Health insurance disruptor guarantees costs upfront for every doctor visit nationwide, proving transparency in healthcare is possible

LOS ANGELES: Sidecar Health members can now see a guaranteed cost for nearly every doctor in the U.S. before receiving care. Following the company’s 2025 update introducing provider quality scores, this is the latest step in advancing Sidecar Health’s effort to bring unprecedented transparency to healthcare and empower people to truly shop for care the way they shop for everything else.

With this update, members can search for doctors, therapists, and specialists in the Sidecar Health app and immediately see what their visit will cost - or what they’ll earn if the provider charges less than the plan pays. These costs or earnings are guaranteed for nearly every kind of doctor visit - from primary care to therapy and nearly every kind of specialist. Common add-on services like vaccines, blood draws, EKGs, and urinalysis are also included in the guaranteed cost.

“Healthcare has remained virtually the only part of the American economy that isn’t shoppable,” said Patrick Quigley. “This changes that. Now, Sidecar Health members can compare cost and quality and choose for themselves - without artificial barriers like networks, referrals, and prior authorizations - where they want to get care.”

With Sidecar Health’s disruptive model, every service has a Benefit Amount, based on local provider prices, so members know exactly what their plan pays before they get care. If the member chooses care below that amount, they keep half the savings; if they choose higher-priced care, they pay the difference.

The legacy insurance model uses opaque networks, prior authorizations, and complex contracts as tools to control costs - but the result is a system where both doctors and patients are left guessing about what care will cost. This outdated and inefficient system results in an industry average of 19% denial rates and has left 20M Americans saddled with more than $220B in medical debt. Sidecar Health operates without those barriers, resulting in a clinical denial rate of less than 1%. Today’s expansion of upfront guaranteed costs shows the next step in reinventing health insurance: proving that true transparency and patient empowerment are possible on a large scale.

Sidecar Health also shows clinical quality scores alongside costs, helping members evaluate not just the cost of care but the quality of the provider. These scores, powered by Global Appropriateness Measures (GAM), assess clinical appropriateness and treatment effectiveness - offering members a data-backed view into whether a provider delivers care aligned with evidence-based standards.

“The industry has spent decades building systems to control costs by limiting access. We’ve taken the opposite approach: open access, clear financial outcomes, and aligned incentives. And it’s working - not only in keeping costs in check but also in empowering members to make their own informed choices about their care,” said Quigley.

This latest update underscores Sidecar Health’s belief that real change in healthcare doesn’t require more complexity - it requires more transparency. By showing guaranteed costs and quality scores upfront, Sidecar Health is removing the guesswork and giving control back to members. Today, employers ranging from 51-person electrician shops to major multinationals with tens of thousands of employees are choosing Sidecar Health to deliver that clarity and value.

About Sidecar Health

Sidecar Health is a major medical insurance company on a mission to make high-quality healthcare more affordable and accessible for everyone. We lower costs by putting people in control of their health decisions - no prior authorizations, no referrals, no networks. Members can visit any provider and pay directly with the Sidecar Health Visa card. And because they see what their plan covers upfront, members are empowered to treat healthcare dollars like their own - making informed, cost-conscious choices without sacrificing access or coverage. If they spend less, they keep half of the savings; if they spend more, they pay the difference. This model reshapes behavior, reduces costs, and cuts through the red tape that defines traditional insurance. With fewer than 1% of claims clinically denied, Sidecar Health puts people - not insurers - at the center of the system. The result: better access, greater transparency, and more empowered consumers. Learn more at sidecarhealth.com.

Fonte: Business Wire