ABLE Accounts: A Payment Solution for Your Patient Advocacy Services

As an independent patient advocate, you know that one of the biggest challenges your clients face isn't just navigating the healthcare system—it's figuring out how to pay for your valuable services. While many of your clients recognize the importance of professional advocacy, the out-of-pocket costs can be a significant barrier.

GNA NOW is happy to share some good news you probably haven't heard: if you're working with clients who have disabilities, they may be able to use their ABLE account to pay for your services. This could be a game-changer for expanding access to your advocacy work, and frankly, it's an opportunity that's flying under the radar in our field.

What Are ABLE Accounts?
ABLE (Achieving a Better Life Experience) accounts are tax-advantaged savings accounts for individuals with disabilities. Think of them as similar to 529 education accounts, but designed specifically for disability-related expenses. These accounts were created through federal legislation in 2014, and they allow people with disabilities to save money without losing eligibility for means-tested benefits like SSI or Medicaid.

The key point for you as an advocate: ABLE accounts can be used for «Qualified Disability Expenses» (QDEs)—and your services likely fall into this category.

Why Your Services Probably Qualify
ABLE account funds can be used for any “expenses that are for the benefit of the beneficiary in maintaining or improving health, independence, or quality of life” of someone living with a disability. The definition is intentionally broad, and patient advocacy services fit squarely within this framework.

When you help a client with a disability navigate their healthcare, coordinate care, resolve billing issues, or advocate for appropriate treatments, you're providing services that directly relate to their disability and improve their quality of life. Whether you're helping them understand treatment options, coordinating between multiple specialists, or ensuring they receive proper accommodations during medical care, your work may qualify as a disability-related expense.

The Financial Reality Your Clients Face
Many of your clients with disabilities are managing complex medical situations on limited budgets. They may be on fixed incomes, dealing with high medical costs, and struggling to afford advocacy services despite desperately needing them. 

ABLE accounts allow your clients to set aside money specifically for disability-related expenses—including your services—while maintaining their eligibility for government benefits. For someone who previously couldn't afford professional advocacy, this could open doors to the support they need.

How to Help Your Clients Access This Option
Start by asking your clients with disabilities if they have an ABLE account. If they don't, consider providing information about how to establish one. Each State offers ABLE programs, and many States allow out-of-State residents to participate in their programs.

When discussing payment options, explain how your services qualify as QDEs. Be specific about how your advocacy work relates to their disability and improves their quality of life. Document this connection in your service agreements and invoices.

Documentation That Protects Everyone
Since ABLE account holders need to maintain records for potential IRS review, help your clients by providing clear documentation. Your invoices should specify how your services relate to their disability management and healthcare navigation. Consider including language that explicitly connects your work to their disability-related needs.

Keep detailed records of the services you provide and how they help your client manage their disability or access appropriate healthcare. This documentation protects both you and your client if questions arise about the legitimacy of the expense.

HSAs: A More Limited Option
While we're on the topic of tax-advantaged accounts, Health Savings Accounts (HSAs) are another potential payment source, though with more restrictions. HSA funds can only be used for qualified medical expenses as defined by the IRS. Your advocacy services might qualify if they're directly related to medical care—like helping coordinate treatment decisions or resolving medical billing issues—but purely administrative or general support services likely wouldn't qualify.

The eligibility criteria for HSAs are stricter than ABLE accounts, so ABLE remains your better bet for clients with disabilities.

The Bottom Line for Your Practice
ABLE accounts represent an underutilized resource that could help more people access your advocacy services. Many people with disabilities don't know their ABLE funds can be used this way, and many advocates don't even know to suggest it.

By educating yourself about ABLE accounts and informing eligible clients about this option, you're not just expanding your payment possibilities—you're removing barriers that prevent people with disabilities from accessing the advocacy support they need and deserve.

This isn't about finding creative ways to get paid. It's about helping your clients understand all their options for accessing services that genuinely improve their healthcare outcomes and quality of life; and in a field where we're constantly advocating for our clients' rights and access to care, making our own services more accessible seems like the natural next step.

Important Considerations: 
While ABLE accounts offer genuine opportunities for clients to access advocacy services, it's crucial to approach this topic with professional integrity. As patient advocates, our primary obligation is always to our clients' best interests, not our payment preferences. Before discussing ABLE accounts, ensure your client actually qualifies (disability onset before age 26, or receiving SSI/SSDI) and remember that you're providing information, not tax or legal advice—clients should consult their ABLE account administrator or tax professional for definitive guidance. Document services carefully and honestly, focusing on legitimate disability-related benefits rather than trying to make services «fit» the QDE criteria. Most importantly, never let payment method considerations influence your advocacy recommendations or create situations where clients might face IRS scrutiny because services were improperly categorized as qualified expenses.