Sidecar Health Review: What To Know Before You Sign Up

Introducing Sidecar Health | Not Your Standard Insurance Co | Options and Cost | Eligibility | Customer Service Review | The Verdict

The Affordable Healthcare Act passed in 2010, making healthcare accessible to millions of uninsured Americans. However, some people still find themselves in a coverage gap, unable to get the kind of healthcare they want at a price that doesn’t raise their blood pressure.

Enter Sidecar Health Insurance, the latest in boutique insurance plans created for users who want more control over their health insurance needs. Sidecar Health offers plans that can be customized to fit specific healthcare needs at prices they claim are generally 40% lower than traditional plans.

Flexible coverage options and 40% savings are attractive features of Sidecar.

Before you sign up, we’ve done your homework for you — here’s what you should know about the company and how it works. 

Who is Sidecar Health? 

Sidecar isn’t an insurance company. They’re the insurance plan manager of the plans they sell. When you sign up for Sidecar, your insurance policy is underwritten by an insurance company that has partnered with Sidecar to extend you coverage. An important note about Sidecar Health is that this is a fixed indemnity plan, not an expense incurred medical plan. It does not provide ACA-qualified Essential Health Benefits or Minimum Essential Coverage.

Currently, Sidecar partners with the Crum & Forster companies United States Fire Insurance Company and The North River Insurance Company. Sidecar operates like a middleman between you and the insurance company. 

This is great because: 

• It makes communication easier and more accessible
• It helps you understand your coverage and your policy better (Sidecar puts coverage information in layman terms on their app and website)
• Sidecar processes your claims, which results in faster turnaround time

The insurance companies that partner with Sidecar are reputable, trustworthy, and have been in business for decades.

What Makes Sidecar Health Insurance Different

Most health insurance policies work like this: You agree to pay a certain yearly premium to the company, and in return they agree to “cover” certain health-related expenses for you. “Coverage” is the amount they’ll pay for a particular service. Coverage differs from plan to plan.

Insurance companies also negotiate rates for services with practitioners who will become preferred providers in their network. When you elect to buy a preferred provider (“PPO”) policy, you’ll get better benefits and pay less out of pocket expenses when you use providers that are in-network than when you elect to use providers who are out of network. In most cases, policies that allow you to choose your own provider are more expensive.

Once you receive treatment from your healthcare professional, they will file a claim with your insurance carrier. Then, you’ll either be expected to pay your portion at the time of treatment, or be billed once your insurance has paid any amount they provide for the service directly to your doctor.

Sidecar Health Insurance operates differently. Here’s how:

• You can pick your practitioner. Instead of negotiating rates with providers and creating a network, they provide a flat benefit per procedure or medical visit. This allows you to visit any doctor or hospital you’d like for treatment. 
• You can customize your plan based on medical need and budget. Sidecar Health also allows you to carve out a policy that is custom-fit to you. This means if you don’t go to the doctor a lot, you could choose a plan with a low yearly premium and limited amount of coverage. 

On the other hand, if you have underlying medical issues and regularly visit the doctor, you can opt for a plan with a slightly higher yearly premium with more coverage (up to $2,000,000.00). 

• You handle your medical claims and get compensated for them. With Sidecar, you file your own claims and receive coverage benefits yourself. It might sound intimidating, but their app makes it very user-friendly.

They also encourage prior authorization, which is easily handled by uploading a pre-bill or “super bill” from your doctor’s office to the app using your camera phone.

Sidecar Health can be a great option for some, but it does require you to be a bit more proactive with your healthcare than you might be used to. A few examples of that:

• Shopping around. For instance, you’ll need to get quotes from different providers for particular health services to make sure you get the best deal.
• Being aware of additional services. Many times a routine exam will require lab work or an x-ray. Be aware that even if you have these services performed at your doctor’s office, you may not be getting the best deal, and you’ll have to pay an additional fee for them. It may be cheaper for you to get your bloodwork done somewhere else.
• Ultimately, you are responsible. Because Sidecar doesn’t negotiate with your doctor or receive claims from them, you are ultimately responsible for the bill. Some doctor’s may allow you to postpone payment until a later date, but if your doctor requires payment before Sidecar has reimbursed you for the service provided, you’ll have to pay it up front.

For some subscribers, being more in control of their health insurance hasn’t been easy.

“Small missteps [in medical claims] will cost you big $$,” says Amanda, who rates Sidecar 1/5 stars on Trustpilot.

However, if you don’t go to the doctor often, or feel you’re capable of handling your medical claims, Sidecar may be for you. 

Plan Options and Cost

There are four different plans offered through Sidecar Health. Budget, standard, premium, and custom plans are based on yearly coverage amounts that range from $10,000 to $2,000,000.00. All plans have a $0 deductible, although you can change that option to lower your monthly premium.

Speaking of premiums, they’re paid monthly. However, you can save between 3-5% if you opt to pay your premium quarterly or yearly.

What’s Covered

Each plan covers medically necessary treatment which basically means you won’t be able to use Sidecar benefits to fund your Botox treatments. We reviewed their coverage and found it comparable to a traditional insurance plan. Prescription drug coverage is also standard on each policy, but you may also decline it.

Coverage is determined by indemnity benefits specific to each policy, up to the policy limits each year.

For instance, if you select the premium plan and need to make a visit to the emergency room, your plan will cover $72-$1,143 per visit, depending on the actual covered service provided. For regular office visits, the premium plan will pay $4-$460 depending on the actual covered service provided.

You’ll get those benefits up to the plan limits, which for the premium plan is $2,000,000.00. That means you can keep using your coverage until you’ve exhausted the $2,000,000.00 cap.

What’s Not Covered

Vision and dental are not covered by Sidecar Health policies, and there’s no option to add them. When we asked Sidecar about these types of policies, they directed us to Healthcare.gov.

Maternity is also not included in standard coverage for any policy. You can add a maternity benefit to your policy for an additional $265.00 per year.

What’s the Actual Cost

Your policy premium with Sidecar is very straightforward.

We used their website to see what plans were available for a single user with no pre-existing medical issues, in their thirties. Policies were priced between $165-$269 per month. The budget plan ($165/month premium) offers $10,000.00 in benefits. The premium plan ($269/monthly premium and also advertised as their most popular plan) offers $2,000,000.00 in benefits.

We also explored policies for users in their forties and found that monthly premiums rose about $30 per month across the board.

How Do You Get Paid?

We didn’t find the information on their website extremely clear in terms of how payment of benefits worked, so we reached out to Sidecar via the on-page chat option. Here’s what we learned.

When you sign up for Sidecar, you’ll get a Sidecar Visa, which is provided to you at no additional fee. This card is also attached to a method of payment you determine, like your checking or savings account.

When you see a practitioner, you can use your Sidecar Visa to pay for services, up to $2,000.00.

Still lost? So were we. 

Here are the two most popular ways of getting paid:

1. Pre-approval (Sidecar recommended). Contact your healthcare professional for the service you need and obtain a prebill. Sumit the prebill to Sidecar via the app. If the claim is approved, Sidecar will adjust your healthcare card so that you can pay Sidecar’s portion directly to the practitioner (using your health card Visa) at the time of service. You are responsible for the remainder of the bill.
2. Post-approval. Pay your medical professional directly for services. If you use your Sidecar Visa, 20% of the amount charged will be deducted from the payment method you have attached to your Sidecar Visa as your estimated expense. 80% of the charge will be paid by Sidecar as estimated benefit.

When you submit the billing statement to Sidecar, your account will be adjusted. If the benefit from Sidecar exceeds the bill, you pocket the difference. If it’s more, you’ll have to pay for it. 

Because Sidecar is designed to pay benefits directly to you, it’s also a great option as supplemental insurance.

Who Can Get Coverage?

This is where Sidecar gets a little sticky. When using their website to obtain a quote, you’ll have to answer whether or not you have any of the following medical conditions:

• Mental health disorders (including depression and bipolar disorder)
• Diabetes
• Lung disease
• Lupus
• Muscular dystrophy
• Kidney or renal failure
• Back issues requiring surgery
• Obesity (300 pounds as a man or 260 as a women)
• Liver issues
• Heart disease
• Blood disorders
• HIV or Aids

If you check any of those boxes, you’ll get a prompt that tells you Sidecar isn’t a good fit for you. We also tried listing medications that are commonly taken for some of these issues and received similar (but not consistent) responses.

You’ll also be disqualified for coverage if you use a wheelchair, CPAP machine, respirator, ventilator, supplemental oxygen, or are on dialysis.

And one more thing: if you’ve used tobacco products (including vapes), had chiropractic care, psychiatric care, or psychologist care in the last 12  months, your monthly premium will increase between $80-$290 per month.

How’s the Customer Service?

Sidecar’s customer service gets great reviews. In fact, we were really impressed with the speed and accuracy of their online chat feature, which we used extensively while researching their product.

Additionally, it seems Sidecar values their customer’s feedback. Of the limited number of negative reviews we read on Trustpilot, Sidecar had responded to all of them and attempted to help rectify the complaint.

Across the board, their customers seem very happy. Two reviews we read stood out in terms of customer service and accessibility of service representatives.

“Unlike most health insurance companies, Sidecar answers the phone promptly with VERY helpful people to resolve any questions or issues you may have. Awesome!” 

• Joann, 5/5 stars on Trustpilot

“Sidecar online help is always fast and efficient. Unlike other chat services, Sidecar quickly responds to resolve issues and answers questions. Can't say enough good things about them.” 

• Tucker, 5/5 stars on Trustpilot

Sidecar makes a bold statement that they are available and accessible to their customers, and it seems they take it to heart.

The Bottom Line

Is Sidecar for you? Maybe. If you’re in good health, don’t visit the doctor much, and are tech-savvy enough to use an app to upload and file claims, Sidecar can be a very valuable, and cost-effective healthcare option for you.

If you have ongoing medical issues, don’t want to devote the time to shop for medical services, and would rather have your doctor’s office file your medical claims for you, Sidecar might not be the best solution.

Sources:

Price Transparency in Healthcare|HMPI.org 

HealthCare.gov:  Get 2021 health coverage. Health Insurance Marketplace® 

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