Frequently Asked Questions

SurgeryPlus is a free supplemental program provided with your medical benefits. It provides many common outpatient surgeries and inpatient surgical procedures to help you from head to toe. The experts at SurgeryPlus negotiate costs before you undergo surgery and only work with board-certified providers. As a result, they can get an unbeatable price with the highest quality surgeons.

SurgeryPlus is included as part of your ET medical coverage. You do not need to enroll. When you need to plan a surgical procedure, call 855-200-9512 to speak to a dedicated Care Advocate or go to ET.SurgeryPlus.com.

The SurgeryPlus program is included in your medical plan. Also, the Partnership picks up the entire cost of the surgery after your deductible is met. As an added incentive for employees enrolled in the CDHP plan, the Partnership will make an additional contribution to your HSA based on the type of surgery you receive, $250 for minor surgeries and $1,000 for major surgeries (limited to $1,000 total annual contribution).

Yes, you are required to use SurgeryPlus for spine and bariatric surgeries. If you do not use a SurgeryPlus provider, these procedures will no longer be covered as of January 1, 2020. While SurgeryPlus also provides many other outpatient and inpatient surgeries, they are on a voluntary basis. SurgeryPlus can help you save money on pre-planned surgeries and procedures. Call 855-200-9512 to speak to a dedicated Care Advocate today!

To locate a provider in the SurgeryPlus network, you must first contact a Care Advocate at 855-200-9512 to register and discuss your case. The Care Advocate and the SurgeryPlus provider team will review your case based on your medical needs and other preferences to develop a list of providers who are the best fit possible.

The criteria that SurgeryPlus uses to select surgeons is more stringent than most health plan requirements. All SurgeryPlus doctors are board-certified and are the best in their specialty. Not only will your doctor be high quality, he or she has already performed your specific procedure many times with great results. Surgery is complicated. Getting a high-quality doctor no longer needs to be. Call 855-200-9512 to speak to a dedicated Care Advocate today!

If you already working with a non-SurgeryPlus surgeon, it may not be too late to switch. Also, remember that all bariatric and spine surgeries must be performed with SurgeryPlus providers to be covered under your medical benefits. Experience the SurgeryPlus difference and call 855-200-9512 to speak to a dedicated Care Advocate today.

It depends on the type of surgery you need and where you live. Your SurgeryPlus benefit includes the cost of travel and lodging. If you do need to travel, your dedicated Care Advocate will make all your travel arrangements and handle all the travel bills for you.

Yes. Once your annual deductible has been met, the Partnership covers the full remaining cost of the surgery. This means that your coinsurance is waived completely.  Additionally, if you are enrolled in the CDHP plan and you or a covered dependent use SurgeryPlus for a covered surgery, the Partnership will contribute extra money to your HSA: $1,000 for major surgery and $250 for minor surgery. The annual incentive maximum is $1,000 per family.

Post-operative care is provided locally when appropriate to avoid additional travel disruption.  However, if it is appropriate for a member to have a post-operative follow-up appointment with a SurgeryPlus provider, travel benefits will be provided as needed.

It is recommended that you call SurgeryPlus as soon as you learn you may need surgery.

If you drive a personal vehicle to a SurgeryPlus consultation and/or procedure, you will be given a flat-dollar allowance to cover travel expenses. For distances ranging from 0 – 99 miles, you will receive $25.  For 100 – 199 miles, you will receive $50. For distances 200 miles and over, you will receive $100. When travel distance approaches 300 miles or more, airfare is generally recommended. Mileage allowances are loaded to a Swift debit card that you receive in the mail from SurgeryPlus along with your welcome letter. Funds are pre-loaded 48 hours prior to the appointment.

If travel is necessary, benefits may include airfare, hotel, mileage reimbursement, rental car and a meal per diem of $35 per person ($70 total per day). Your SurgeryPlus Care Advocate will book travel arrangements in advance for you when possible. When this is not a possibility, funds to cover the cost will be loaded to a Swift debit card prior to your travel start date to ensure you avoid unnecessary out-of-pocket spending.

If you travel for your surgery, travel benefits are provided until you have been cleared for travel back home by the surgeon. Travel benefits may include hotel and per diem amounts for food for you and your travel care companion.

Yes. A travel care companion is permitted to accompany you for procedures. The travel care companion can be a family member or other individual of the patient’s preference. Airfare, if needed, will be provided as well as the daily $35 per diem for meals loaded to the patient’s Swift card prior to the travel date.

Yes, when necessary for a travel care companion.

A surgeon is welcome to apply to join the SurgeryPlus network. Interested providers must be able to meet contractual and credentialing requirements in order to join the network. A physician can reach out directly by emailing the SurgeryPlus provider team at EDHCProviderTeam@edhc.com or by calling 855-200-2099.

Yes, epidurals are covered as part of conservative pain management services by some SurgeryPlus providers. For more information about this procedure, please reach out to a Care Advocate.

The SurgeryPlus Network includes both Orthopedic Spine Surgeons (must have fellowship training specific to the spine) and Neurosurgeons. Depending on the specific details of the surgery, SurgeryPlus will recommend the most appropriate surgeon to perform the procedure required.