Not found |
| Named customers | MVP Health Care, which sells in Vermont and New York, and Highmark Wholecare in Pennsylvania, both quoted in the July 2025 release. Alomere Health in Alexandria, Minnesota. Channel partners Cedar and, since Nov 19, 2025, Unite Us. | Partner-stated |
| State footprint | Eight fully integrated states per Forbes in July 2025; 11 on the home page in September 2026, against a stated goal of all 56 programs. | Claim versus pace |
| Outcome numbers | Churn cut 15%, 95% application approval, 5x faster, 52% of users acting the same day, uncompensated care down 27% at Alomere and up to 53% through Cedar, MVP retention at 98%, 11x user growth to July 2025. All company supplied, none audited or confirmed. | Company-stated |
| Numbers in the pitch | The 2023 launch post put procedural disenrollments at 75% and Medicaid enrollment at roughly 90 million. KFF found 69% procedural, and CMS preliminary data for January 2025 showed 71.4 million on Medicaid plus 7.3 million on CHIP. | Differs from the record |
| Regulatory and research record | No FDA records, registered trials or federal research awards as of September 22, 2026. | Not applicable |
Read plainly: the capital is documented, the board is documented, and the customers are real enough that their executives put names to quotes. Performance is not. Every number Fortuna sells itself with comes from Fortuna. A 27 percent cut in uncompensated care at one Minnesota hospital and 98 percent retention at one regional plan are claims a customer or a state auditor could confirm, and neither has.
What to watch
- The state count. Eight to eleven in fourteen months does not reach 56 programs, and January 1, 2027 is when demand peaks.
- A direct state agency contract, which would put Fortuna against Deloitte and its roughly $6 billion in eligibility contracts across 25 states.
- Any outcome number confirmed by someone other than Fortuna.
- The next Form D, and whether the six investor structure widens.
- January 1, 2028, when CMS tightens the documentation standard.
In their words
“It’s become a very convoluted system over the decades as far as how Medicaid has been designed, unfortunately, for people who are trying to navigate their eligibility and enrollment process,”
Nikita Singareddy, co-founder and CEO, to Fierce Healthcare, 2023 · Independent
“Navigating Medicaid shouldn’t be an obstacle course. Complexity, administrative red tape, and a flood of policy changes are leaving millions uninsured for procedural reasons, not to mention providers going unpaid and payors losing membership,”
Julie Yoo, general partner, a16z Bio + Health, Series A release, 2025 · Company release
“Any company claiming they’ve already solved for work requirements is overstating what’s possible at this stage.”
Nikita Singareddy, Health Tech Nerds interview, 2025 · Interview
“In short: paperwork. That’s not because these beneficiaries don’t meet the requirements, but because they won’t successfully complete the paperwork or navigate the verification process.”
Nikita Singareddy on projected coverage losses, Health Tech Nerds, 2025 · Interview
“They’re only in a handful of states, so they either need a major payer or health system to get behind them in each new market,”
Ryan Daniels, healthcare analyst, William Blair, to Forbes, 2025 · Independent
“We are not new to this problem. We didn’t get created just to solve the Big Beautiful Bill,”
Nikita Singareddy, to Forbes, 2025 · Independent
“We’ve been very happy partnering with Fortuna. Their product has guided uninsured patients successfully through Medical Assistance, including those who previously struggled enrolling and navigating financial assistance processes.”
Laurie Swanson, director of revenue cycle, Alomere Health, company case study · Customer, via company
Related companies
Sources
- Public recordForm D, Fortuna Health, Inc., CIK 0002080965
- Public recordEDGAR full text search, all forms
- Public recordMedicaid Community Engagement Requirement, CMS-2454-IFC
- Public recordMedicaid Program; Community Engagement Requirement
- Public recordMedicaid Renewal Outcomes at the End of the Unwinding
- IndependentMedicaid navigation startup Fortuna Health picks up $4M
- IndependentHow Trump’s Medicaid Crackdown Is Fueling This Startup’s Expansion
- IndependentFortuna Health: Initiation of Coverage Report
- InterviewNikita Singareddy on building in Medicaid
- CompanyFortuna Health Raises $18M Led by Andreessen Horowitz
- PartnerUnite Us and Fortuna Health Partner to Support Medicaid Members
- CompanyAlomere Health System Cuts Uncompensated Care by 27% Using Fortuna
- CompanyFortuna Health home page and state counter
- CompanyFortuna Health: TurboTax for Medicaid, launch post
Profile researched and written by Healthcare Discovery. Last updated September 29, 2026.
