Insurance isn’t just complicated—it’s time-consuming, frustrating, and way too easy to get wrong.

Most people don’t realize how many hours they spend:

• Sitting on hold with insurance
• Trying to decode denial letters
• Chasing down claim updates
• Fighting over prescription coverage
• Comparing health plans during open enrollment

Whether you’re dealing with a confusing medical bill, trying to understand your benefits, or managing ongoing out-of-network claims, Sheer Health helps you navigate the insurance process without spending hours on the phone.

Here’s how each plan works, what’s included, and which Sheer Health membership may make the most sense for your situation.

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Standard (Free)

Best for: Benefits questions, bill review, and mostly in-network care

You have a question about your benefits. You received a bill that doesn’t look right. You’re not sure whether a provider is in-network. You want help understanding what your insurance actually covers.

What this actually means for you: When something confusing comes up, you don’t have to figure it out alone.

The Standard plan is free to join and gives you access to core insurance navigation support.

What’s included

• Medical, dental, and vision bill review
• Insurance benefits and coverage questions
• Help understanding EOBs and insurance terminology
• General insurance navigation support

When this plan makes sense

• You mainly need help understanding benefits or bills
• You rarely submit out-of-network claims
• You want occasional insurance guidance
• Most of your care is in-network

Bottom line: A free way to get clarity on insurance—without hands-on claims management.

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Premium ($60/month)

Best for: Regular out-of-network care, ongoing claims, prescription coverage issues, and plan selection support

Premium includes everything in Standard, plus full hands-on claims support for managing insurance claims and navigating more complex coverage questions.

This is the plan for people who don’t just need answers—they need someone to actually handle the insurance process end-to-end.

What you get

• Everything in Standard
• End-to-end out-of-network claim support
• Claim submission assistance
• Claims tracking and follow-up
• Insurance denial management
• Appeals support
• Prescription coverage support
• Insurance plan analysis and selection guidance

Example

You regularly see an out-of-network therapist and have to submit claims every month.

• You upload your visits once
• Sheer continuously submits and tracks your claims
• We follow up, fix issues, and handle any denials automatically

When this plan makes sense

• You see out-of-network providers regularly (therapy, specialists, etc.)
• You submit claims often
• You want predictable costs instead of per-claim fees

Bottom line: If you’re consistently dealing with insurance, this usually pays for itself quickly.

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Max ($95/month)

Best for: Complex insurance situations + high-cost care

Max is built for people dealing with layered, complicated insurance setups—where mistakes are expensive and coordination matters.

What you get

• Everything in Premium
• Primary + secondary insurance coordination
• Fertility treatment support
• FSA/HSA submission help
• Third-party benefits coordination (e.g., Accolade)
• Advanced benefits optimization

Example

You’re going through fertility treatment with multiple insurance plans and aren’t sure how to coordinate benefits or maximize coverage.

• Sheer reviews your plans and maps out the optimal way to submit claims
• We coordinate between primary and secondary insurance
• We handle submissions, follow-ups, and any issues that come up

When this plan makes sense

• You have multiple insurance plans
• You’re navigating fertility benefits
• Your employer uses a third-party benefits manager
• Your claims are high-value or complicated

Bottom line: Designed for high-stakes insurance situations where expert support matters.

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Plan Comparison

• ✅ = included with no fees
• ☑️ = available with fee
• ❌ = not included

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How to Choose the Right Plan

Here’s the simplest way to decide:

• Go with Standard if you want a free option and mainly need help understanding benefits, bills, and coverage.
• Choose Premium if you regularly need help submitting and managing out-of-network claims.
• Upgrade to Max if your situation is more complex and requires advanced coordination, like multiple plans or fertility care.

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What You’re Really Paying For

No matter which plan you choose, the biggest value isn’t just the money recovered—it’s everything you don’t have to do anymore.

That includes:

• Hours on hold with insurance companies
• Trying to interpret denial letters
• Re-submitting claims over and over
• Keeping track of what’s been paid (and what hasn’t)
• Wondering if you’re leaving money on the table

For most members, this adds hours—sometimes days—of time saved.

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Still Unsure?

Start with any plan—you can switch anytime without losing progress.

FAQ

Can I switch plans later?

Yes. You can upgrade or downgrade at any time—no penalties, no lost progress. If we’re already working on claims or billing issues, everything carries over with you.

Do I need to pay upfront to get help?

Not on Standard. Premium and Max are flat monthly plans.

What if my situation is complicated?

That’s exactly what Max is for. If you’re dealing with multiple plans, fertility benefits, or high-cost care, we handle coordination and make sure nothing slips through the cracks.

Still have questions?

We’re here to help. Whether you’re trying to choose a plan or figure out a specific bill, you can reach out anytime—or just get started and we’ll guide you from there.