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Microsoft provides comprehensive medical coverage for you and your eligible dependents with zero paycheck premiums. Surest is an innovative health plan designed to simplify healthcare with predictable upfront copays, no deductible or coinsurance, and an extensive nationwide network of providers.
You’re eligible to participate in the Surest Health Plan if you’re a benefit-eligible employee on the Microsoft US payroll and don’t live in Hawaii. You can also enroll eligible dependents including your legally married spouse or domestic partner (same or opposite sex), dependent children under age 26, and incapacitated children aged 26 and older. For additional details, review the full definition of an eligible employee, eligible dependents, and the explanation of those who are not eligible for coverage.
If both you and your spouse or domestic partner are employed by Microsoft and are eligible for benefit coverage, you are only allowed to be covered under one plan. You can either enroll as a dependent under your spouse or eligible domestic partner's plan or enroll in your own separate coverage, but not both. Your eligible children must be enrolled under only one employee's coverage.
Important note: If you have other coverage, learn how Coordination of Benefits (COB) applies to you and your enrolled dependents.
Search Surest for a provider, service, or medication and view how much everything will cost before you make an appointment or pick up a prescription. The Surest Health Plan uses the United Healthcare Choice Plus network (or Select Plus for California employees).The Surest pharmacy benefit is operated by OptumRx, which offers nationwide access to pharmacies including home delivery options.
The Surest health plan simplifies healthcare expenses by offering a single copay for most services provided in the same appointment, making it easier to know exactly what you will be paying.
Compare the copays shown on the Surest app with other in-network providers and at other locations to find the best value. Copays are based on a provider’s quality, effectiveness, efficiency, safety, and patient outcomes. Lower copays indicate higher quality care.
Quick tip! Learn more here about how Surest sets copays and evaluates providers.
Since the Surest Plan is not a high-deductible plan, enrolling in it means you won’t be eligible to contribute to (or receive Microsoft contributions on your behalf for) a Health Savings Account. You can use dollars that you already have in your HSA to pay for out-of-pocket medical expenses such as copays. You can also use your General Purpose Flexible Spending Account and use pre-tax dollars to pay for qualified health care expenses
You can fill a prescription at any retail pharmacy in the Surest (Optum Rx) network, including the on-campus Living Well Health Center in Building 21 (Redmond, WA). If you take medications on an ongoing basis, you can also use the mail-order option through Optum Home Delivery Pharmacy. Specialty medications must be filled through the Optum Specialty Pharmacy.
Your prescription copay depends on the tier your medication falls under: generic, preferred brand, or non-preferred brand. Preventive prescription drugs are covered in full.
You can only enroll in or make changes to your medical insurance election as a new hire, during the annual open enrollment period, or if you have a qualifying status change (like a marriage, divorce, or the birth of a child). To learn more, go to Qualified Status Change. To enroll or update your benefits with an eligible status change, go to Enroll/Change Benefits.
The Surest Health Plan has no deductible and no coinsurance. For everything besides in-network preventive care (which is fully covered), you’ll pay a copay. There is an annual out-of-pocket maximum that provides you with a safety net.
You can log into your Surest Account and search to see what your copays are in advance, compare provider and treatment options, and then decide how to get care or plan for health care expenses.
Lower prices indicate providers evaluated as high-value options based on quality, efficiency, and overall effectiveness of care.
Here’s a snapshot of the most commonly used benefits but be sure to reference the Summary Plan Detail for full details.
Benefit | In-Network Coverage | Out-of-Network Coverage* |
Annual deductible | None | |
Copayments | Variable (see list below for examples) | |
Coinsurance | None | |
Annual out-of-pocket maximums
| Employee only: $2,750 Employee + 1: $5,500 Employee + 2 or more: $6,875 | |
Ambulance | $160 copay | $160 copay* |
Autism/ABA therapy | $20 copay | $60 copay* |
Chiropractic and acupuncture services (medically necessary) | $30 copay | $90 copay* |
Combined 24 visit limit per person per calendar year | ||
Complex Imaging (MRI, CT, etc.) | $60 - $450 copay | Up to $1,350 copay* |
Diabetes health education | $0 copay | $100 copay* |
Diabetes prevention and management program (Virta) | $0 copay | Not applicable |
Emergency room | $350 copay | $350 copay* |
Home health care | $30 copay | $90 copay* |
Hospice care
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Hospital Services
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Hypertension program to manage high blood pressure (Virta) | $0 copay | Not applicable |
Immunization | $0 copay | $100 copay* |
Infertility | $50 - $2,000 copay. Must use the Progyny provider network, subject to certain limits | Not applicable |
Lab tests, X-rays, Ultrasounds (Routine Diagnostic Tests) | $0 copay | $0 copay |
Maternity care
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Maternity virtual support | Free virtual care and on-demand support through Maven Clinic | Not applicable |
Medical equipment and supplies | $0 to $500 copay | Up to $1,000 copay* |
Mental Health and Substance Use Disorder (SUD)
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Mental health outpatient services through Spring Health (MS CARES employee assistance program) | $0 copay Up to 24 sessions per calendar year | |
Prescription Drugs provided by OptumRx | ||
Retail or Onsite (Redmond) Pharmacy
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Mail Order Pharmacy or Onsite (Redmond) Pharmacy – up to a 90-day supply
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Specialty Retail Pharmacy – up to a 30-day supply
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Preventive care | Preventive services: $0 copay | Preventive services: $100 |
Physician and specialist office visits | $20 to $75 copay | $120 copay* |
Rehabilitative Therapies
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Skilled nursing facility | $1,000 copay | $1,000 copay |
120-day limit per calendar year | ||
Urgent care | $40 copay | $120 copay* |
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*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.
Under the Surest Plan certain, medical services may require you to obtain a Prior Authorization (PA) before it is covered. Check with your provider or reach out to Surest Member Services at (866) 222-1298 to see if a Prior Authorization applies in your situation. Some scenarios where a Prior Authorization may apply are bariatric surgery, chemotherapy, organ transplants, sleep studies, etc.
Visit the Surest website in order to:
Use the Surest Claim Form to submit medical claims for out of network providers.
To ask questions about the Surest Health Plan, call Surest Member Services at (866) 222-1298 or send a message at https://benefits.surest.com/support/send-message.
Go to the Microsoft COBRA Service Center or call (833) 253-4929 to ask questions or learn about COBRA coverage for you or eligible dependents.