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Start Health is a fixed benefit health plan, not traditional insurance. We issue fixed benefits, or set rates, for eligible medical services. This approach gives you the freedom to choose any provider and shop for care that best fits your needs and budget by comparing provider cash prices with our fixed benefit rates.

What makes Start Health unique is that it is designed to be HSA-eligible*, allowing you to pay for care tax-free through your Start HSA Card. This combination of flexibility, transparency, and savings creates an extraordinary benefit for our members.

A fixed benefit health plan, or fixed indemnity plan, is a type of health coverage that issues set benefits for eligible medical services received, regardless of your provider’s charges. Members can often take advantage of discounted cash pricing and compare costs across providers to find care that best fits their needs and budget.

With Start Health, you pay for care on the date of service with your Start HSA Card or a payment method of choice, then submit your itemized bill to receive benefits for eligible medical services.

Preventive care is eligible for benefits right away, and once your deductible is met, eligible benefits are issued directly to you. This approach puts you in control of your care, helping you choose where to go, compare costs, and keep more money in your pocket.

What makes Start Health unique is that it is designed to be HSA-eligible*, allowing you to pay for care tax-free through your Start HSA Card.

To submit an eligible medical expense under your Start Health plan, you’ll first need to create your Start Member Account and request an itemized bill from your provider. Once you have your bill, log into your Member Portal, create an expense, and upload your documentation within 90 days of the date of service.

Your itemized bill should include:

• Patient’s full name
• Provider’s name and address
• Date(s) of service
• Charge amount(s)
• CPT / procedure code(s) (service codes)
• Diagnosis code(s)
• Prescription drug name, form, strength, dosage, or NDC code (if applicable)

Once approved, eligible benefits are applied toward your deductible if it has not yet been met. After your deductible is satisfied, eligible benefits are issued directly to you. Eligible preventive services are available pre-deductible.

Start Health is best suited for healthy individuals who want to lower their healthcare costs without sacrificing coverage. It’s particularly beneficial for those who do not qualify for significant subsidies through the marketplace and are looking for an affordable plan that provides comprehensive coverage, flexibility, and the ability to take advantage of tax-advantaged HSA savings.

Start Health is not the best fit for individuals who are managing ongoing health conditions, as we keep costs low by offering this plan to those in good overall health.

Start Health qualifies applicants based on a medical questionnaire. 

Any affirmative response (“Yes”) to the following 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 disorder
• Stroke

Yes, Start Health plans are designed to be HSA-eligible*. They meet IRS and Department of Insurance (DOI) requirements for High Deductible Health Plans (HDHPs), including providing benefits for preventive care pre-deductible.

While our plan does not follow a traditional out-of-pocket maximum structure, once the deductible is met, Start Health issues eligible benefits at 100% of our fixed benefit rates directly to the member. This design is intended to meet HSA eligibility requirements, allowing members to contribute to and use a Health Savings Account.

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

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 are encouraged to explore an ACA plan or another alternative until after the baby is born.

Learn more here. 

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

Start Health does not reimburse for other forms of alternative (or experimental) treatments like acupressure, acupuncture, aroma therapy, hypnotism, massage therapy, and rolfing.