A reimbursement model is when we pay you a set rate for care instead of having contracted rates with providers. Like any health plan, you will pay a monthly premium for coverage. However, unlike other health plans, you will pay upfront for eligible services and be reimbursed at a determined set rate for a given service or procedure. To be reimbursed, you are required to upload an itemized receipt of your care within 60 days of your service date.

Providers often offer a cash-rate for procedures when they don’t bill through insurance. When visiting the doctor’s office, simply state that you are paying cash for your procedure. If they ask for your insurance card, let them know you’re on a reimbursement model and paying cash for your procedure / service.

Users will pay for services with their Start card which can pay from HSA funds or the desired account set in the user’s preferences.

Start will apply 100% of the reimbursable amount for procedures and services to the member’s deductible amounts before the deductible is met.

Once the deductible is reached, 20% of the reimbursable amount will be applied to the OOPM amounts and the rest will be credited / reimbursed to the user.

If the reimbursable amount is higher than what the user paid at the service, then the user will keep the rest and will be credited in the form of an HSA contribution (if not exceeding HSA limits set by the IRS), ACH payment (direct deposit), or premium credit depending on the user’s preferences.

Your Start policy will include all covered procedures and services. You will also be able to utilize the search feature in your find care dashboard to search for eligible / covered procedures and the Start reimbursable amount will be displayed. If you have questions about coverage, please call us.

You will pay for services using your Start card which can pay from HSA funds or the desired account set in your account preferences. Upon card swipe, an expense will be generated for your policy and you will then need to upload your itemized receipt within 60 days of your service date. If you forget to use your Start card when paying for your procedure or services, or pay with cash, you may submit your itemized receipt for reimbursement in your expense dashboard.