Start is a new approach to insurance. Like anything that’s unfamiliar, we know you might have questions, so let’s answer some of the most pressing ones:
What does a “reimbursement model” mean?
As a reimbursement model, we pay you a set rate for care instead of having contracted rates with providers. This rate is referred to as the “Start Reimbursement Rate.” Like any health plan, you will pay a deductible and a monthly premium for coverage. However, unlike other health plans, there are no co-pays, out-of-pocket maximums, coinsurance phases, or claims processes. You will pay upfront (self-pay) for eligible services and be reimbursed the Start Reimbursement Rate for the given service. To be reimbursed, you must upload an itemized receipt of your care, preferably with CPT codes , within 30 days of your service date.
How do I self-pay?
Providers often offer a cash rate for procedures when they are not billed through insurance. When visiting the doctor’s office, simply state that you will not be using insurance and are paying cash for your procedure. If they ask for your insurance card, let them know you are on a reimbursement model and paying cash for your procedure/service.
Do Start members get reimbursed before or after the deductible is met?
You will use your Start Benefit Card to pay for services. Your Start Benefit Card draws either from HSA funds or from another account you prefer.
Start will apply 100% of the Start Reimbursement Rate to your deductible amount until the deductible is met. Once your deductible is reached, 100% of the reimbursable amount will be credited to you in full.
If the reimbursable amount is higher than what you paid at service, you will be credited the excess amount in the form of an HSA contribution (as long as it does not exceed the HSA limits set by the IRS), ACH payment (direct deposit), or premium credit, depending on your preferences.
How do I know if my procedure is covered?
Your Start policy will include all covered procedures and services. You will also be able to use the search feature in the “Find Care” dashboard in the Start app to search for covered procedures and view the Start Reimbursement Rate for each procedure. If you have questions about coverage, please call us at (800) 894-9454.
How do I use my Start Benefit Card?
You will use your Start Benefit Card to pay for all medical services. Your Start Benefit Card draws from HSA funds or another account that you prefer. After you swipe your card, an expense will be generated for your policy. You will then need to upload your itemized receipt (preferably with CPT codes) within 30 days of your service date. If you forget to use your Start Benefit Card when paying for medical services, or if you pay with cash, you can simply submit your itemized receipt for reimbursement.
Have more questions? Please call us at (800) 894-9454
