Start is not a traditional health insurance plan—rather, it is a healthcare reimbursement model. It is insurance redefined. On this new model, your health coverage will not be dropping at all. The only thing dropping will be your costs. Keep reading for a detailed plan comparison.
Traditional Health Insurance Rundown
You’re familiar with traditional health insurance. On a co-pay plan, you pay a set premium each month for coverage. Before coverage kicks in, you must meet your deductible. After meeting your deductible, you enter the coinsurance phase, which means you only pay a percentage of medical costs while your insurance pays the rest. You must reach your out-of-pocket maximum for the year before your insurance covers everything.
Traditional Plans Are Old News
Sure, traditional plans get the job done—but not without shortcomings:
- Traditional plans are typically linked to an employer, which presents a problem for the self-employed, small businesses, and those who are in between jobs.
- Traditional plans contain networks, meaning you can’t go to any provider that’s not listed under your plan.
- Traditional plans generally charge high premiums. Do you really want to pay high monthly “what-if-I-get-sick” fees? It would make more sense to pay lower monthly premiums and get reimbursed for the care that you actually receive (This is what Start does).
- Traditional plans are slow. While a co-pay is taken care of at the time of a healthcare visit, coinsurance fees arrive later down the road—sometimes way down the road—patients are often left waiting for months, and they don’t even know the bill amount until it arrives.
- Traditional plans don’t provide access to self-pay savings opportunities. When you “self-pay” (pay in advance or on the day of your medical service without utilizing insurance), you generally receive a significantly discounted rate as the provider doesn’t need to spend time and resources on the cumbersome claims process.
Start Saving Big
Your Start plan shares many positive features with traditional insurance but fills in the gaps.
Start is a healthcare reimbursement model, meaning we reimburse you a set rate for care instead of having contracted rates with providers. (Hooray—no networks!) These set rates are referred to as “Start Reimbursable Rates.” Each covered medical service is associated with a specific reimbursable rate. Like any health plan, you pay a monthly premium for coverage (don’t worry—it’s lower than traditional premiums), and preventive services are covered at 100%. In fact, Start covers everything a traditional plan does but for a much lower cost. As a bonus, your Start plan is completely portable and offers an HSA. Learn about the tax advantages of HSAs here.
Cash is King
The most important difference between Start and traditional plans is that you pay upfront (self-pay) for eligible services, rather than paying a co-pay. And we’re not kidding about those self-pay (a.k.a. “cash-pay”) discounts:
“I was told a procedure would be $1,850,” says one healthcare consumer. “I have a $7,500 deductible. So, I talked to the [healthcare facility] office manager who said if I paid upfront and agreed not to report the procedure to [my insurer], that it would be $580.”
“I was going to be billed $830 through my PPO for an MRI. The cash price? $500,” says another.
Why can self-paying for healthcare result in discounts? Providers are relieved not to pay a claims team to process your bill, which can take months. Our simplified payment process is a win-win: You’re relieved not to think about the bill anymore—there’s no overhanging “pay-it-later” stress and no surprise costs.
Your Start Plan in Action
You don’t often hear about “self-paying” for healthcare. How exactly do you go about paying upfront?
Once you’ve received a medical service, tell your provider, “I’m not going to be using health insurance today. I’ll be paying in cash.”
You can then hand them your Start Card or pay with an account of your choosing. Once the service is paid for, ask for an itemized receipt, preferably with CPT codes listed on it. Upload the receipt to your Start App within 30 days, and you will quickly receive the Start Reimbursable Rate associated with your medical service. No lengthy claims process. No surprise bills. You go; you’re done.
Like a traditional plan, Start has a monthly premium and a deductible. It covers preventive services at 100%. Unlike traditional insurance, Start does not have a co-pay or a coinsurance phase, and its premiums are much lower. It’s completely portable and has no networks. Start is the only HSA-qualified reimbursement model. HSAs are key to lowering healthcare costs due to their triple-tax advantage: tax-free contributions, growth, and withdrawals for qualified medical expenses. HSA funds can be used toward deductibles and can even be invested—a prime way to take advantage of their tax-free growth. 100% of the Start Reimbursable Rate will be applied to your deductible until it is met. Once you’ve reached your deductible, the full Start Reimbursable Rate will be credited to you.