Start Health members pay a monthly premium for coverage. When visiting a provider, they pay upfront using their Start Benefit Card or another payment method. By paying cash for eligible services, members often receive a discounted rate. When members submit an itemized receipt to their member portal, the Start Reimbursement Rate is applied to the deductible. Once the deductible is met, the reimbursement amount is credited directly to the policy holder.

Any affirmative response (“Yes”) to the preceding questions will result in the applicant being deemed ineligible for qualification.

Any tobacco use in the past 12 months?

Are you currently pregnant or have reason to suspect you might be pregnant?

In the past 24 months, have you been recommended to have, or been scheduled for, diagnostic testing, treatment, or surgery that has not been completed?

Within the past 24 months, have you had a health related condition for which you have not sought medical advice or treatment?

Within the past five years, have you received any abnormal test results, medical or surgical treatment, healthcare professional consultation, or prescribed medication for any of the following conditions?

Please indicate ALL that apply:

• Arthritis, Rheumatologic disorder or any disease or disorder of the joints, bones, muscles or back. (Indicate if any condition that has lasted more than one month or that you have been prescribed anything other than over the counter pain relievers.)
• AIDS or tested positive for HIV
• Asthma, Emphysema, COPD, TB, or any other disease or disorder of the respiratory system
• Cardiovascular disease or disorder of the heart, arteries, blood vessels, or blood. (Indicate for any condition for which you were treated with any procedure or prescribed a medication other than statins.)
• Cancer or tumor
• Chemical dependency, drug or alcohol abuse, or any other mental health disease or disorder
• Crohn’s disease, ulcerative colitis, hepatitis, or any other disorder of the liver, stomach, colon, or intestines. (Indicate for any condition for which you received a treatment or prescribed a medication other than over the counter medications.)
• Diabetes or any other pancreas disorder
• Immune system disease or disorder
• Kidney disease or disorder
• Brain or nervous/neurological system
• Stroke

Start Health plans are HSA-qualified because they meet the IRS and DOI requirements for a High Deductible Health Plan (HDHP). Our plans have high deductibles and cover preventive care 100% before the deductible is met. While Start Health plans don’t have a traditional maximum out-of-pocket limit, once the deductible is met, Start Health reimburses 100% of eligible healthcare costs at our set reimbursement rate. This structure ensures members are protected from large out-of-pocket expenses, allowing our plans to be considered comprehensive coverage and HSA-compatible.

Yes, Start Health has set reimbursement rates based on medicare rates for generic prescription medications.

Yes, Start Health has set reimbursement rates for alternative modalities like Chiropractic Procedures, Acupuncture, Osteopathic Manipulative Treatment, Physical Therapy, Allergy Testing, and more.

Yes, Start Health provides set reimbursement rates for pregnancy and birth-related care. However, if a member is pregnant at the time of renewal, they won’t be eligible to renew their plan, as pregnancy is considered a disqualifying condition. Members due to deliver after their Start Health coverage expires can switch to an ACA plan or another alternative.

Yes, ineligibility for renewal is considered a Loss of Coverage event, allowing clients to sign up for an ACA plan.

Start Health reimbursement rates are set at 110-130% or medicare rates.