Fortuna Enters West Virginia Market with Highmark Health Options

PARKERSBURG, W.Va. — (Oct. 6, 2026) — In anticipation of changing Medicaid eligibility guidelines through the implementation of new federal rules, Highmark Health Options West Virginia (HHO) has introduced Fortuna, a consumer-first navigation platform that simplifies the Medicaid renewal process and helps members impacted by the upcoming changes address eligibility requirements to maintain health coverage if eligible. Fortuna is one of several companies currently working with the federal government on the technical requirements for the new law.

The federal government estimates that roughly 15% of all adults in the Medicaid expansion population may lose health coverage once new federal Medicaid changes take effect on Jan. 1, 2027, the majority from people who can’t show they meet the new eligibility requirements, and a meaningful share simply because of missed deadlines or documentation gaps.

Fortuna’s work with HHO builds on a model designed to reduce preventable coverage loss by meeting members where they are. The platform combines timely outreach by text, email and phone; plain-language guidance; multilingual support; document and notice assistance; and access to live navigators. The service is designed to help members understand renewal notices, know when action is due and complete the appropriate steps with confidence. Fortuna’s approach addresses common renewal barriers, including confusing notices, missed deadlines, language access needs and uncertainty about required documentation.

“As Medicaid programs across the country prepare for more frequent eligibility checks and community-engagement requirements for certain adults, member communication and navigation will play an increasingly important role in helping eligible people avoid unnecessary gaps in coverage,” said Jason Landers, president and CEO, Highmark Health Options. “It’s our job, as a leading managed care organization, to help the state communicate the upcoming changes and provide the tools and support to maintain coverage if eligible for members impacted by the new requirements.”

Fortuna and HHO, the state’s first Blue Cross Blue Shield-branded managed care organization, are working in alignment with West Virginia’s Medicaid renewal process and under the oversight of the West Virginia Bureau for Medical Services. West Virginia Medicaid members are already being encouraged to prepare for upcoming federal changes by keeping contact information current, reading state communications and watching for future notices about required actions. As of June, there were nearly 390,000 Medicaid beneficiaries in the state of West Virginia.

“As new requirements take effect, we're proud to expand our partnership with Highmark Health Options to bring technology and navigation support to Medicaid members in West Virginia,” said Nikita Singareddy, co-founder and CEO of Fortuna Health. “We're also grateful to the Bureau for Medical Services for their commitment to effective, member-first outreach and engagement, and we're proud to support West Virginians maintaining their coverage and connecting to work and community engagement opportunities.”

Fortuna estimates that 77% of all Medicaid expansion beneficiaries are uncertain of when they need to take action to maintain eligibility. According to a 2024 survey by the National Association of Community Health Centers, 85% of enrollees don’t understand how to read their coverage notices and 63% try more than once to renew coverage. The program is intended to support eligible members through the administrative steps required to keep coverage active, while ensuring that eligibility decisions remain with the appropriate state authorities.

A similar pilot program with Highmark’s Medicaid population in Pennsylvania has yielded strong results. On average, Fortuna’s managed care customers see an approximate 10% increase in monthly renewal rates over baseline.

About Highmark Health Options West Virginia

Highmark Health Options West Virginia is a managed care organization serving West Virginians who qualify for Medicaid. We help each of our members receive the care and services they need to live healthier and more independent lives, and we collaborate with providers and regulators to improve health outcomes, simplify the health care experience, and ensure affordability. Highmark Health Options West Virginia members include individuals and families with low income or complex health and social needs, expectant mothers, children, and people with disabilities. Learn more at https://www.highmark.com/health-options-wv

About Fortuna Health

Fortuna Health is a consumer-first Medicaid navigation platform — “TurboTax® for Medicaid” — enabling guided renewal support across eligibility, enrollment, renewal, and transitions off the program. Fortuna partners with managed care plans to deliver simplified, member-first navigation that drives higher enrollment, faster renewals, and stronger long-term retention for the 80 million Americans who rely on Medicaid.

Media Contacts

John Pepper
Highmark Health Options
412-951-1533
John.Pepper@highmarkhealth.org

Neel Revankar
Fortuna Health
218-216-1668
neel@fortunahealth.com

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