Planning for your surgery

When you're planning for surgery, it's important to be well-prepared to ensure you receive the best care, minimize costs, and streamline bill paying so you can focus on your recovery.

Learn more about your treatment options, get a second opinion, or find a leading physician in your area through the Second Medical Opinion program. A nationally-recognized expert will review your situation and provide input on your current course of treatment or help you and your doctor consider another perspective.

Compare quality providers

The Embold Health Provider Guide is a tool designed to help you find highly rated healthcare providers in your area and within your insurance network. Premera and Surest members have access to the Embold Health Provider Guide.

 

The Embold Health Provider Guide provides ratings for a variety of specialties, including: 

 

  • Primary care

  • Obstetrics

  • Cardiology

  • Endocrinology

  • Pulmonology

  • Joint care (orthopedic)

  • Spine care (both orthopedic and neurosurgical)

  • Gastroenterology

  • Pediatrics 

Here are a few things you can do to ensure your surgery is covered at the highest level and prevent surprise medical bills: 

 

  • Make sure your providers are covered under your enrollment plan. Once you’ve identified your providers – including your surgeon and the facility – make sure they are in your network. Have your doctor contact your health plan for prior authorization to ensure you and your doctor understand what costs are covered.

  • Ask your doctor about all services related to your surgery, such as pre-surgery X-rays and consultations, facility fees, and post-surgery medical devices and rehab services. 

After you have an estimate of your out-of-pocket costs, use these tax-saving options to help cover your expenses:

 

  • If you have a Health Savings Account (HSA), consider contributing additional money to the account up to the IRS maximum. Even if your future funds are not available at the time of payment, you can pay out of pocket and reimburse yourself when the HSA funds become available. You can make changes to your HSA contribution amount anytime using the Benefits Enrollment Tool.

  • If your surgery isn’t immediate, consider signing up for a Flexible Spending Account (FSA) during Open Enrollment in the fall (effective the next January).

 

Note: You can only sign up for an HSA or FSA during the Open Enrollment period, which occurs in the fall. When considering which elections you want to make at that time, consider what procedures you may need in the coming year. 

 

For additional considerations when choosing care, go to Minimizing my medical expenses.

If your surgery will keep you away from work, consider the leave of absence options available to you. Based on the procedure and recovery time, you may have enough sick/HHTO time available to cover it, or you may need to consider a disability leave. 

Depending on your medical plan, you may have a copay for your surgery, or you may have a deductible and coinsurance to pay. Copays are usually paid at the time of service. 

 

For plans where you have a deductible and coinsurance (like the Health Savings Plan and Hawaii Only Plan), you typically won't pay anything at the time of your surgery or procedure, other than for prescription drugs at the pharmacy. Your provider will bill you directly, typically after your procedure and your claim has been processed by your health plan.

 

Following surgery, you will receive:

 

  • An Explanation of Benefits (EOB) from your health plan that lists your share of the costs.

  • Bills from each provider and/or facility used for your care. Be sure to compare the bills with the EOB to ensure they match before you pay.

  • You can then pay your bill with funds from your HSA, FSA, or out of pocket. 

More resources

Contacts page

Minimizing my medical expenses

Leave of absence

Sick/HHTO

Accommodations