Stethoscope on 'Preventive Care' folder for medical concept

Guard Your Health and Your Wealth

Save on future medical costs by making healthy choices today. Start Health reimburses certain preventive care services before you meet your deductible.

Your plan covers a fixed amount based on the type of care you receive, regardless of your provider’s charges. If your provider charges more than our benefit amount, you’ll still be responsible for leftover expenses. If your provider charges less, you enjoy the savings.

Important Note: Your benefits depend on whether your visit is billed as routine or diagnostic. Routine (preventive) care means you don’t have symptoms or a diagnosed condition, and only services on the Preventive Schedule are covered by Start 100% at our fixed rates. If your doctor orders extra tests, those may go toward your deductible or not be covered. Diagnostic care is when you have symptoms or a medical condition, and tests are done to find, monitor, or treat and is usually applied to your deductible.

What’s Covered as Preventive Care?

The following procedures and tests may be considered preventive and may be eligible to be reimbursed at the associated Start Health Reimbursement Amount even before your deductible is met. 

Wellness Visits:
  • Annual Physical Exams & Visits: Regular checkups to keep you healthy.
  • Newborn Checkups: Includes visits at 2 weeks, 4 weeks, 8 weeks, and 3 months of age and annual check-ups after that.
  • OBGYN Visits: Yearly screenings for women’s health including Pap Smears & Lab Tests
Cancer Screenings:
  • Lung Cancer Screening: Available if you meet certain qualifications. Call our Care Coordinators for more information.
  • Mammograms: Government guidelines recommend screening for breast cancer once every two years for women over the age of 40. Start Health will reimburse for mammograms according to the recommended limit set by USPSTF
  • Preventative Colonoscopy including polyp removal if necessary (See USPSTF Limits)
  • Preventative Prostate Exam (See USPSTF Limits)
    • PSA (Prostate-Specific Antigen): A blood test for prostate cancer.
Blood Tests:
  • Metabolic Panels: Tests for overall health and organ function.
  • CBC (Complete Blood Count): A general test to check for conditions like anemia.
Diabetes Screening:
  • Yearly testing for diabetes.
    • Hemoglobin A1C
Birth Control:
  • IUD, ring, and pill forms 
Immunizations (Vaccines):
  • COVID-19 Vaccines
  • Flu Vaccines
  • Hepatitis A and Hepatitis B Vaccines
  • General Immunizations:
    • Shingles
    • Tetanus
    • HPV (Human Papillomavirus)
    • Pneumococcal
    • Polio
    • Measles
  • If billed as preventive:
    • Meningococcal vaccines
    • Rabies (human diploid-cell vaccine)
    • Yellow fever
Other Covered Services:
  • Routine vision and hearing screenings for kids
  • Behavioral screenings for children 18 and under

Have questions about preventive procedures? Contact our Member Support team for help finding quality, affordable care by calling or texting: (800) 894-9454

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Get Added Peace of Mind with Start Shield

Start Health plans keep planned costs low by paying fixed benefit amounts for medical services. In most cases, members can find providers who accept those amounts by using cash-pay pricing or working with our Support Team. When that is not possible, such as during emergencies or situations where you cannot shop ahead, Start Shield provides added protection.

If you receive a bill that exceeds your plan’s reimbursement:

  • Our team reviews the charges for accuracy
  • We advocate on your behalf and negotiate with providers to reduce the total amount you owe

If a large balance remains after advocacy, Start Shield may provide additional financial assistance. Financial support is determined on a case-by-case basis and is designed to help limit your total financial exposure—similar to an Out-of-Pocket-Max.

Emergency care is automatically eligible for Start Shield. For planned procedures, a pre-bill must be submitted in advance to be eligible for Start Shield consideration. Start Shield works alongside your Start Health plan to help you manage unexpected medical bills with more confidence.

Start Shield Terms of Service

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