I had to visit the ER
A trip to the Emergency Room (ER) for you or a family member can be scary. The costs and paperwork afterward can be almost as scary, too. Read on for help understanding your coverage and options.
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- What’s covered
- Get follow-up care
Your health plan will be the major determining factor of what you owe when you initially go to the ER, and what you may owe afterward. Review your plan information to see if you’ll need to pay a specific copay, or if your coverage works in some other fashion. Additionally, what you owe may change depending on the hospital you visit, and whether it’s in-network or out-of-network.
Use the table below to see how your visit will be covered:
| Plan | In-network | Out-of-network |
| Surest | $350 copay | $350 copay* |
| Kaiser (WA & CA) | $75 copay (waived if admitted) | $75 copay (waived if admitted) |
| Health Connect Plan | $250 copay (waived if admitted) | $250 copay (waived if admitted) |
| Hawaii-only | 90% after deductible | 90% of allowable charges after deductible |
| Health Savings Plan | 90% after deductible | 90% of allowable charges after deductible |
*Out-of-Network: In addition to your higher out-of-network copayment, you may be responsible for the Provider’s total billed amounts that exceed the Eligible Expenses (similar to allowable charges) that the Surest Plan pays for a Covered Health Service (known as out-of-network Provider “balance billing”), which can be significant.
After a trip to the ER, it’s common for there to be at least one follow-up visit to determine how successful the care was, and if continued care will be necessary. Use these resources for help making informed choices and for support with difficult medical issues. If you know you will need continued care, think about looking at I’m coping with a serious health condition.
Get a second opinion
Your Microsoft health plan offers an opportunity to seek out a second opinion on your medical concerns. You can learn more about this at our Second Medical Opinion page. Teladoc Expert Medical Services is available to Microsoft employees and dependents on Premera and Kaiser plans. If you’re on a Surest plan, you have access to 2nd.MD for advice on medical decisions.
Check in with your primary care doctor
After a visit to the ER, you should always check in with your primary care provider to discuss options and next steps. They can help you determine if further action is needed or schedule additional follow-ups to continue to monitor your progress. If you need continued care, they can help you figure out next steps and perhaps make recommendations of specialists they’ve worked with previously.
Find in-network providers or compare costs
Your health plan provides resources to help you look for providers that are in-network and help you keep your costs down. If you’re on a Premera or Surest plan, you can also take advantage of provider quality navigation services through Embold.
Select your plan below to see specific steps you can take to find a doctor that will work for you and your budget: