Meet the team that takes money worries off patients’ minds
Penn Medicine’s patient financial advocates help keep out-of-pocket costs from interfering with patients’ care.
When Peter Conver arrived at Penn Medicine for treatment of stage 3 throat cancer, he had a lot on his mind. He faced 35 proton radiation treatments plus several immunotherapy infusions, largely on his own.
Conver, a retired supermarket employee, hadn’t even thought about how much all of it would cost.
As Conver was dealing with the enormity of the situation, he got a call from Shawn Carney, a member of the Patient Financial Advocacy Team at the University of Pennsylvania Health System, inviting him to meet.
Carney explained that Conver’s Medicare plan would require him to pay 20 percent of the cost of his cancer treatment until he hit his out-of-pocket maximum of $8,500—which Conver didn’t have. But Carney said Conver, who relied on Social Security benefits, qualified for Penn Medicine’s Financial Assistance Program to cover those out-of-pocket costs. The program provides free or discounted care to eligible patients to help fill gaps left by insurance and other forms of financial support.
“Shawn said, ‘We’re going to pay 100 percent of this,’” said Conver, 76. “The team was such an important part of my treatment, because it was one less thing that I had to worry about. And it was a big thing.”
Easing the pressures
Working behind the scenes, the financial advocates provide a safety net for patients whose out-of-pocket medical expenses could prevent them from getting care or leave them with unmanageable medical debt. For patients receiving specialty infusions or undergoing surgery, deductibles, coinsurance, and other fees can range from $5,000 to $100,000 within a few months.
Whenever a patient requires complex medical care like Conver's cancer treatment, their insurance information is first passed to the health system's financial clearance team, which verifies benefits, calculates out-of-pocket costs, and secures authorization for treatment. When that coverage falls short or doesn't exist, the advocates step in.
They look for co-pay assistance or free drug supplies from manufacturers, seek grants, screen the patient for Medicaid, evaluate the patient for financial assistance, or offer a payment plan.
As in Conver’s case, the advocates aim to get involved before patients even realize they need help.
“That's the overall goal: What we can do for this patient now, instead of six months from now, when they have a $5,000 bill?” said Lyndsay Ridgway, associate director of the team. “From the start of the patient's care—whether that is through their primary care office, through a specialty office, through their new patient consult—we are saying, what type of insurance does this patient have? Do they have insurance? Do they have an out-of-pocket? Is this something that they can afford? Is there assistance available to this patient?”
The financial advocacy team was formed in 2014 to support patients at the Hospital of the University of Pennsylvania and has grown significantly since then, with 42 staff members supporting every hospital and outpatient office in the health system. They work closely with the social work department and clinical teams, but anyone can refer a patient to them. Patients can also contact the team directly through the MyChart by myPennMedicine platform.
Drawing on extensive knowledge of public and private insurance and financial assistance programs, the advocates assess people’s needs and explain options they may not know exist. They stay with patients over time and across different care settings.
The people who do this kind of work come from various jobs in health care—admissions, social work, insurance pre-authorizations—but share a passion for solving problems.
“We're going to figure it out,” Elizabeth Vazquez, a patient financial advocate at HUP, always tells people. “If I don't know the answer, we're going to know how to navigate it.”
Advocacy in action
Much of the advocates’ time is spent educating patients about Medicare, the federal health insurance for people 65 and over and some younger people with disabilities, and supplemental coverage options that can reduce out-of-pocket costs. They also help patients understand Medicaid, the joint federal-state program that provides free or low-cost health coverage to people with low incomes or certain disabilities.
“We may not always have a perfect ending for every case, but we give every case all the effort we can and offer our guidance and insight,” said Carney, who oversees the advocates for the health system’s Philadelphia hospitals.
Ana Park, a patient financial advocate at Penn Hematology Oncology Bucks, persisted for months on a case when a patient’s insurance company unexpectedly denied coverage for their cancer infusions. The care team felt that drug was the best treatment for the patient, but the expected out-of-pocket cost was over $200,000.
Park and a co-worker bounced between the employer providing the insurance, the drug manufacturer, and even a state representative.
“We would be constantly emailing them and then they would respond one out of every three times,” Park said. “We had people saying, ‘we’re not going to respond to your emails anymore.’”
Ultimately, the drug company agreed to provide the drug for future treatment, and the Penn financial assistance program—the same one that helped with Conver’s expenses—covered the past treatment. There was never a gap in the patient’s care.
From July 2025 to June 2026, the financial advocacy team enrolled hundreds of patients in drug company copay assistance programs and signed up hundreds more who qualified but weren’t aware they could receive Medicaid.
“Our team’s most important role is identifying the best possible pathways for patients. Obtaining Medicaid, navigating Medicare, and obtaining pharmacy coverage or copay assistance helps patients far beyond their financial liabilities at Penn,” Ridgway said. “These programs benefit patients beyond the treatment here.”
From July 2025 to June 2026, the team also awarded financial assistance to nearly 2,500 patients. Most nonprofit hospitals in the U.S. are required by federal law to offer financial assistance programs, though each hospital sets its own criteria. Penn Medicine offers free care for patients with incomes up to 300 percent of the Federal Poverty Level; and above that, if a patient's balance is 10 percent or greater of their annual income, they may qualify for a discount.
“We don’t want a patient to turn their care down because they have high out-of-pocket costs, copays, or deductibles,” Ridgway said.
Finding help where patients don’t expect it
In addition to contacting patients before they start treatment, the advocates go to events in the community to educate people about insurance and the financial assistance process.
At a health fair in Philadelphia’s Kensington neighborhood this summer, Siomairra Sanchez approached the financial advocacy table on behalf of her best friend, who was on dialysis and waiting for a kidney transplant. The friend was having trouble paying her $900 monthly private insurance premium and sometimes skipped her medications. Sanchez said they had been applying for “every grant, everything you can think of, for over a year.”
Vazquez asked about the friend’s diagnosis and coverage. When she heard “end-stage renal failure,” she recognized a possibility.
Medicare kicks in when people turn 65, but it also covers younger people with disabilities, including those with end-stage renal disease. Vazquez told Sanchez her friend could likely switch to the federal program and lower her premiums by several hundred dollars a month. She could layer on a state-run Medicare savings plan and a supplemental plan to pay some of the remaining costs that Medicare didn’t. Vazquez encouraged Sanchez and her friend to call her with questions. Sanchez hugged her.
“She jumped in to my rescue,” Sanchez said. “I didn't know, and my bestie didn't know. We thought Medicare is only for 65 and older.”
Vazquez once worked to assist a man who lived in Delaware and needed Medicaid coverage for skilled nursing care. Although he had a very low income, a county assistance employee said he wasn't eligible.
The advocate reviewed the state Medicaid rules and discovered that nursing home coverage was handled through a specialized state program, not the usual County Assistance Office process. She drove to Delaware to help the patient, and a month later, she saw his Medicaid coverage was active.
That expertise will become more important as new Medicaid eligibility rules take effect. Beginning in October 2026, federal rules changed to restrict eligibility for lawfully present noncitizens, and in 2027, certain non-exempt adults will need to meet requirements that they are working, volunteering, attending school, or participating in job training for at least 80 hours per month. They will also be required to prove their eligibility every six months, rather than annually.
One patient, one case at a time
Patients often don’t know their benefits. Sometimes, they don’t want to get treatment because they assume their insurance won’t cover much of it at all, and they’ll be on the hook for hundreds of thousands of dollars, Carney said. Explaining their portion of the bill is helpful because the patient’s financial responsibility may not be as daunting as they fear.
“Then, when we give them the potential assistance options, it’s one less thing they have to worry about in these times of health uncertainty,” he said.
In 2018, when Conver received Carney’s offer of financial assistance to pay for his cancer treatment, he didn’t consider himself poor enough to need charity. But he knew that without it, he might spend the rest of his life paying off medical debt and might have to leave the Lansdale, PA, apartment he shared with his beloved cats. He ultimately viewed Carney’s call as a sign that “God was offering me help.”
Eight years later, Conver is happy his cancer is behind him—and grateful that he still doesn’t have to worry about medical bills. Whenever he goes to a Penn Medicine appointment or pharmacy, all he has to do is show his letter from the Patient Financial Advocacy office. Through the financial assistance program, his coinsurance is covered each year until he meets his out-of-pocket limit, at which point Medicare takes over completely.
Thinking back on everything that has happened, Conver considers Carney “one of my favorite people in the whole world.”
The financial advocates “never once made me feel like, this is your fault you’re poor,” he said. “There are so many people at Penn that I’m grateful for, and Shawn is one of many.”