Traditional insurance limits you to narrow networks—often forcing you into certain providers, even when costs or quality don’t line up. Sometimes the same care is double the price depending on where you go.
Start Health is different. You can see any provider (locally, nationally, or even abroad!) and receive the same benefits. The key is using your Start reimbursement rate to compare prices so you can choose the best care at the best value.
Step 1: Know Your Reimbursement Rate
Log in to your Start Health member portal at my.starthealth.com and select “Find Care.” From there, you can search for any test, procedure, or medication—by name or by CPT/NDC code. You’ll see the fixed reimbursement amount that Start Health provides for that service.
This fixed reimbursement amount is:
- Applied toward your deductible, or
- Paid directly to your bank account if your deductible has already been met.
Preventive care is always reimbursed right away.
Step 2: Compare Prices Before You Go
One of the biggest advantages of Start Health is the ability to shop around for care. Prices for the same procedure can vary widely, even within the same city.
Here’s how to make your dollars go further:
- Call providers beforehand and ask for their cash price for the service you need.
- Compare that price with your Start reimbursement rate shown in your portal.
- If the provider’s price is at or below your reimbursement amount, your care is effectively free, meaning you’ll be reimbursed the full cost.
- If the provider’s price is higher, you’re responsible for the difference.
Quick Example
Let’s say your plan reimburses $300 for a lab test. If Provider A charges $250, you’ll get your full $250 reimbursed—meaning your care was free. If Provider B charges $400, Start reimburses $300, and you’d pay the $100 difference.
Our Member Support Team can also help you compare prices or find affordable facilities near you.
Step 3: Choose Smart Care Options
Use these guidelines to find quality care without overpaying:
Telemedicine first: For minor conditions like sinus infections, UTIs, or rashes, telehealth visits are fast, convenient, and affordable.
Ask about outpatient options: If you need a planned procedure, ask your doctor which facilities can perform it. Outpatient clinics often use the same equipment and staff as hospitals, but at a fraction of the cost.
Save the ER for emergencies: Emergency rooms are for life-threatening situations. For smaller injuries or illnesses, visit an urgent care clinic instead.
Always ask for a cash-pay discount: Many providers offer significant savings when you pay upfront.
Step 4: Get Reimbursed Quickly
After your visit, upload your itemized bill through the member portal. If your itemized bill isn’t ready, or you’re having trouble getting it from your provider, you should still upload whatever proof of care you have within 90 days of the date of service to stay eligible for reimbursement—you can always upload your itemized bill later!
To ensure you receive your benefits quickly, please be sure to provide all the needed information to process your expense. Without the right details, we won’t know what to reimburse you or whether the care performed was preventive and should be paid to you directly.
By knowing your reimbursement rates, comparing local providers’ cash-pay prices, and choosing providers strategically, you can make the most of your Start Health plan and receive high-quality care at the best possible price.
Need help finding care? Call or text us at (800) 894-9454
