The ask

01Seed round · Non-confidential summary

your AI Medicare advocate

Giving consumers the Advantage in Medicare.

Dorthy is an AI Medicare advocate for the 67 million Americans on Medicare. We start by licensing it to Medicare carriers under their own brand. Then we take the same engine straight to consumers.

See the story The ask
One engine Carriers Consumers Agents

Scroll to read, or use ←→ to move chapter by chapter.

Dorthy
Dorthy home screen in light mode: Explore and Optimize starting points, a plan decision map, and the Ask Dorthy composer. Dorthy in dark mode with the Options panel open.

02The problem

Medicare is a maze, and people walk it alone.

Choosing and using a Medicare plan is complex and confusing, and there is little real help to understand the options and enroll.

11,000+

people enter this maze every single day.

About one every 8 seconds. 0 since you opened this page.

Complexity at every turn

Eligibility, benefits, networks, drug costs and plan choice create stress and confusion.

Tools that list, not explain

Plan finders and online brokers digitized the paperwork. They did not digitize the guidance.

Carriers feel it too

Carriers pay brokers up to $725 for each new member and still lose the relationship. Their members call confused, or leave.

03The solution

Meet Dorthy

An AI Medicare advocate that guides people from first question to enrollment, and through every year after.

Plan, drug and provider data
Conversational AI advocate
Compliance built in

Simplifies complexity

Explains Medicare in plain language, so people choose with confidence.

Personal recommendations

Compares plans against the person's own drugs, doctors and budget.

Full lifecycle support

From first eligibility through every annual enrollment period, not just the sale.

03Working POC live today

Dorthy is answering real Medicare questions.

Explore or optimize

Start from scratch and let Dorthy lead, or bring current coverage to review cost, drugs and network fit.

A plan decision map

A visual summary of the conversation, choices and next steps: profile, plan options, prescriptions and providers.

Ask in plain language

People ask Dorthy anything about Medicare. Every AI conversation is logged and retained.

One engine, any brand

The same product runs under Dorthy's name for consumers or under a carrier's own brand for its members. Medications, providers and plans stay in context either way.

Dorthy
Dorthy home screen in light mode. Dorthy in dark mode with the Options panel open.
Explore · Optimize
The Options panel in light mode.

04The opportunity

The prize is the consumer.

Every Medicare enrollment pays a commission, then a renewal every year after. That is where Dorthy is headed.

New enrollment market / yr

$2.8B

  • 4.1M Americans turn 65 in 2026, more than 11,000 every day (Peak 65)
  • $694 initial commission, the CMS 2026 maximum ($725 in 2027)

4.1M × $694 ≈ $2.8B

Circle areas drawn to scale: the $2.8B yearly new enrollment market flows into the $23B+ recurring commission base. $2.8B new / yr $23B+ recurring base / yr

Circle areas drawn to scale

Recurring commission base

$23B+

  • 67M Medicare members nationwide
  • $347 renewal commission per member per year, the CMS 2026 maximum
  • Every enrollment keeps paying

67M × $347 ≈ $23B+

Why we don't start there

Launching straight to consumers means paying to learn.

  1. Contracts first. Sales agreements and carrier appointments before anyone knows the product.
  2. Marketing before proof. Paying to acquire members before Dorthy has met a single one.
  3. One season to find out. Most enrollments happen in one quarter a year, so a miss costs a year.

So we start where we get paid to learn: with the carriers.

Sources: CMS CY2026 and CY2027 agent and broker compensation maximums; U.S. Census / Peak 65 (4.1M turning 65 in 2026).

05The stepping stone

One engine. Carriers pay for it first.

Medicare carriers license Dorthy under their own brand, for their members and the people shopping their plans. The same engine later goes straight to consumers.

The Dorthy engineConversational AI advocate · plan, drug and provider data · compliance built in

This round · 2027

Carriers

A white-label Dorthy in the carrier's own brand.

Who pays
The carrier: a setup fee, an annual license priced per member, and AI usage at cost plus an admin fee. No commissions.
Carrier gets
Its own AI guide, carrier-approved plan content, every chat on record, and a warm handoff to its own agents.
We get
Revenue from 2027, real members using Dorthy, and carrier relationships.

Next · mid-2028

Consumers

The Dorthy app, backed by Civil Health's licensed agency.

Who pays
Carriers pay a commission on each enrollment, then a renewal every year.
When
Launch in mid-2028, first enrollment season in fall 2028.
Where
Maricopa County first, then anywhere we're licensed.

Later

Agents

Agencies license Dorthy so their agents work alongside the same AI advocate.

Who pays
Agencies, from the commissions Dorthy helps them earn.
Status
In design.

Every carrier dollar does two jobs. It pays for the engine, and it proves the engine.

Money in

Setup fees, paid pilots and annual licenses start in 2027. Going straight to consumers earns nothing until commissions arrive after the first enrollment season.

Risk out

By the time Dorthy reaches consumers, it has served real members, carriers trust it, and its compliance record has been reviewed by their teams.

Why carriers pay

$725paid to a broker for each new Medicare Advantage member in 2027, the CMS maximum. The member's relationship stays with the broker.
123 plansAetna Medicare Advantage plans that pay brokers no commission for 2027. Those members still need help choosing.
Rising riskThe Justice Department is suing three large carriers and three brokers over broker payments. The court let most of the case proceed in March 2026.

Sources: CMS CY2027 broker compensation maximums; Aetna 2027 commission schedule (Medical Daily, Becker's Payer); U.S. Department of Justice complaint, May 2025, and ruling, March 2026 (Fierce Healthcare).

06Who buys

161 carriers. 101 are the right size.

The largest carriers are building AI for their own members. Mid-size carriers have the same need and no team to build it.

~$68M / yrif all 161 carriers licensed Dorthy at $6 per member per year, covering 11.3M members
~$34M / yrfrom the 101 mid-size carriers we target first (5,000 to 250,000 members), estimated from typical sizes
9 carrierslive by the end of 2029 in our base plan, 12 in the upside
Annual license and setup fee by carrier size, at $6 per member per year
Carrier size (members)CarriersTypical membersAnnual licenseSetup fee
250k+13300,000$1.8M$40K
100k-250k14175,000$1.05M$40K
25k-100k4460,000$360K$25K
5k-25k4315,000$90K$15K
Under 5k473,000$40K (minimum)$15K
Total16111.3M~$68M / yr

Carriers pay $0.50 per member per month ($6 per member per year), billed as an annual license up front, with a $40K minimum. Every carrier starts with a six-month paid pilot at half price. The setup fee covers branding, carrier review of plan content, compliance setup and staff training. AI usage is billed at cost plus an admin fee.

For a 60,000-member carrier, the $360K license pays for itself in year one if Dorthy moves about one in eight broker enrollments to the carrier's own channel, at $725 per enrollment saved. We never charge per enrollment.

Source: CMS Monthly Enrollment by Contract, September 2026. Typical member counts and prices are company assumptions; the value example is illustrative.

07Why carriers first

Same destination. Less money at risk on the way.

We modeled both paths with the same team costs, the same marketing cost per enrollment and the same commissions. The only difference is the order.

By June 2028, on a $2M seed

MeasureCarriers firstStraight to consumers
Net cash spent$1.31M$2.07M
Marketing spent before any member used Dorthy$0$576K
Cash left from the seed$746KRuns out in June
Paying customers3 carriersMembers from one season
Proof the product worksReal members across several carriersOne test market

Going straight to consumers would launch about a year sooner. Carriers first still comes out ahead: by the end of 2029 it has collected $6.6M against $4.2M and spent $2.5M less, because carrier licenses keep paying while the consumer business ramps up. We would rather reach the consumer market with proof than spend our way to it.

08Revenue plan

Carriers first, then consumers.

Cash collected each year from our monthly operating model. Carrier fees start in 2027. Consumer commissions start after the first enrollment season in fall 2028.

  • Carriers
  • Consumers

Forward-looking estimates, not guarantees. Carriers: setup fees, pilots, licenses and AI usage. Consumers: commissions.

2 → 5 → 9carriers live at the end of 2027, 2028 and 2029
$2.59Mcarrier recurring revenue (ARR) at the end of 2029
4,800consumer enrollments in 2029, after 1,560 in the first season

09How we differ

Nobody gives carriers their own AI guide.

Carriers can buy plan-shopping tools, AI for their call centers, or broker distribution. None of them is a branded AI advocate the carrier owns.

Capabilities of Dorthy compared with four kinds of alternatives
CapabilityDorthyAI tools for agentsMedicareCopilot, Medicare VoxPlan-shopping softwareSunFire, Zipari, SoftheonGeneral AI for health plansInfinitus, Hippocratic AI, UshurConsumer brokersChapter, eHealth, Healthpilot

Why now

Carriers are cutting broker commissions. Their members still need someone to help them choose.

Consumer AI guidance is proven

Chapter, a consumer Medicare guide, raised $100M at a $3B valuation in April 2026. It sells to consumers, not to carriers.

CMS wants AI plan help

In February 2026, CMS asked vendors for AI tools that help people choose Medicare plans.

Big carriers built for members only

UnitedHealthcare, Aetna and Elevance launched AI assistants for existing members, not for people choosing a plan.

And the free option? The Medicare.gov Plan Finder lists plans. It doesn't explain them, advocate for the person, or follow up the next year.

Sources: company announcements and Fierce Healthcare, MedCity News, TechTarget and Becker's Payer coverage, 2024 to 2026. Categories reflect public product descriptions as of October 2026.

10Roadmap

Build → license → launch to consumers → scale.

Phase 1POC live today

  1. Seed · Jan to Jun 2027

    Carrier-ready

    Production build, carrier compliance controls and security certification. First carrier pilots signed.

    Carrier demo Compliance demo

  2. Seed · Jul 2027 to Jun 2028

    First carriers live

    Paid pilots live for the 2027 enrollment season, then annual licenses. Consumer product built and tested from mid-2027.

    Live for AEP 2027 Consumer R&D

  3. Series A · mid-2028

    Consumers launch

    The Dorthy app launches in Maricopa County, ahead of its first enrollment season in fall 2028. Carrier licensing keeps growing.

    Maricopa County 5+ carriers

  4. Later rounds

    Scale

    More markets for the Dorthy app, larger carriers, and an agent edition of the same engine.

    New markets Agents

At month 18 · June 2028

What this seed proves

The Series A is raised on these results, after the first carrier enrollment season.

  • Carriers live and paying
  • Engagement data from real Medicare members
  • An 18-month compliance record that carriers have reviewed
  • A consumer product tested and ready to launch

Supporting proof: about $450K in carrier recurring revenue in the base case ($810K upside), with more carriers in pilot.

One engine Carriers 2027 Consumers 2028 Agents Later

It's not two business plans. It's one engine that grows.

11Compliance & risk

Built for a regulated market.

In Medicare, compliance is part of the product. Carriers will review it before they sign.

How we build compliance in

  • Carrier-approved contentDorthy only uses plan information the carrier has approved.
  • Every conversation on recordEach AI conversation is logged and retained for review.
  • Required notices in every chatAI disclosure and Medicare marketing disclaimers are built into the conversation.
  • The person choosesPlain comparisons, with a licensed agent wherever the rules require one.
  • Health data protectedMember data stays on AWS under a HIPAA business associate agreement, and the AI never trains on it.
  • Clean carrier feesFlat license and usage fees. Never paid per enrollment.

Risks we plan around

Carrier sales take time
Health plans buy slowly. Plan: introductions through our Medicare data partner, paid pilots, and selling from January 2027 for the fall enrollment season.
Medicare Advantage changes
Carriers exit counties and change commissions. Plan: carrier fees are flat, so they don't depend on commissions.
Rule changes
CMS marketing and compensation rules shift every year. Plan: a compliance-first build that carriers' own teams review.
Price acceptance
Per-member pricing is not yet tested with carriers. Plan: half-price paid pilots, a $40K minimum, and renewal prices set from what each pilot shows.
Relying on one data partner
Plan: non-exclusive terms, and we own the AI, prompts and models.
Series A timing
The consumer launch needs the next round. Plan: raise in the first half of 2028 on results from the first carrier enrollment season.

12Use of funds & runway

$2.0M over 18 months.

Built bottom-up, hire by hire, from January 2027 to June 2028. Spending comes to $2.03M. Carrier fees collected along the way cover the difference and leave about $746K in the bank at month 18 in the base case.

Build the engine

$898K

44% of 18-month spending

  • A production platform built to carrier security standards
  • Carrier white-label: their brand, approved plan content, handoff to their agents
  • AI accuracy testing on real Medicare questions
  • Consumer product R&D from mid-2027

Win and serve carriers

$648K

32% of 18-month spending

  • Implementation and customer success lead
  • Carrier sales lead and commission
  • Travel, events and sales materials

Compliance & security

$198K

10% of 18-month spending

  • Security certification and testing
  • Legal: carrier contracts and data agreements
  • Insurance

Platform & data

$146K

7% of 18-month spending

  • Medicare plan, drug and provider data
  • Cloud infrastructure

Admin

$84K

4% of 18-month spending

  • Accounting, payroll and software
  • Recruiting

Consumer launch prep

$54K

3% of 18-month spending

  • Marketing lead and licensed agents, starting just before launch

Founder time is counted where it is spent: one founder in building the engine, one in carrier work.

Cash runway

The seed covers the full 18 months in both cases. Without a Series A, carrier licenses keep base-case cash positive through 2029, but it dips to about $13K in December 2028 as the consumer launch ramps up. The Series A in mid-2028 funds the consumer launch at full speed and keeps a cushion.

Cash at the end of the seed period: $746K base, $1.22M upside.

13Traction

The pre-seed already did its job.

Carrier channel

A leading Medicare data partner already serving 160 carriers

We are building with a national Medicare data and enrollment platform. It has told us its carrier customers want Dorthy, and our carrier demo is in final build.

Working POC live today

Dorthy is answering real Medicare questions. A live demo follows this deck.

Compliance demo in build

A walkthrough with test members that shows carriers every notice and record Dorthy keeps.

$250K pre-seed raised

Friends and family, fully subscribed, and turned into a working product, a build plan and a legal foundation.

Licensed to sell

A co-founder holds an active Arizona insurance license and agency number in Maricopa County, home to about 727,000 Medicare eligibles.

Diligence-ready model

A monthly operating model to 2029, built hire by hire. Available on request.

14Civil Health team

Engineering depth meets Medicare experience.

Chase Holtan

Chase Holtan

Co-Founder

chase@civil.health

12 years in engineering and data analytics; led technical teams on multimillion-dollar public infrastructure and government military contracts. Machine learning and AI scholarship awards; serves on the AI Council of a company with $100M in annual recurring revenue.

Geoffrey Sahs

Geoffrey Sahs

Co-Founder · Compliance

geoffrey@civil.health

4.5 years as a product manager at a top national health insurer, including 2.5 years leading its Medicare strategic initiatives. Delivered enterprise and federal programs representing $25M+ in investment, and digital delivery for two of the world's largest consultancies.

Licensed AZ insurance agent + agency number

15The ask

$2.0M

Seed round (SAFE) · 18 months of runway

What this seed buys

  • A carrier-ready platform with compliance and security built in
  • First carriers live for the 2027 enrollment season
  • Recurring license revenue and engagement data from real members
  • A consumer product tested and ready to launch in mid-2028
  • A Series A raised on proof, to launch Dorthy to consumers
Non-confidential summary · Financial model available on request