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Depending on which plans your employer has chosen to offer, your medical benefits may vary from the examples listed below. Make sure that you have a copy of your enrollment brochure in front of you when you’re ready to enroll.
How do Starbridge Outpatient Benefits work?
Outpatient benefits typically cover services outside of the hospital. These benefits apply to things like doctor office visits, outpatient surgery, lab work, X-rays and urgent care.
Doctor Visits
As an example, you simply pay a co-pay of $15 at the doctor’s office and Starbridge pays the rest of the bill up to $1,500 per coverage year. The $1,500 is called the annual benefit maximum.
Other Outpatient Services
If you need to use other outpatient services such as lab work or X-rays, you’ll need to meet a deductible before coverage applies—but you have no required co-pay.
For example, with plan 372 your deductible is $100 per coverage year. After you have paid this deductible, you’ll pay only 20% of the outpatient bill (this is called co-insurance). Starbridge pays 80%, up to $1,500 in coverage for the rest of the year. In addition to this 80%, you’ll receive valuable network discounts that can reduce your original bill up to 40% from what you’d pay without insurance.
For more information, view the tab Network Discounts.
*All of the above information is based on example plans shown. Your coverage may vary. Refer to your enrollment brochure for details or call for more information about your employer’s Starbridge plan.
How do Starbridge (Hospital) Benefits work?
Inpatient benefits cover a portion of the cost of hospital visits if an overnight stay is required. Some plans also offer additional coverage for surgery and maternity (pregnancy).
Although Starbridge is a limited-benefit health plan, we do provide some coverage for more serious medical conditions, but the benefit maximums are much lower than you would find with major medical coverage.
Inpatient Benefit Example
As an example, you have no inpatient deductible so your coverage starts right away—on the first day of the hospital stay. Your inpatient coverage is $1,500 per occurrence, with an additional $2,500 if you require surgery or are having a baby in the hospital. That’s $4,500 or more in total coverage with no deductible or co-pay required.
*All of the above information is based on example plans shown. Your coverage may vary. Refer to your enrollment brochure for details or call for more information about your employer’s Starbridge plan.
How do the Starbridge prescription drug programs work?
Some Starbridge plans offer a prescription discount-only program. With the 370 plan, you’ll receive a discount on your prescriptions, but you will be responsible for paying the remaining prescription costs after the discount is applied. Other plans offer more comprehensive prescription coverage. With these plans, you not only receive a discount, but Starbridge pays 100% of your cost after you pay a low co-pay.
Prescription Example
For example, with plan 372 you pay $15 for a generic drug and $30 for a brand name drug. After that, Starbridge covers the remainder of the cost up to $600 per coverage year.
The graphic below shows how you can save by requesting generics.
Benefit of Generic Prescription Drugs
Since brand name drugs are more expensive, the total cost of your prescription will count against your annual benefit maximums.
You won't use your coverage up as quickly if you request a generic. Be sure to ask your doctor to prescribe generic drugs so that you can maximize your benefit.
*All of the above information is based on example plans shown. Your coverage may vary. Refer to your enrollment brochure for details or call for more information about your employer’s Starbridge plan.
Save even more
Find out about our Network Discounts
If you use a doctor or health care center that’s in our network, you’ll receive a discount of up to 50% off of the original charges. We’ve negotiated great deals for you up front, so that you can save even more.
Your benefits will stretch a whole lot farther when you visit a Network Doctor. And even if you reach your benefit maximums, you can still receive big discounts throughout the year.
After you’ve enrolled, you’ll receive a list of Network Doctors in your area. Refer to this list or click here to find out if your doctor is in our network.
How do Starbridge Wellness Benefits work?
In addition to coverage for doctor’s visits, many Starbridge plans offer additional wellness coverage.
For example, plan 371 provides $100 per year towards a wellness exam after you pay a co-pay of $20. A Wellness Benefit can apply to things like a Pap Smear, annual exam, and vaccinations.
*All of the above information is based on example plans shown. Your coverage may vary. Refer to your enrollment brochure for details or call for more information about your employer’s Starbridge plan.