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There are so many costs that are associated with medical care, including facility fees, doctor fees, and prescription costs. We want to help you navigate the confusing process of keeping your costs as low as possible, whether you’re going through a serious medical issue, or just dealing with mild medical concerns.
For almost any health plan, where you go to receive your care matters. One of the best ways to minimize your medical costs is to receive care at an in-network facility and/or from an in-network provider. Use the plan provided resources to find an in-network provider that will both meet your needs and keep your costs as low as possible.
Use the table below for more information about finding an in-network provider.
| Plan | Details |
Premera (HSP, HCP, HI)
| With an in-network provider, you’re guaranteed to pay the allowable amount, which is the negotiated rate that the providers have agreed to accept as payment.
Selecting an out-of-network provider may result in you paying above the allowable amount, and these costs do not apply toward your deductible or out-of-pocket maximum. |
Surest Health Plan
| When you are seeking medical care, stay within the extensive United Healthcare network in order to receive the highest level of coverage. In the United Healthcare network, you’ll pay a flat copayment for your care.
Seeing an out-of-network provider may result in a higher copayment and responsibility for up to the total billed amount. |
Kaiser Foundation Health Plan of Washington
| If you are using the Kaiser Foundation Health Plan of Washington, you can find an in-organization provider and compare costs through the website or by calling one of the two numbers below:
(206) 901-4636 or (888) 901-4636
Group number 172300 |
Kaiser Permanente
| If you are using Kaiser Permanente, you can find a provider and compare costs through the website or by calling (800) 464-4000.
Northern California group number: 603873
Southern California group number: 231325 |
It can be difficult to “shop around” when it comes to medical procedures and providers. Your health plan has processes in place to help you do this. You have a right to research and look into who is providing your care and where you will receive it.
Prior authorization
Often, your provider will call your health plan on your behalf to inquire about the cost of a particular treatment or test. You can also contact your health plan to get this same information. For certain services, they may request a prior authorization in order to receive an advance determination that the service is medically necessary and covered by the plan. Knowing that this is something necessary can help you be a proactive member of your own—or your family’s—care team.
Find costs and ratings
Access your health plan’s website to review costs and ratings for a variety of procedures including:
Office visits
Women's health and Obstetrics
Physical Rehabilitation (Chiro, OT, PT, ST)
Tests and Screenings
MRIs and other Imaging
Surgical Procedures
Health plan provider |
Review costs and ratings |
Premera
| Sign in to your Premera Account.
Click Find Care, then click Find a Doctor.
Click Search Your Network.
Under Browse by Category, click Medical Procedure Costs. |
Surest
| Sign in to your Surest account.
Click Find Care.
Enter your Provider or Medical Procedure. |
Kaiser Washington
| Sign in to your Kaiser WA member account to find care.
|
Kaiser California
| Sign in to your Kaiser CA member account to find care.
|
If you have a Flexible Spending Account (FSA), use these funds first to pay out-of-pocket expenses. Since health FSAs only offer a small carryover amount, it's important to use up the funds in your FSA before the end of the calendar year. If you have a Health Savings Account (HSA), you can pay for eligible medical expenses with pre-tax dollars (or save the money in your HSA to allow it to grow over time!).
Review the Eligible Expenses Guide to learn more.
Microsoft plans contain prescription coverage and each provides the same opportunities to minimize those costs.
Generic drugs
A generic equivalent prescription is made with the same ingredients at the same dose as the brand-name drug. You can expect the same results as with the brand-name drug. For example: simvastatin (generic) is the same drug as Zocor (brand name).
A generic alternative prescription works like a brand-name drug or another generic drug, is in the same class of medicines, and may be prescribed when a generic drug is not available. However, the ingredients are different from the brand-name drug or its generic equivalent, so overall results may be somewhat different.
For example: simvastatin (generic alternative) is used for the same desired effect as Crestor (brand name).
Ask your doctor about lower-priced alternatives to brand-name medications. If there is no generic version of your brand-name medication, your doctor might be able to provide you with a less expensive medication that, while different, can still effectively treat your condition and/or symptoms.
90-day supply
Maintenance medications will often be most cost-effective if purchased in bulk as a 90-day supply.
Generic maintenance medications are often less expensive at the Living Well Health Center, if you live and work in the Redmond area, or at other retail pharmacies. If you’re unsure which pharmacies are willing to fill 90-day prescriptions, contact your health plan customer service for assistance.
Brand maintenance medications are often more affordable when purchased through your health plan’s prescription mail-order programs, such as OptumRx for Surest members or ExpressScripts for Premera members. Redmond locals can also get these at the Living Well Health Center.
Preventive drugs
Preventive drugs generally include medications that are:
Prescribed for a person who has developed risk factors for a condition that hasn't shown symptoms yet.
Example: Treatment of high cholesterol with cholesterol-lowering medications.
Prescribed to prevent the recurrence of a disease.
Examples: Treatment of recovered heart attack, or ACE inhibitor medications to prevent a recurrence for stroke victims.
Common preventive drug types
Asthma medication
Birth control medication
Blood thinning agents
Common drugs not considered preventive
Sleep medications
Antibiotics