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 employer or fund cares about your health. In order to help you find the best care, they pay for you to have the Garner benefit. High-quality care lowers healthcare costs—patients who see Top 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 or fund pass these savings along to you through an innovative health reimbursement arrangement (HRA)—get paid to see the best doctors and stay healthy. 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.

Reimbursements will be sent 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 click here to navigate to your account settings. 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 320 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 Health app, you can search for doctors by symptom, name, or ZIP code. Look for the Top Provider badge—only doctors with this badge 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. 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 be eligible for reimbursement of out-of-pocket costs, the doctor must be a Top Provider and in-network, and the services must be covered by your health insurance.

Yes, in primary care, psychiatry, dermatology, obstetrics, and gynecology. Garner’s methodology is unchanged: Advanced Practice Providers go through the same quality evaluation as physicians and have to clear the same Top Provider bar. Search for a Nurse Practitioner, Physician’s Assistant, or midwife in the Garner app by specialty or name.

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 be reimbursed.

Once an in-network Top Provider is added to your Care Team, they're approved for your Garner benefit, and your out-of-pocket costs for that provider qualify for reimbursement.

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, we will still provide reimbursement.

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

You are welcome to, but it is not necessary. Garner will move any provider you have been reimbursed for onto your Care Team in January 2027.

You will continue to receive reimbursements for any providers you have received reimbursements for in the past.

Garner Top Provider rankings 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 a Top Provider and approved for your Garner benefit.

Yes. Even if your colleague found the Top Provider 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 Garner 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 reimbursement 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 reimbursement.

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 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 Garner Top Providers based on doctors who:

• Follow current medical guidelines

• Avoid unnecessary procedures

• Charge fair prices for their services

• Help patients recover faster

Garner Top Providers 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 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 respect your decision. However, please note that visits with non-Top Providers are not eligible for your Garner benefit.

We encourage you to consider a second opinion from a Garner Top 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.

Applies to oncology, transplant, and obstetrics care only: We understand when it comes to oncologic care/transplant procedures/pregnancy, you are often asked to see multiple providers and do not have control over who will be available throughout your journey. So long as your main medical oncologist/transplant surgeon or physician/OB has been added to your Care Team before your appointments, qualifying out-of-pocket costs for related services will qualify for your Garner benefit even if your main provider is not there.

Applies to primary care, pediatrics, and gynecology care only: If you see a Top Provider at a practice that is already on your Care Team, then upon request, Garner will add other providers in that practice to your Care Team if you cannot choose your provider and need to schedule with the soonest available provider.

Garner reimburses qualifying out-of-pocket medical costs for office visits, lab work, imaging and procedures. 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

• 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.

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

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

• You added the Top Provider to your Care Team before the date of service. This is the best way to ensure you will be reimbursed.

• 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 is eligible for 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.

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.

You will receive your reimbursement 6-8 weeks after you submit your claim.

1. Your provider will submit a claim to your insurance, and your insurance company will send you an Explanation of Benefits (EOB). Some providers submit claims within days; others take weeks.

2. Collect your documentation and file your claim in the Garner Health app. Garner begins processing your claim as soon as we receive it.

3. Track your claim in the app.

The Concierge team may contact you if more information or documentation is needed. We recommend setting up direct deposit for faster payments. You can manage your payment preferences in the Garner Health app.

Claims for out-of-pocket medical costs incurred in the year prior to the benefit reset date must be submitted with full documentation no later than 90 days after the benefit reset date. Find this date in the “Your benefit” section in the app.

Yes. You can see an overview of all your claims and check the status of each claim on the “Claims” page in the Garner Health app. Simply click on a claim for the status.

The Garner Concierge is dedicated to ensuring your claims process goes smoothly. If additional information is needed for your claim, they will reach out to you directly. They are here to help and ensure you have the right documentation.

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.

An EOB is a statement from your insurance company showing how your benefits were applied to a medical claim. An EOB is not a bill—your doctor will send a bill to you separately.

You can view your EOBs and claims on your health plan administrator’s website or app. Your health plan might also mail this document to you.

There are several reasons why a claim might not qualify for reimbursement; for example, your provider may not be a Top Provider, or the services may be out-of-network according to your insurance. If you believe your claim was denied in error, here is how to determine what happened and get it resolved:

• Check the claim status. Review your claim in the app to see its current status.

• Contact the Garner Concierge. Reach out to our Concierge team and share any paperwork that supports your claim—such as your doctor's NPI, a referral, or a visit note.

How to reach the Garner Concierge:

• In-app chat

• Email: concierge@getgarner.com

• Phone: (866) 761-9586

• Hours: Monday – Friday, 8:00 a.m. – 10:00 p.m. ET. Se habla español.

We'll take another look. If we made a mistake (such as missing a doctor's NPI in the documents), we will fix it and overturn the denial.

Still denied? If the claim is reviewed and the denial is upheld, but you still disagree with the decision, you can file a formal appeal directly in the Garner Health app.

If your claim is denied and you’d like to appeal this decision, please reach out to the Concierge via in-app chat.

About 20% of the time, a claim for an Advanced Practice Provider reaches us under the supervising physician's name rather than your provider's. When this happens, we can’t match the claim to a provider on your Care Team automatically. If this happens, please reach out to Concierge so we can link the providers together and reprocess your claims.

A Health Savings Account (HSA) is an account you and your employer or fund can contribute pre-tax dollars to. If you have an HSA paired with a High-Deductible Health Plan (HDHP), you must first meet the IRS minimum spending requirement 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 Top 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 $1,700 for individuals or $3,400 for families in 2026, or $1,750 for individuals or $3,500 for families in 2027, Garner can reimburse you for out-of-pocket medical costs.

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.

You don't have to wait until you meet your deductible 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 minimum spending 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, such as dental care.

If you believe you may have accidentally submitted a claim for reimbursement that was already paid using HSA or FSA funds, there are some important next steps we'll need to take.

Your Garner benefit works like a Health Reimbursement Arrangement (HRA), which is funded by your employer or fund and not taxed as income to you. In contrast, Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are tax-advantaged accounts you fund yourself.

According to IRS guidelines, using HSA/FSA funds to pay for an expense and then getting reimbursed for that same expense through an HRA (like your Garner benefit) is considered “double-dipping.” This is not allowed because it results in receiving two tax benefits for the same expense.

If Garner confirms that reimbursement was issued for a claim already paid with HSA or FSA funds, and the payment has been received (via deposited check or direct deposit), Garner will reach out to request repayment for that amount. Once repayment is received, the amount will be credited back to your remaining Garner 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 operation are Mon-Fri 8 a.m. to 10 p.m. ET. Se habla español.