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Start Health works differently than traditional insurance—we reimburse fixed amounts based on the care you receive (regardless what your provider charges you). This gives you the freedom to shop for care and often save money by asking your provider for their cash price up front.

When you receive care, you’ll pay on the date of service using your Start HSA Card (for tax-free savings) or any payment method you prefer. Be sure to request an itemized bill at the time of service. Having this information not only helps you compare costs but also ensures a smooth reimbursement process once you submit your expense.

Here’s how you’ll get reimbursed by Start Health:

Step 1: Ask for an Itemized Bill

When you visit a doctor or fill a prescription, be sure to ask for an itemized bill. Itemized bills must include specific details, including CPT and diagnosis codes. These codes allow us to determine the correct reimbursement amount based on our fixed rates. 

Note: The following details need to be included in your itemized bill: 

  • Patient’s full name
  • Provider’s name and address
  • Date(s) of service
  • Charge amount(s)
  • CPT / Procedure code(s) (Also known as Service Code(s))
  • Dx or Diagnoses code(s)
  • Prescription drug(s) name, form, strength and dosage or NDC code

Step 2: Submit Within 90 Days

A notice of claim must be given within 90 days of the date of service to be eligible for reimbursement, as outlined in your policy. If you’re having trouble getting your full itemized bill in time, submit whatever you have so we can preserve your eligibility while you work with your provider. Even calling us to notify a medical event occurred works!

Step 3: Create an Expense in Your Member Portal

Log in to your Start Health Member Portal and click “Create an Expense.” From there, enter basic details such as the patient’s name and date of service, then upload photos of your itemized bill(s). This same process applies to medical services and medications. 

Note: You will create an expense based on the date(s) of service with the provider who rendered care, meaning you do not need to create a separate expense per card transaction.

Step 4: Processing and Reimbursement

After you submit your expense, the Start Health team will review it and let you know if it’s approved, denied, or partially denied. Approved reimbursements are first applied to your deductible, and once your deductible is met, payments go directly to you via ACH transfer. Preventive care is paid directly to you pre-deductible at our fixed rates.

Need Help?

If you need assistance submitting an expense with Start Health, call or text us at (800) 894-9454

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Get Added Peace of Mind with Start Shield

Your Start Health base policy already provides comprehensive coverage on a fixed reimbursement schedule-typically 110-145% of Medicare rates. Once your deductible is met, Start Health covers 100% of eligible medical expenses up to our fixed reimbursement schedule. If your provider charges more than the reimbursement rate, you're responsible for the difference.

Start Shield helps when your provider charges more than your base policy covers, after the base policy's deductible has been met. It pays 80% of the extra costs above your base policy's reimbursement, until you reach your Max Out-of-Pocket:

  • $8,000 for individuals
  • $16,000 for families

Once you hit that limit, Start Shield covers 100% of any remaining costs beyond what your base policy pays. Start Shield only applies to in-network procedures and only after the base policy's deductible has been met. All emergency care is treated as in-network.

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