Below, you’ll find all the information you need to use Garner
Below, you’ll find all the information you need to use Garner
You can view all the details about your Garner benefit by clicking “Your benefit” on the home screen of your Garner Health app.
No. Garner is not your health insurance. Garner is a separate benefit that is paired with your health insurance plan to help you find the best providers and reduce the amount you must pay out of pocket before you meet your insurance deductible.
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.
To change your language to Spanish, go to your account settings by clicking on the gear icon. Under the “Language” section, choose “Spanish” from the drop-down menu.
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.
Garner has compiled and analyzed the largest medical claims database in the United States to objectively identify the top 20% of all providers. These Top Providers have shown to:
Garner has no financial relationships with doctors. Garner recommendations are based solely on independent analysis, not commissions or fees.
Next, find Top Providers. You can search by name or by the type of care you need. Top Providers have a green badge next to their name and are automatically added to your list of approved providers as soon as they are visible on your screen.
We try our best to recommend Top Providers that are in-network with your health insurance plan. Since insurance companies change their networks regularly, we always recommend verifying with your health plan that a provider is still in-network on or before the day of service.
No. You may choose to receive care from a doctor who is not a Top Provider. However, those out-of-pocket costs will not qualify for reimbursement.
Your employer cares about your health. In order to help you find the best care, your employer pays for you to have the Garner Health benefit.
Because receiving better care results in better outcomes with fewer complications, patients who see Top Providers will generally pay less in the long run and be healthier overall. Garner helps your employer pass these savings along to you through an innovative health reimbursement arrangement (HRA) that incentivizes getting the best care and staying healthier. It’s a win-win for everyone involved.
Yes. Garner Top Provider recommendations are updated monthly based on the latest data. However, if a member has previously added a Garner Top Provider to their list of approved providers, any recommendation updates will not affect the provider’s approved status for that individual member and their dependents.
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.
Go to the “Settings” page in the Garner Health app by clicking the gear icon in the upper right corner of the home screen and select “Approved providers” in the menu.
Top Providers are automatically added to your list of approved providers as soon as their Top Provider badge is visible on your screen. The Concierge may also add approved providers to your account. Just remember, all providers must be in-network and your health insurance plan must cover the services you receive for any out-of-pocket costs to be eligible for reimbursement.
Search for your specialist by entering their name and zip code or search by facility. If your specialist has a Top Provider badge, qualifying out-of-pocket medical costs from services performed or ordered by that specialist are eligible for reimbursement on or after the date you add them to your list of approved providers.
If your specialist is not an approved provider, you can still choose to receive care from them, but those out-of-pocket medical costs will not qualify for reimbursement.
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.
If you have an appointment with a Top Provider or an approved primary care physician, and a nurse practitioner in their practice sees you instead, the costs from that visit will qualify for reimbursement. However, to ensure your claim is processed as quickly as possible, contact the Concierge and ask to have the nurse practitioner’s name added to your list of approved providers, even if it is after the date of service. Otherwise, we may deny your claim until we are able to associate the mid-level provider you saw with a provider that has been added to your list of approved providers.
No. Garner evaluates the performance of individual doctors, not entire medical centers or hospitals. Use the Garner Health app to search for specific providers by name to see if they are a Top Provider and approved for your Garner benefit.
No. Your list of approved providers carries over each year.
Your out-of-pocket medical costs will qualify for reimbursement if:
When you receive care from an approved provider, pay your upfront costs as usual. Garner has access to your insurance plan’s claims. After your health insurance company processes the claim, Garner will reimburse your qualifying out-of-pocket medical costs.
Because the speed that billing departments submit claims to your health insurance company can vary, it typically takes 6-8 weeks to receive reimbursement after the service takes place. Your reimbursement check will arrive in a plain white envelope.
The Concierge can answer questions about your reimbursements.
A reimbursement check will arrive in a plain white envelope. The check will be sent to the mailing address the primary member has on file with their employer.
Sometimes clinics will have a physician’s assistant or nurse practitioner submit prescription refill orders to pharmacies on behalf of the practice. If you pick up a prescription and notice that the prescribing provider is someone other than your approved provider, contact the Concierge and ask to have the physician’s assistant or nurse practitioner’s name added to your account.
We understand you can’t choose ancillary providers such as anesthesiologists, radiologists and nurses. Your Garner benefit will reimburse all qualifying out-of-pocket medical costs if:
No. Garner reimbursement occurs after costs are processed by your health insurance plan. Your health insurance plan must cover qualifying medical care and you must submit your out-of-pocket costs to your insurance company for them to be eligible for reimbursement.
No. Garner reimbursement occurs after costs are processed by your health insurance plan. Your health insurance plan must cover qualifying medical care and you must submit your out-of-pocket expenses to your insurance company for them to be eligible for reimbursement.
Garner works with your medical insurance, which generally does not cover dental or vision services. Garner may reimburse qualifying out-of-pocket medical costs for procedures such as oral surgery, but only if the claim for that service is processed by your health insurance plan.
Garner provides recommendations for the following types of facilities in the Garner Health app and on our website:
Qualifying out-of-pocket medical costs from the types of facilities listed above that you find through Garner will be eligible for reimbursement regardless of whether the services were ordered by an approved provider or not, so long as:
We strive to ensure the facilities we recommend are in-network with your health insurance plan, but since that information is subject to change by your health insurance plan, we always recommend confirming with the facility before making an appointment.
Garner does not recommend specific hospitals or facilities other than the types listed above. To look for care at a hospital or another type of facility, search in the Garner Health app or website for the specific provider you wish to see. If they are a Top Provider, they will be approved for your Garner benefit.
Yes. You have 90 days after your benefit reset date to ensure we receive your remaining claims from the previous year. Claims received after this deadline will be denied.
To see your benefit reset date, check the “Your benefit” section of the Garner Health app.
If your insurance carrier takes too long to send your EOB and you do not believe it will be received by the deadline, you are required to contact Garner before your deadline.
When contacting Garner, clearly outline the following details:
Your deadline can be extended by 90 days to account for a delayed EOB if you contact us in time. The deadline cannot be extended further, even if you don’t receive your bill in time.
Go to the “Your benefit” page in the Garner Health app for detailed information about your Garner benefit or contact the Concierge.
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 an HSA through your employer-sponsored high-deductible health plan (HDHP), you must first spend the minimum amount toward your health insurance deductible. Once you spend that amount, you are able to utilize the Garner HRA.
You are not required to spend HSA dollars on Garner-approved providers. However, we encourage you to seek care from Top Providers.
Garner tracks the claims we receive from your health insurance. Once you spend $1,500 for individuals or $3,000 for families in 2023 or $1,600 for individuals or $3,200 for families in 2024, we will start issuing reimbursement checks for qualifying out-of-pocket medical costs. You can also visit your health insurance carrier’s website to determine the progress you’ve made toward meeting this minimum deductible spending amount.
Importantly, meeting your deductible doesn’t mean you have to wait to start using Garner. You can still set up a Garner account and search for doctors before your visit. This ensures that your qualifying out-of-pocket medical costs will qualify for reimbursement as soon as you meet the IRS out-of-pocket requirement.
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.
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