For Members

Healthcare benefits that are actually … benefits.

No copays. Waived deductibles. 24/7 access to the best doctors. A concierge team of health care experts that guide you to the best possible health outcomes. This is what Avergent One health plans look like.

What makes Avergent health plans different?

White Glove Experience

Our team provides attentive, concierge-level service to guide you through the critical steps of your healthcare journey.

Comprehensive Access

As long as the service is covered by the Health Plan, we don't limit what physician or facility you can go to. The same benefit applies.

Personalized Guidance

Just because you can go anywhere, doesn't mean you should. Our Collaborative Care team gives you the expert guidance and support to find the right doctor, for the right care, at the right price.

Affordable Care

Instead of high deductibles, co-pays, and co-insurance that make accessing care incredibly complex and expensive, Avergent plans offer members access to countless health services at no cost.

Smart, Informed Care Choices

When you need care outside of primary care, your Care Coordinator creates a tailored report highlighting the best clinician specific to your symptoms, diagnosis, and treatment options — so your decisions are informed, not guessed.

No-Cost Specialty Paths

Pick our curated care paths and your out-of-pocket costs are waived. Or choose your own path at affordable copays. The choice is yours.

They are living up to their promises on helping to navigate these complex health situations. I'm not sure who found this company but know this change has had a profound impact on our family.
Avergent Plan Member

Your Avergent Plan experience step by step.

01 — Prevent

Primary care — at no cost

Avergent plans include faster access and more time with advanced primary care providers so you can focus on proactive health care and prevention.

02 — Connect

Reach your Care Coordinator

When you need non-emergent specialty care, reach out through text, app, or the phone number on your ID card.

03 — Plan

Personalized care planning

Together we review your history and needs, then produce a Care Options Report with the best clinician for your situation.

04 — Access

Curated or your choice

Pick our curated options at no cost to you, or choose your own path at affordable copays. Either way, you're supported.

05 — Beyond

Are you in a transition stage?

When life changes — retirement, disability, COBRA, a new baby — our 1-on-1 counseling helps you navigate insurance options. Get in touch →

Proof in practice.

View the full FAQ →
Cataract Surgery · Smart Shopper

Same procedure, 80% less.

Phil needed a routine cataract correction (CPT 66820). His physician's health system had one price; Avergent's Smart Shopper found a surgeon with thousands of these procedures under his belt — and the same procedure was delivered for 80% less. The plan covered the full cost.

80% less
High-Cost Rx · Patient Assistance

Monthly prescription, no cost.

Jill had a high-cost prescription that needed to be filled monthly. Together with Avergent and several vendor partners, the team identified a patient assistance program specifically suited for her. She received the same medication at no cost.

$0
Response Time · Smart Shopper

2 business days to an answer.

Submit a request and the team responds within 2 business days with clarifying questions. A full analysis and recommendation comes back in 2–5 business days. Then you decide which path to take — the team coordinates the rest with the TPA and provider.

2–5 days
Common Inquiries

We're sure you have questions. Here are a few of the basics.

Not only do our Health Plans provide essential medical and pharmacy coverage, but with Collaborative Care we have the ability to extend benefits to patients based on their specific need in order to get the best outcome for less.

Members enjoy a white glove experience with waived out-of-pocket costs for covered services that our Care Coordinators research. Otherwise standard benefit out-of-pocket charges apply.

Through text message, app, or the phone number on your ID card, we're easily available to support your needs.

The enrollment process is personalized, incorporating 1-to-1 benefit counseling to walk members through the Health Plan and how it applies to their needs.

Medical: Phil was an Avergent health plan member. He needed a routine cataract correction (procedure code 66820). Before scheduling within his physician's health system, he reached out to Collaborative Care. The team identified a surgeon who had done thousands of these procedures, met the quality criteria, and could do the same procedure for 80% less. The plan coordinated the care and covered the full cost.

Pharmacy: Jill had a high-cost monthly prescription. Together with several Avergent pharmacy vendor partners, Collaborative Care identified a patient assistance program specifically suited for her — and she received the same medication at no cost.

Have a question about your benefits?

Your Care Coordinator is on the other end of a phone call. For anything bigger — a new baby, a new job, a new diagnosis — we're here.