Sidecar Health is personalized, affordable health insurance. Unlike traditional insurance which sits between the patient and the doctor, our members pay for care directly when they get it using the Sidecar Health payment card. As a result, our members can see any doctor, all coverage is transparent, and members save 40%† over comparable traditional plans. Simply put, Sidecar Health is health insurance the way it should be.
Sidecar Health is the way health insurance should be:
Sidecar Health is different from traditional insurance in that we pay a fixed amount for any medically necessary service or prescription drug that you buy. That means if your provider charges more than that fixed amount, you pay the difference. And if your provider charges less, you keep the difference. Also, this allows you to know exactly what your coverage is so there won’t be any surprises from your plan. With Sidecar Health, you are in the driver’s seat.
You can sign up for a Sidecar Health plan at any time, just like you can cancel at any time. Think of us like you would a subscription service.
Soon! Your coverage begins as soon as 14 days from the day you enroll. But check your policy to see the exact date when coverage will begin.
All our plans last for a year, and you have the option to lock in your plan and rate for three years. You can also cancel at any time.
Sidecar Health plans are priced to be as affordable as possible for its members, and we can offer low monthly costs by pricing each member by their needs. Your monthly cost is based on the real cost of your care, so make sure you tell the truth to avoid lapses in coverage.
If you think you made a mistake in the questionnaire, simply give your Member Care Team a call at 877-653-6440. Go ahead and call them now to avoid lapses in coverage.
Anyone can enroll in a Sidecar Health plan, unless you’re not 18 years old yet. Then you’ll have to be enrolled by a parent or guardian.
After you've received your care, submit a picture of your itemized bill to the Sidecar Health app or website so we can determine your final Benefit Amount. If this is more than the initial Benefit Amount, we will credit you the difference. If it is less, you will be responsible for the difference. Please note that if an itemized bill is not uploaded within 30 days, we will send you reminders. You must pay the entire amount of your care if you don't submit your itemized bill by the deadline explained in your policy.
NOTE: We have partnered with ScriptSave® WellRx to offer you discount codes you can use at the pharmacy to get lower rates for your prescriptions. Using these codes is optional. They are provided by ScriptSave® WellRx and administered by Medical Security Card Company, LLC. Tucson, AZ and are not part of your Sidecar Health plan.
Yes! If you don’t upload your medical bills, your deductible won’t go down. That’s because as you receive health services, the fixed benefit amount of those services that we’d normally pay you will be applied towards your deductible instead. Once your deductible has been met, Sidecar Health will start paying you the fixed benefit amount for covered services.
In order for us to process your claim, you need to send us an itemized medical bill – otherwise known as a “super bill” or “medical invoice”. The itemized bill must include the following five things:
You can easily find the Benefit Amount of your covered service using the Sidecar Health app or website.
We also share information on doctor and health care provider prices that other Sidecar Health members have paid within the Sidecar Health app and website. However, it is important to understand that provider prices can vary, but the Benefit Amounts for the same services will remain the same.
You should expect to pay anything above the Benefit Amount when getting care. Sometimes a provider will charge more than the Benefit Amount, and sometimes they will charge less. Prices can vary a lot and that is why we always recommend shopping around and comparing prices from health care providers for the services you need before you get care.
There may be some instances where you are unable to know the cost of your care ahead of time because you don’t know what services you need before seeing a doctor. In this case, we recommend you use the Sidecar Health cost estimator tool to look up the procedures or medical services that your doctor recommends while you’re with your doctor. This way, you’ll always know what your plan pays and you can compare that amount to what your doctor will charge before deciding to get care.
Congrats! You made a great decision. In this case, you get to keep the difference between the Sidecar Health Benefit Amount and what your doctor charges. The difference will be added to your Sidecar Health account and, if unused, will be sent to you when your policy ends. Your plan pays a fixed amount per service regardless of the cost of your treatment.
Absolutely. Preventative services are covered the same way as other health care services that you may receive.
Of course not. You can see any doctor you want.
Your Sidecar Health plan doesn’t cover anything that is not medically necessary, meaning that things like cosmetic and elective procedures may not be covered.
Here is an overview of what’s not covered, but please look at your policy for specifics. Your policy provides the details of your coverage, including any exclusions and limitations.
To see the most up-to-date list of exclusions, be sure to view your policy document.
See the following FAQ about what medically necessary means for more information.
Sidecar Health plans also currently do not cover maternity services, including prenatal and postpartum care, labor, and delivery. We are working on rolling out this type of coverage.
We cover services prescribed by a doctor for health reasons, but things like cosmetic and elective procedures may not be covered. Whether something is medically necessary is always up to Sidecar Health. Please refer to your policy for exact details about what procedures and drugs are covered. If you have any questions about whether a service is medically necessary or covered by your policy, please give your Member Care Team a call at 877-653-6440. We’d be happy to help you.
A deductible is how much you will pay in covered medical costs before your plan starts paying for any health care expenses. Adding a deductible to your plan will help lower your monthly cost but means you will have to pay more out of pocket before your plan starts covering expenses.
For example, with a $500 deductible, you pay the first $500 of covered services yourself. Only what Sidecar Health thinks a service should cost, found in the Sidecar Health app, will apply toward your deductible. After you pay your deductible, your plan will start to pay for the covered medical care you receive up to the annual max benefit you chose when enrolling.
Annual max benefit is the amount your plan will pay toward your covered medical expenses within one year. You can choose an annual max benefit between $5,000 and $2 million. For example, if you have an annual max benefit of $25,000, your plan will pay the fixed Benefit Amount for medical care up to $25,000.
As an added feature, if you select $2 million annual max benefit, after your plan has paid $10,000 in benefits, your Benefit Amount for each covered service will increase by 25%, as will be shown in the Sidecar Health app when you look up your Benefit Amount.
For example, say you had an emergency and ended up in the hospital. The hospital charged $20,000 for your stay, which happens to be how much those services should cost per the Sidecar Health app or website. Let's say you selected a $25,000 annual max benefit, your plan would pay $16,000 and you would be responsible for $4,000. If you had selected a $2 million annual max benefit, you would pay only $2,500 (Calculation: first your plan would pay $10,000 of fixed Benefit Amount. On the remaining $6,000 of fixed Benefit Amount, you get an extra 25%, which is $1,500. So your cost is $20,000 -$10,000 - $6,000 - $1,500 = $2,500).
It’s up to you. Prescription coverage is included with all our plans, but you can choose to exclude it when you enroll in coverage. Similar to medical services there is a fixed Benefit Amount for each drug, which you can look up in the Sidecar Health app. The app will also tell you what your portion is depending on where you buy it.
Currently, Sidecar Health does not offer maternity coverage. While Sidecar Health won't cover maternity related expenses if they arise, your existing coverage on expenses unrelated to maternity will remain the same. We hope to offer maternity coverage in the near future, so stay tuned!
Monthly cost is the amount you pay every month for your Sidecar Health coverage. Think about it like every other subscription service.
Your monthly cost is based on the plan you choose, and any additional plan features you select. For example, the higher your annual max benefit, the higher your monthly cost will be. It will also be higher if you add the three-year rate lock. Where you live, your age, and how you expect to use your coverage can all impact your monthly cost.
We use your credit/debit card or bank account information to charge you for your Sidecar Health monthly cost, and for your share of any medical costs charged to your Sidecar Health payment card. Your share is based on the difference between how much your doctor charges and your Benefit Amount for any covered service.
A rate lock is an optional feature that locks in your monthly cost for three years. Note that if you make any changes to your coverage level during this three-year period, your monthly cost may increase or decrease depending on the change in coverage.
We will cry. But, you can cancel your policy at any time using the Sidecar Health app or website, or by calling your Member Care Team. The cancellation will go into effect on the next billing cycle. For example, if your monthly cost is charged on the 15th of every month and you cancelled on the 20th, you would be covered until the 15th of the following month but would not be charged again.
A fixed indemnity insurance plan means that there are pre-set– or fixed- amounts your plan will pay toward medically necessary services regardless of what your medical provider charges. Keep in mind that in all cases, you are responsible for the balance above the Benefit Amount your plan pays. You can think of this as using a retail store gift card. The gift card balance is like your Benefit Amount for a covered service. If the charge is higher than the gift card amount, you must use another method to pay the difference. The same applies using your Sidecar Health payment card.
To see what fixed rates are available, visit app.sidecarhealth.com/previewCoverage
Give your Member Care Team a call at 877-653-6440. Go ahead; they’re waiting to talk to you.
Protecting our members’ personal information is extremely important to us. Sidecar Health does not sell your information. Rather, we go above and beyond to ensure that the information you share and entrust with us is protected by taking security measures beyond necessary standards.
No. Our plans provide members with affordable, highly customizable coverage, but our plans do not qualify as an Affordable Care Act (ACA)/Obamacare plans and are not for everyone. If you’d like to explore if an ACA plan is right for you, go to www.healthcare.gov.
Beginning in 2019 there are no tax penalties associated with not having a qualified plan under the ACA. If you have any questions about this, please consult your tax advisor.
You can manage most aspects of your plan, like coverage and expenses by selecting “Account” in the bottom navigation from your dashboard. If you need any assistance, contact your Member Care Team at 877-653-6440.
Sidecar Health is not technically an insurance company, but instead is the exclusive program manager of the fixed indemnity insurance plans it sells. Basically, Sidecar Health has partnered with an insurance company to provide insurance plans to Sidecar Health members. This partnership makes it possible for us to have Sidecar Health members’ backs because our partner has our back. Sidecar Health is simply authorized to act on their behalf to create, market, and manage insurance plans which are underwritten by them. So when you have a claim, our insurance partner is actually the one picking up the bill as they are officially the insurance carrier.
Coverage is administered by Sidecar Health Insurance Solutions, LLC. This is only a brief description of the insurance coverage(s) available. The Policy contains reductions, limitations, exclusions, and termination provisions. Full details of the coverage are contained in the Policy. If there are any conflicts between this document and the Policy, the Policy shall govern in all cases. Insurance plans in Alabama, Georgia, and Texas are underwritten by United States Fire Insurance Company, 5 Christopher Way, 3rd Floor, Eatontown, NJ 07724. Insurance plans in Arkansas and Kentucky are underwritten by Sirius America Insurance Company, 140 Broadway, 32nd Floor, New York, NY 10005. Coverage under these plans is unavailable to applicants age 65 years or older.
Fixed indemnity insurance plans do not provide ACA-qualified Essential Health Benefits or Minimum Essential Coverage. You cannot receive a subsidy (premium tax credit and/or cost-sharing reduction) under the ACA in connection with your purchase of such a fixed indemnity insurance plan. Also, the termination or loss of this policy does not entitle you to a special enrollment period to purchase a health benefit plan that qualifies as minimum essential coverage outside of an open enrollment period.
This is a limited benefits insurance plan and is not an expense incurred medical plan. The benefits provided under this plan are limited in nature and are not related to the costs you may incur for health care services. As a fixed indemnity insurance plan, this plan is exempt from many state and federal requirements that apply to other types of health benefit plans. This policy does not provide major medical expenses coverage, minimum essential coverage or essential health benefits.
†Comparison of premiums quoted to a 30-year-old person, with no pre-existing health conditions and residing in ZIP code 77002, for a standard policy administered by Sidecar Health and a Blue Advantage Plus BronzeSM plan issued by BlueCross BlueShield of Texas (as of April 18, 2019). Benefits are clearly labeled in the member portal and subject to your individual policy. New drugs and experimental procedures may not be covered by Sidecar Health. Please refer to your policy for exact coverage details.
‡Beck, Melinda. “How to Cut Your Health-Care Bill: Pay Cash” The Wall Street Journal,
www.wsj.com/articles/how-to-cut-your-health-care-bill-pay-cash-1455592277. Accessed 22 April 2019.