Your Guide to Preferred Coverage

Garner is a health benefits company that partners with your employer to reduce your out-of-pocket costs when you see certain high-quality doctors in your area.

Preferred Coverage is a benefit that covers your out-of-pocket costs when you see certain high-performing doctors. Not all in-network doctors are approved for Preferred Coverage—you can find which doctors are approved for Preferred Coverage in the Garner Health app.

No. Preferred Coverage is different from your insurance network. Garner curates Preferred Coverage by identifying certain high-quality doctors. Only a subset of your in-network doctors are approved for Preferred Coverage. All doctors approved for Preferred Coverage are in-network, but not all in-network doctors are approved for Preferred Coverage.

No. Preferred Coverage is not your health insurance. Preferred Coverage is a Health Reimbursement Arrangement (HRA) that is paired with your health insurance plan to help you find high-quality, in-network doctors and covers your out-of-pocket costs when you visit them.

No. While we encourage you to see Top Providers to ensure you are receiving the best care, you have the choice to receive care from a doctor who is not approved for Preferred Coverage. Out-of-pocket costs from these doctors will not qualify for Preferred Coverage.

Your employer cares about your health. To help you find the best care, they pay for you to have the Preferred Coverage benefit. High-quality care lowers healthcare costs—patients who see approved providers will generally pay less in the long run and be healthier. For example, if you have a smooth recovery, your total cost of care will be lower than if you have complications and need to be hospitalized.

Garner helps your employer pass these savings along to you through an innovative health reimbursement arrangement (HRA)—reduce your out-of-pocket costs by seeing the best doctors and staying healthy. It's a win-win for everyone involved.

Your employer or health plan sponsor pays Garner a small fee to access Preferred Coverage and enhance your health plan. Garner does not let doctors pay to show up in our recommendations.

Any dependent covered by your health insurance plan is eligible to use Garner to find providers approved for Preferred Coverage and have out-of-pocket medical costs covered. Your family only needs one account, but any dependent aged 18 or older is welcome to create their own account.

You can log in to your Garner account and view more details here.

To use the app in Spanish, log into your Garner account and click here to navigate to your account settings. Under the “Language” section, choose “Spanish” from the drop-down menu.

Garner identifies providers approved for Preferred Coverage by analyzing one of the largest medical claims databases in the U.S.—that’s more than 60 billion medical claims representing more than 320 million patients. They are highlighted in the Garner Health app with a green badge and banner and represent the best available doctors near you who are in your network and have appointment availability.

We try our best to recommend 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.

In the Garner Health app, you can search for doctors by symptom, name, or ZIP code. Look for the green badge—only these doctors are eligible for your Garner benefit.

How to Add a Doctor to Your Care Team:

1. Click "Find Care" in the navigation bar.

2. Use the search bar to enter a doctor's name, specialty, condition, or procedure, then click "Find Providers."

3. In the search results, select a doctor with the green badge to view their profile.

4. Click "Add to Care Team." A red heart will fill in to confirm the doctor has been successfully added. Your list of doctors on your Care Team will carry over each year.

This ensures the doctor is approved for your benefit and easy to find later. You can access your full Care Team from the navigation bar.

Upon request, the Concierge can also assist with adding doctors to your Care Team.

Please note: To use Preferred Coverage for out-of-pocket costs, the doctor must be approved for Preferred Coverage, in-network and the services must be covered by your health insurance.

To view your Care Team, please log into your Garner account and select "Care Team" from the navigation bar.

No. Your list of doctors on your Care Team will carry over each year.

Adding a provider to your Care Team is the best way to ensure you will qualify for your Preferred Coverage benefit.

Once an in-network Top Provider is added to your Care Team, they're approved for Preferred Coverage, and your out-of-pocket costs qualify for Preferred Coverage.

Please add the provider to your Care Team as soon as you remember.

If Garner sees that you forgot to add a provider before your visit, we will check our records to see if you received a recommendation for that provider in the app prior to your visit date. If you did, you will still qualify for your Preferred Coverage benefit.

For future visits, please make sure to add a Top Provider to your Care Team before the visit. This is the best way to access your benefit.

You are welcome to, but it is not necessary. Garner will move any Top Provider that has qualified for Preferred Coverage onto your Care Team in January 2027.

Preferred Coverage will continue to cover your out-of-pocket costs for any Top Providers you have seen in the past.

Garner Top Providers approved for Preferred Coverage can change each month. While a doctor’s quality of care typically doesn't change much month to month, this is to ensure we have the most up to date directory information and new patient availability.

If a member has previously added a Garner Top Provider to their Care Team, any recommendation updates will not affect the doctor’s approved status for that individual member and their dependents.

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 approved for Preferred Coverage.

Yes. Even if your colleague found a doctor approved for Preferred Coverage through Garner, search for that provider in the Garner Health app and add them to your Care Team before your visit.

All providers, including specialists, must be Top Providers in order to qualify for the Preferred Coverage benefit. This applies to a specialist you have already seen or a new provider. Search for a specialist by entering their name or specialty and zip code. If your specialist has a Top Provider badge, qualifying out-of-pocket medical costs from services performed or ordered by that specialist are approved for Preferred Coverage if they are added to your Care Team before your appointment.

For example, if your primary care doctor recommends seeing a GI specialist for stomach pain:

1. Search in the Garner Health app to confirm the specialist is a Top Provider.

2. If they are a Top Provider, be sure to add them to your Care Team before your appointment.

If your specialist is not a Top Provider, you can still choose to receive care from them, but the out-of-pocket medical costs will not qualify for Preferred Coverage.

We understand it can be disappointing if your current doctor isn’t approved for Preferred Coverage. Our mission is to help you access high-quality care while reducing your out-of-pocket costs.

How does Garner choose which doctors are approved for Preferred Coverage?

Garner's doctor recommendations are based on real patient outcomes to help you find the best doctors near you. Our recommendations go far beyond patient reviews. We look at billions of claims to understand the specifics of how doctors provide care.

Doctors can't pay to show up in our recommendations. Garner is an objective third party that selects doctors approved for Preferred Coverage based on doctors who:

• Follow current medical guidelines

• Avoid unnecessary procedures

• Charge fair prices for their services

• Help patients recover faster

Doctors approved for Preferred Coverage are the best doctors in each specialty and region of the country. Garner always looks for the best doctor option in your region, and accounts for the number of doctors available in your neighborhood.

How does Garner evaluate doctors? We assess each doctor based on specific metrics related to their specialties, such as:

• Complication rate: Measure a doctor's complication rates

• Invasive procedure rate: Determine if a doctor performs more invasive procedures only when necessary given they entail longer recovery times and complication risks

• Follows current medical guidelines: Evaluate if a doctor recommends optimal treatment according to medical guidelines

If your doctor isn’t approved for Preferred Coverage, it doesn't mean they aren't a good provider—it simply means they haven't met Garner's criteria at this time. If you choose to continue seeing your current doctor, we respect your decision. However, please note that visits with non-approved providers are not eligible for Preferred Coverage.

We encourage you to consider a free second opinion from an approved provider to ensure you're receiving the best possible care. You can always return to the Garner Health app to search for new doctors for future care.

If you're currently seeing a provider for a critical or ongoing care need, please reach out to Garner Concierge through the Garner Health app or email us at concierge@getgarner.com.

Preferred Coverage covers qualifying out-of-pocket medical costs for office visits, lab work, imaging and procedures. To learn if other medical costs qualify for Preferred Coverage, log into your Garner account and navigate to the benefit section.

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

• You have created a Garner account

• Your provider is in-network and the cost was covered by your health insurance plan.

• The type of cost qualifies for Preferred Coverage under your Garner plan.

• You haven’t reached your maximum annual Preferred Coverage limit.

• If your health insurance plan is paired with an HSA, you will need to incur costs greater than the “spending requirement.” The Garner app will show you how much more you have to spend before you can use Preferred Coverage.

Additionally, make sure to add the provider to your Care Team before the date of service.

When an approved provider orders lab work or imaging, the associated out-of-pocket costs are eligible for Preferred Coverage if:

• Add the approved provider to your Care Team before the date of service. This is the best way to ensure you will qualify for your Preferred Coverage benefit.

• The facility is in-network, and the services are covered by your health insurance plan.

In this case, you do not need to search for the facility in the Garner Health app.

If You Choose to Find a Facility Yourself, you can also search for labs and imaging centers in the Garner Health app or website. To qualify for Preferred Coverage, the following conditions must be met:

• You found the facility in the Garner Health app or website before your appointment

• The facility's profile page shows a green banner that says: "Approved for Preferred Coverage."

• The facility is in-network, and the services are covered by your health insurance.

Note: Garner strives to recommend in-network facilities, but insurance networks can change. Always confirm with the facility before your appointment. Garner does not recommend specific hospitals or facilities beyond those that meet the qualifications above. If you plan to use a facility that is not listed, ensure the provider ordering your care is approved for Preferred Coverage and is added to your Care Team before your appointment to have your out-of-pocket costs covered.

We understand you can't choose ancillary providers such as anesthesiologists, radiologists and nurses. Your Preferred Coverage benefit will cover all qualifying out-of-pocket medical costs if:

• An in-network Top Provider is ordering or is primarily performing the service.

• The service is in-network with your health insurance plan.

Make sure you add the Top Provider ordering the service to your Care Team before your visit.

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.

Preferred Coverage works with your medical insurance, which generally does not cover dental or vision services. Preferred Coverage may be used for qualifying out-of-pocket medical costs for procedures such as oral surgery, but only if the claim for that service is processed by your medical insurance plan.

No. Preferred Coverage only covers services processed by your health insurance plan.

When you receive care from a Top Provider, your medical plan will automatically cover eligible out-of-pocket costs using Preferred Coverage when they process the claim by paying the provider directly. Remember to add your Top Provider to your Care Team before the date of service.

Preferred Coverage is automatically applied to eligible out-of-pocket costs when you see approved providers - no action needed from you.

You can reach out to the Garner Concierge for answers to your Preferred Coverage questions by messaging them.

To learn more about what medical costs are eligible for Preferred Coverage, log in to your Garner account and check your benefit details or message the Concierge.

An HSA is a Health Savings Account (HSA). You and your organization are able to contribute pre-tax dollars to this account. Because of IRS requirements, you are required to spend a minimum amount toward your health insurance deductible before you can use your Preferred Coverage benefit. In 2026, once you have spent $1,700 for individuals or $3,400 for families, or in 2027, $1,750 for individuals or $3,500 for families, Preferred Coverage will begin to cover your out-of-pocket expenses. Note that this rule applies even if you are not actively contributing to your HSA this year.

Meeting this minimum amount doesn’t mean you have to wait to start using Garner. You can still set up a Garner account, search for doctors in advance of your visit, and ensure that your qualifying out-of-pocket medical costs will qualify for Preferred Coverage 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 Preferred Coverage benefit. You can’t use FSA dollars to pay for any expenses that your Preferred Coverage benefit already paid. This is referred to as double-dipping and is prohibited by the IRS. You can save your FSA for when your Preferred Coverage benefit has reached its limit or for out-of-pocket medical costs that do not qualify for Preferred Coverage (e.g., dental, vision).

If you believe you may have accidentally used HSA or FSA funds to pay for a claim that was covered by Preferred Coverage, there are some important next steps we’ll need to take.

If Garner confirms that HSA or FSA funds were used to pay for a claim that was covered using Preferred Coverage, Garner will reach out to the provider to request repayment for that amount. Once repayment is received, the amount will be credited back to your remaining Preferred Coverage benefit.

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. If you need help finding a Top Provider or have a question about your benefit, you can message the Concierge for assistance.

You can message through in-app chat in the Garner Health app, email at concierge@getgarner.com, or phone at (866) 761-9586. Concierge hours of operations are Mon-Fri 8 a.m. to 10 p.m. ET. Se habla español.