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Judi Health

Unified claims processing for health benefits

Overview

Judi Health is a New York health tech and benefits administrator serving employers, unions, health plans, and government entities, with three brands: Judi Rx, a transparent pass-through PBM; Judi Care, which handles medical, dental, and vision benefits and care navigation; and Judi Cloud, which licenses the platform to health plans and TPAs. Its core product is the Judi platform, a Unified Claims Processing system that brings pharmacy and medical claims onto a single cloud with AI-enabled workflows to adjudicate benefits. The company differentiates itself with price transparency through flat fees and a single, unified platform that reduces fragmentation, pursuing growth without acquisitions. Its goal is to simplify and lower the cost of health benefits administration and scale across commercial, Medicare, and Medicaid by licensing the platform and offering care services.

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About Judi Health

Simplify's Rating
Why Judi Health is rated
B-
Rated B on Competitive Edge
Rated B on Growth Potential
Rated C on Differentiation

Industries

Data & AnalyticsEnterprise SoftwareAI & Machine LearningHealthcare

Company Size

501-1,000

Company Stage

Series F

Total Funding

$585M

Headquarters

New York City, New York

Founded

2017

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Simplify's take

What believers are saying

  • November 3, 2026 DOL transparency momentum directly favors Judi's pass-through model.
  • September 3, 2026 partnerships with Color Health, WellTheory, and Cylinder deepen employer cross-sell.
  • August 11, 2026 Inc. 5000 ranking confirms five straight years of rapid organic growth.

What critics are saying

  • UnitedHealth Optum, CVS Caremark, and Cigna Evernorth can undercut Judi on distribution and contracting.
  • Unified Claims Processing needs flawless migrations; one failed enterprise rollout damages trust in 2027 renewals.
  • If transparent PBM pricing compresses faster than Judi scales Judi Cloud, margin expansion stalls.

What makes Judi Health unique

  • Judi Health unifies pharmacy, medical, dental, and vision claims on Judi.
  • Judi Rx Retire won CMS approval on October 20, 2026, for employer retirees.
  • FedRAMP Ready status on July 30, 2026 opens federal health-plan sales.

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Funding

Total Funding

$585M

Above

Industry Average

Funded Over

6 Rounds

Notable Investors:
Series F funding comparison data is currently unavailable. We're working to provide this information soon!
Series F Funding Comparison Coming Soon

Benefits

  • Health Insurance
  • Remote Work Options
  • Hybrid Work Options
  • Wellness Program
  • Mental Health Support
  • Conference Attendance Budget
  • Professional Development Budget

Growth & Insights and Company News

6 month growth

0%

1 year growth

0%

2 year growth

2%
Business Wire
Oct 20th, 2026
Judi Health launches Judi Rx Retire, a CMS-approved Medicare Part D plan for employer groups

Judi Health, a health technology company and benefits administrator, has launched Judi Rx Retire, a Medicare Part D plan for employer groups and their Medicare-eligible retirees. The Centers for Medicare & Medicaid Services (CMS) approved it as an Employer Group Waiver Plan (PDP-EGWP). The plan runs on Judi Health's Judi platform and offers transparent pricing, flexible coverage, and technology-enabled administration. Employers can access claims data, cut out third-party middlemen, and verify the full value of the CMS subsidy. "Retirees are often an afterthought in a healthcare system that continues to defy logic and reward complexity over clarity," said chief executive officer AJ Loiacono. Judi Rx Retire holds the CMS contract directly and keeps eligibility, claims, and formulary data in one system. Its member care team promises 24/7/365 support, with 97% first-call resolution.

Associated Press
Sep 8th, 2026
Employers Health and Judi Health launch StarkRx transparent PBM solution for self-funded plans

Employers Health has launched StarkRx, a transparent pharmacy benefit solution developed with Judi Health. The cost-plus model aims to give self-funded plan sponsors greater visibility into pharmacy costs and more control over their benefit plans. StarkRx offers flexible plan designs backed by Judi Health's technology platform. Features include a broad retail pharmacy network using cost-plus reimbursement, a specialty pharmacy network including Amazon and Accredo by Evernorth, and integration with third-party solution providers. The offering allows Employers Health's 500-plus clients, covering 2.5 million lives and nearly $6.1 billion in spend, to work collaboratively whilst avoiding restrictions associated with traditional spread models. Chris Goff, Employers Health's CEO, said the platform enables clients to identify market innovators and implement solutions more quickly.

HIT Consultant
Jul 15th, 2026
Capital Rx rebrands as Judi Health, raises $400M to unify pharmacy, medical, dental and vision claims

Capital Rx has rebranded as Judi Health following a $400 million funding round. The transparent pharmacy benefit manager is expanding beyond prescription drugs to launch Unified Claims Processing, consolidating pharmacy, medical, vision, and dental benefits on a single cloud platform called Judi. The company has achieved 20,000% organic enrolment growth over five years, now serving over 50 million individuals across commercial, Medicare, and Medicaid segments. Judi Health operates through three divisions: Judi Rx (pass-through pharmacy benefit model), Judi Care (medical benefit administration), and Judi Cloud (platform licensing for health plans). A June 2026 survey by Employee Benefit News found that 100% of transparent pharmacy benefit manager adopters would choose the pass-through framework again, with most migrating from traditional incumbents.

Associated Press
Jul 15th, 2026
Capital Rx rebrands to Judi Rx after $400M funding, launches medical benefits and cloud licensing arms

Judi Health has rebranded its pharmacy benefit manager Capital Rx to Judi Rx and launched two new divisions: Judi Care for medical benefit administration and Judi Cloud for platform licensing. The announcement follows a $400 million financing round. Founded in 2017, the company has grown its contracted lives by 20,000% over five years to more than 50 million across commercial, Medicare, and Medicaid. A June 2026 survey found transparent PBMs are now expected to dominate the industry over the next three to five years. The company's proprietary Judi platform consolidates pharmacy and medical benefit administration on a single system. Judi Care handles medical, dental, and vision solutions, whilst Judi Cloud enables health plans and third-party administrators to license the technology.

Business Wire
Feb 12th, 2026
Judi Health names John Nicolosi as CAO following $400M funding round

Judi Health has appointed John Nicolosi as Chief Administrative Officer to lead its newly established Administrative Services function. Nicolosi will oversee client-facing operations including implementation, client services, customer care and government programmes. Nicolosi brings over 20 years of healthcare and pharmacy benefit management experience, with a track record in driving organisational growth and client satisfaction. He previously held multiple leadership roles overseeing large-scale implementations and clinical strategy. The appointment follows Judi Health's significant expansion, including over 80 new partnerships, a $400 million funding round, and the launch of its unified pharmacy and medical claims adjudication platform. Nicolosi holds a Doctor of Pharmacy degree from Midwestern University and a bachelor's degree from the University of Illinois.

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