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.)

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: 

• The approved provider is added to your list of approved providers prior to your appointment.
• The approved provider is ordering or is primarily performing the service.
• The service is in-network with your health insurance plan. To confirm coverage, check the list of services on your health insurance card or call the number on the card. If you have an online account with your health insurance provider, log in to your portal to confirm coverage details.

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:

• Labs
• Imaging centers
• Urgent care clinics

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:

• The profile page for the facility has a yellow banner that says “eligible with some exceptions.” This indicates that out-of-pocket medical costs for the service you are seeking at that facility qualify for reimbursement.
• You find the facility in the Garner Health app or website prior to your date of service.
• The facility is in-network and services provided are covered by your health insurance plan.

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:

• Patient name
• Date of service
• Services rendered
• Garner recommended provider

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.