Medical Plan Options

Your family only needs one account. However, any dependent over the age of 18 who is on your health insurance plan is welcome to create their own account.

If a doctor you are seeing currently isn’t a Top Provider, you may be able to add them to your list of approved providers so that out-of-pocket costs for their services will qualify for reimbursement.

To be approved, your doctor must fall into one of these categories:

• Primary care provider
• Pediatrician
• Geriatrician
• Gynecologist
• Therapist Psychologist (not psychiatrist)

Please Note:  To be eligible for reimbursement, your chosen providers MUST be pre-selected and added to your Garner App BEFORE your appointment.  We recommend adding them when you sign up with Garner.

1. Open the Garner Health app and find your doctor’s profile page.
2. Click “Request approval.”
3. Follow the on-screen workflow to complete the request.
4. Once your doctor is approved, go to “Settings” on the home screen.
5. Click “Approved providers” to view your list.
6. Your approved doctors will appear with an “Added on” date.
7. Out-of-pocket costs for services from that doctor are eligible for reimbursement starting from that date.

For issues or questions, please use Garner's Concierge service within the app.

All new providers, including specialists, MUST be Top Providers in order to qualify for the Garner benefit.

If you need to find a new provider, use the Garner Health app to find a Top Provider or contact the Concierge for assistance.

Specialists must be added to your list of approved providers prior to the date of service in order for out-of-pocket medical costs to qualify for reimbursement.

For example, if your PCP recommends that you see a GI specialist for stomach pain, you must check with Garner to ensure the specialist is a Top Provider, and then add them to your list of approved providers before your date of service.

Your out-of-pocket medical costs will qualify for reimbursement if:

• You have created a Garner account and added the provider to your list of approved providers prior to the date of service. (Learn how to add providers to your list.)
  
• Your provider is in-network and the cost was covered by your health insurance plan. (Check your health insurance plan.)
  
• The type of cost qualifies for reimbursement under your Garner plan. Depending on your Garner plan, costs for things like prescription drugs or emergency services may or may not qualify for reimbursement. (Check the Your benefit page in the Garner Health app to learn more.)
• If your health insurance plan is paired with an HSA, you will need to incur costs greater than the minimum deductible. (Check the Your benefit page in the Garner Health app to see if this requirement applies.)

Top Providers are the best-performing medical professionals that Garner has identified through an analysis of over 60 billion medical records representing more than 310 million unique patients.

Top Providers are the top 20% of all providers in the industry. They are highlighted in the Garner Health app with a green Top Provider badge and represent the best available doctors near you who are in your network and have appointment availability.

Their analysis determined that patients who see their top providers:

• Diagnose health problems more accurately.
• Prescribe the right treatments based on the latest research
• Have the lowest cases of hospital readmissions

The Garner Concierge is a group of professionals dedicated to answering your questions and helping you find the best care for you and your family.

You can message the Concierge through the Garner Health mobile app, at getgarner.com or by emailing concierge@getgarner.com.

The Concierge team is available Monday through Friday from 8:00 a.m. to 8:00 p.m. ET.. Se habla español.

An HSA is a Health Savings Account. You and your employer are able to contribute pre-tax dollars to this account. Because of IRS requirements, two main rules apply.

First, if you have a high-deductible health insurance plan (HDHP) that is paired with an HSA, you are required to spend a minimum amount toward your health insurance deductible before you can utilize your Garner HRA.

This amount changes annually and depends on whether you have a family or individual plan. Check the “Your benefit” page in the Garner Health app for more detailed information about this amount. Note that this rule applies even if you are not actively contributing to your HSA this year.

Second, you may not request reimbursement from your Garner HRA for any out-of-pocket cost you have already paid for using funds from your HSA. This is often referred to as double dipping and is prohibited by the IRS.

If you have a health Flexible Spending Account (FSA), special rules apply to your Garner benefit.

You may not be reimbursed by the Garner HRA for an out-of-pocket medical cost that will also be paid using your FSA. This is often referred to as double-dipping and is prohibited by the IRS.

If your Garner HRA and your FSA cover the same medical cost, we recommend you use and exhaust your Garner funds before using your FSA. You can save your FSA for when your Garner benefit has reached its limit or for out-of-pocket medical costs that do not qualify for reimbursement by Garner.