Your Garner Guide

No. Garner is not your health insurance. It is an additional benefit that complements your health insurance plan by helping you connect with in-network providers who offer quality care, have availability, and deliver optimal patient outcomes. By choosing these Top Providers, you not only ensure top-notch care but also become eligible for reimbursement of qualifying out-of-pocket medical costs.

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 a Top Provider. Out-of-pocket costs from these doctors will not qualify for reimbursement.

Your organization cares about your health. In order to help you find the best care, they pay for you to have the Garner 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 organization 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.

Any dependent covered by your health insurance plan is eligible to use Garner to find Top Providers and can be reimbursed for qualifying out-of-pocket medical costs. Your family only needs one account, but any dependent aged 18 or older is welcome to create their own account. Reimbursement checks will be mailed to the primary member who holds the health insurance plan.

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 navigate to your account settings here. Under the “Language” section, choose “Spanish” from the drop-down menu.

Garner identifies Top Providers by analyzing one of the largest medical claims databases in the U.S.—that’s more than 60 billion medical claims representing more than 310 million patients. 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.

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.

In the Garner app, you can search for doctors by symptom, name, or ZIP code. Look for the Top Provider 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 Top Provider 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.

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 be eligible for reimbursement of out-of-pocket costs, the doctor must be in-network, added to your Care Team before your appointment, 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.

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 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 a Top Provider and approved for your Garner benefit.

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. 

To ensure your claim is processed as quickly as possible, message the Concierge through the Garner Health app and ask to have the nurse practitioner’s name added to your Care Team, 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 Care Team.

Yes. Even if your colleague found the Top Provider through Garner, you must search for that provider using your Garner account and add them to your Care Team before you receive care from them.

Search for your specialist by entering their name 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 eligible for reimbursement on or after the date you add them to your Care Team. 

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 Care Team before the date of service in order for out-of-pocket medical costs to qualify for reimbursement. 

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

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

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

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

How does Garner select Top Providers?

Garner’s doctor recommendations are based on analyzing data on real patient outcomes to find top-performing doctors in your area. Our team of doctors and data scientists analyze hundreds of metrics to evaluate if doctors are actually helping their patients get better. 

Doctors cannot pay to be recommended by Garner. Garner is an objective third party that selects Garner Top Providers based on doctors who:

• Follow the latest medical research

• Make accurate diagnoses

• Avoid unnecessary procedures

• Charge fair prices for their services 

• Help patients recover faster

Garner Top Providers are top-performing 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 a doctor on specific metrics for their specialty, such as:

• Surgery complications rate: Garner evaluates each surgeon’s performance to measure their success and complication rates (e.g., % of patients who experience complications and have to be re-admitted after knee surgery). Our goal is for every patient to have the best chance of a successful recovery.

• Physical therapy before surgery when appropriate: When you have knee, back, or hip pain, some surgeons jump straight into surgery even though research shows that physical therapy can be equally or more effective and less painful for patients. Garner measures doctors against clinical guidelines and recommends surgeons who are more likely to recommend physical therapy before surgery when appropriate.  

• Cost per service: We evaluate doctors based on their prices and do not select doctors who overcharge for basic services such as an X-ray. 

If your doctor isn’t listed as a Top Provider, 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 completely respect your decision. However, please note that visits with non-Top Providers are not eligible for Garner reimbursement.

We encourage you to consider a free second opinion from a Garner Top Provider to ensure you’re receiving the best possible care. You can always return to the Garner app to search for new doctors and get reimbursed for future care that meets eligibility requirements.

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

Garner reimburses qualifying out-of-pocket medical costs that include office visits, lab work, imaging and procedures ordered or administered by doctors who were added to your Care Team before your appointment. To learn if other medical costs qualify for reimbursement, log into your Garner account and navigate to the benefit section.

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

• You have created a Garner account and added the provider to your Care Team before the date of service.

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

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

• 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 get reimbursed by Garner.

When a Top Provider orders lab work or imaging, the associated out-of-pocket costs automatically qualify for reimbursement if:

• The Top Provider was added to your Care Team before the date of service.

• 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 reimbursement, 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 yellow banner that says: “Eligible with some exceptions.” This means services at the facility may qualify for reimbursement.

• 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 a Top Provider and is added to your Care Team before your appointment to remain eligible for reimbursement.

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 Care Team before your appointment.

• The Top 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.

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 medical insurance plan.

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.

For more information on the services covered by your benefit, please log into your Garner account and view your benefit details.

When you receive care from a Top Provider who was added to your Care Team before your appointment, 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.

You have two options for receiving reimbursement: 

• Recommended - direct deposit: If you are the primary member you can set up direct deposit for faster and more secure reimbursement. Because the speed that billing departments submit claims to your health insurance company can vary, it typically takes 5-6 weeks to receive reimbursement after the service takes place. Watch this demo video to learn how to set up direct deposit.

• If you do not set up direct deposit, a reimbursement check in a white envelope will be sent to the mailing address the primary member has on file with their employer, arriving in about 6-8 weeks.

You have two options for receiving reimbursement:

1. If you are the primary member you can set up direct deposit for faster and more secure reimbursement. You will receive your reimbursement directly to your bank account and faster than a check. Watch this demo video to learn how to set up direct deposit.

2. If you do not set up direct deposit, a reimbursement check in a white envelope will be sent to the mailing address the primary member has on file with their employer.

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

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

Most of the time, you don’t need to do anything—reimbursement is automatic! However, if you have a medical claim over $2,000 or a prescription claim over $900, a member of the Concierge team will reach out to confirm your details before we send your reimbursement. This helps ensure security and accuracy for larger payments.

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, 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 a Health Savings Account (HSA) paired with a High-Deductible Health Plan (HDHP), you must first spend the minimum amount toward your health insurance deductible. Once you have spent that amount, you can use the Garner Health Reimbursement Arrangement (HRA).

You are not required to spend HSA dollars on Garner-approved providers. However, we encourage you to seek care from Top Providers.

Garner keeps track of the claims we receive from your health insurance. Once you have spent $1,650 for individuals or $3,300 for families in 2025, or $1,700 for individuals or $3,400 for families in 2026, we will start issuing reimbursement checks for qualifying out-of-pocket medical costs.

Meeting your deductible 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 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.

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 that is a fit for you or your family, you can message the Concierge for assistance.

You can message through the Garner Health mobile app or email concierge@getgarner.com. Concierge hours of operations are Mon-Fri 8 a.m. to 10 p.m. ET. Se habla español.