Sidecar Health is a health insurance provider that aims to offer an alternative to traditional health insurance plans. The company states that it puts the patient in the driver's seat of their care and provides transparency to medical service costs.
Sidecar Health gives its members fixed prices for medical treatment, procedures, and prescriptions. When you see a doctor, you get the predetermined amount for the health service you receive, regardless of the actual cost at the doctor’s office. In some cases, you may pay more out of pocket. In other cases, you receive the difference and get to keep it.
Sidecar Health can be a great and simple option for health insurance coverage. However, it may not fit everyone’s needs, as it isn’t available for people with preexisting conditions or over 65. It’s also not available in all states. Let’s go into the details in this Sidecar Health insurance review.
Sidecar Health Benefits
Great for small business owners, contract workers and part-time employees
Save money on healthcare by paying the cash rate
May save you 40% or more
Sidecar Health: Is it worth it?
What is Sidecar Health?
Sidecar Health Insurance Solutions, LLC. is a non-traditional health insurance company. The company was founded in 2018 by two California entrepreneurs, Patrick Quigley and Veronica Osetinsky, who wanted to bring more transparency to medical care costs.
Sidecar Health claims it can help members save up to 40% on health care by paying doctors directly without having the doctors negotiate their prices through insurance claims. The company states that this enables health care professionals to offer discounted prices.
The company initially began offering its health insurance in Texas in 2019 and has expanded to offer health insurance plans in 18 states across the U.S.
|Type of insurance offered||Fixed indemnity health insurance|
|What is covered||Medically necessary procedures and prescriptions from the provider of your choice|
|Coverage limit||Between $5,000 and $2 million|
|Eligible age||Up to 65 years old|
|Availability||Alabama, Arizona, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Maryland, Michigan, Mississippi, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Texas, and Utah|
|Visit Sidecar Health|
How does Sidecar Health work?
Sidecar Health used a health coverage model that existed before the company was founded, though it isn’t as common as other health insurance plans. The insurance plans the company offers are known as fixed indemnity plans.
What is a fixed indemnity plan?
A fixed indemnity plan is a plan where the insurer pays a fixed price per service, regardless of the actual cost of the service. For example, Sidecar Health may pay $200 for an urgent care visit. If the visit actually costs $300, you pay the $100 difference out-of-pocket.
Unlike most health insurance plans requiring new members to enroll during a specific open enrollment period, you can sign up for Sidecar Health at any time. You can also cancel your Sidecar Health coverage at any time.
Sidecar Health insurance states that this plan type can help you save money on your health care because you use your own money to self-pay the provider for care. Many medical providers offer significant discounts to patients who self-pay rather than use insurance. Sidecar Health then reimburses you the coverage amount for the medical care you received.
TipTip: As a Sidecar Health member, you can find out how much your plan pays for a procedure or test before you go to the doctor through the company’s member portal. This portal can be accessed through the website on your computer, laptop, or mobile phone.
What access do you get to health care professionals?
As a Sidecar Health member, you aren’t limited to in-network health care providers. You can go to any doctor you choose because Sidecar Health doesn’t use a network system.
Sidecar Health gives you information about the rates different doctors charge for certain services. This allows you to shop around for the best cost that fits your budget.
For example, Say you live in Illinois and need to schedule a visit to a gynecologist. The price for this visit ranges between $114 and $159. If you don’t already have a doctor you prefer, Sidecar Health gives you options and estimates of what they charge for the visit.
How does the doctor visit work with Sidecar Health?
At your appointment, you can pay your doctor directly using a payment method of your choice. The payment method you use is charged 100% of the visit cost.
After your visit, you need to submit an itemized medical invoice using the Sidecar Health member portal. Sidecar Health determines your benefit amount by reviewing this invoice and credits you the benefit amount.
Because Sidecar Health uses a fixed pricing system for each health care service, the benefit amount you get can be lower or higher than the visit cost. You pay the difference if the benefit amount is lower or keep the difference if the benefit amount is higher.
For example, Sidecar Health gives you a $75 benefit amount to see a chiropractor. If your visit costs $90, your out-of-pocket cost is $15 after Sidecar Health pays you. However, if the visit only costs you $65, then you get your visit fully covered and keep a $10 credit.
What is the Sidecar Health VISA benefit card?
After you enroll in Sidecar Health and activate your account, Sidecar Health will ship you a welcome kit that includes your Sidecar Health VISA benefit card. This card can be used to pay your medical provider, but it isn’t required.
The Sidecar Health VISA benefit card acts like a debit card. You link it to one of your bank accounts, and the cost of your medical care is withdrawn from that account.
The Sidecar Health VISA benefit card has a maximum limit of $2,500 for medical procedures and $750 for the pharmacy. You need to call Sidecar Health if you need to authorize a larger payment.
When you use the card, you receive an estimated benefit amount that will be adjusted after you submit an itemized medical invoice to Sidecar Health. You’ll pay the difference if the final benefit amount is less than your medical bill. On the other hand, if the final benefit amount is more than your bill, Sidecar Health, you’ll keep the difference.
What insurance does Sidecar Health offer?
Sidecar Health offers several plans, but its main product is its indemnity-style Access Plan, which has set benefit amounts for different services.
Access Plan coverage
The Access Plan has three levels:
- Budget: This level offers annual benefits of up to $10,000. Once Sidecar Health pays $10,000 toward your medical bills, it will not pay more.
- Standard: This level offers annual coverage of up to $25,000 per person.
- Premium: This level offers annual benefits of up to $2 million per person.
All three Access Plan levels have no deductibles and cover prescriptions and preventive services. An added advantage of the Premium Access Plan is that the benefits for covered services increase by 25% after Sidecar Health pays $10,000 in benefits annually.
You also can create a custom plan by defining the annual coverage and deductibles you want. You can choose between $5,000 and $2 million in yearly coverage and $0 to $1,000 in deductibles.
Maternity coverage is available at an additional cost in 15 of the 18 states Sidecar Health operates in.
Access Plan availability
Sidecar Health offers its Access Plan in 18 states. These states are:
Maternity coverage is available in all these states except Arizona, Maryland, and Utah.
Not everyone is eligible to enroll in Sidecar Health’s Access Plans. The coverage isn’t available for people who are 65 or older. However, those aged 65 or older qualify for Medicare, which can be a better option.
Sidecar Health Access Plan only covers medically necessary services, so elective and cosmetic procedures may not be covered. Exclusions and limitations of the policies can vary by state.
Other medical services and procedures not covered include:
Additional Sidecar Health plans
Sidecar Health offers an Affordable Care Act (ACA) plan for Ohio residents. The ACA plan offers all the same benefits as Sidecar Health plans but also meets ACA requirements.
To be ACA compliant, these plans include:
- No total policy maximums
- 100% preventive care coverage
- Preexisting condition coverage
- Maternity and prescription coverage
Sidecar Health also provides employer plans for companies that want to offer their employees health insurance.
How to get an insurance quote from Sidecar Health
Getting an insurance quote from Sidecar Health is quick and easy.
- Begin by entering your ZIP code and choosing to get a quote on the Sidecar Health website.
TipKeep in mind: Sidecar Health plans are only available in 18 states as of November 2022. If you enter a zip code from a state where Sidecar isn’t available, the site will ask you for your name and email address to contact you when available.
- Enter your name, email address, age, and gender.
- Indicate or include details about personal habits, present health, and preexisting conditions such as cancer, AIDS, diabetes, lupus, muscular dystrophy, and more.
After completing the questionnaire, Sidecar Health will pull up your monthly costs for the three coverage levels. You can also customize your plan options.
How to maximize your savings with Sidecar Health
Sidecar Health may save you money on health care because medical providers often offer discounted prices for people who self-pay compared with the prices offered through a health insurance plan.
Sidecar recommends contacting your provider before your appointment to ask about the exact cash price a self-pay patient will pay to ensure you benefit from the reduced cost.
That said, Sidecar Health insurance plans are geared more toward healthy individuals with no preexisting conditions. Indicating that you have one of several conditions while filling out the questionnaire for a quote may lead to a message stating that you may have better options elsewhere.
If you use tobacco or make frequent visits to a mental health professional, your monthly premiums will be considerably higher. For example, a healthy Florida resident may pay $225 monthly for the Standard plan. However, if they smoke, the monthly premium may jump to $345. If they frequently see a mental health professional, their monthly premium may increase to $519.
Sidecar Health FAQs
Where is Sidecar Health insurance available?
Sidecar Health Access Plans are available in 18 states. These states are Alabama, Arizona, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Maryland, Michigan, Mississippi, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Texas, and Utah.
Who is behind Sidecar Health?
There are two underwriting insurance companies behind Sidecar Health’s Access Plans:
- United States Fire Insurance Company: The underwriter for the Access Plans in Alabama, Arizona, Florida, Georgia, Indiana, Maryland, North Carolina, Oklahoma, South Carolina, Tennessee, and Texas.
- Sirius America Insurance Company: The underwriter for Access Plans in Arkansas, Illinois, Kentucky, Michigan, Mississippi, Ohio, and Utah.
How long after using the Sidecar Health card should I upload an itemized receipt?
You have 30 days to upload an itemized receipt after you use your Sidecar Health Visa benefit card. The itemized receipt should include:
- Patient name
- Provider name and National Provider Identifier (NPI) number
- Date of service
- Amount charged for each service
- CPT codes for services
- Reason for the services
- Drug name, form, strength, and dosage or NDC for prescription drugs
The idea of receiving quality, affordable health care without the hassle of dealing with insurance companies is an attractive one.
Sidecar Health promises no surprises when it comes to your health care cost by offering transparency of costs and benefit amounts. Members can also get significant discounts on medical services when they self-pay providers.
Sidecar Health Access Plans can be a good non-traditional health insurance option for young, healthy individuals who may be self-employed and don’t meet the financial guidelines for Affordable Care Act (ACA) plans.
You also don’t have to worry about the enrollment period of traditional insurance plans because you can also sign up and cancel anytime. This makes Sidecar Health a good short-term health insurance option when you’re unemployed or between jobs.
However, Sidecar Health isn’t for everyone. It is only available in 18 states and doesn’t offer coverage for people with preexisting conditions or who are 65 and older.
- Huge discounts on travel, groceries, prescriptions and more
- Access to financial planning resources and health tools
- Join AARP and get 25% off your first year