Benefits Handbook (SPD)
Health Care
Participation
Medical
Highlights of the Plan
Benefit Summary
Medical Necessity
Allowable Charge
Alliance Direct and Non-Direct Providers
Annual Deductible
Annual Out-of-Pocket Limits
Care Coordination
Centers of Expertise
Travel Benefit
Bundled Surgery Services
Eligible Expenses
Expenses That Are Not Eligible
Preauthorization, Concurrent Review, and Retrospective Review
Benefit Penalties
How to File a Claim
Definitions
Appendix A: Human Organ, Tissue, and Bone Marrow Transplant Services
Appendix B: Designated Procedures for Centers of Expertise
Appendix C: Services and Products That Require Preauthorization
Prescription Drug
Dental
Vision
Flexible Spending Accounts
Income Security
Retirement
Special Benefits
Policies

Bundled Surgery Services

Bundled surgery services can save money for both you and the Plan. With bundled services, the provider charges a single price for nonemergency surgeries and related ancillary services, such as radiology, anesthesia, implants, and post-surgery services.

When you use a Plan-approved bundled surgery provider for a qualifying surgery, you are eligible for the Alliance Direct benefit level (i.e., 100% covered with no deductible). You may also be eligible for the travel benefits described in Travel Benefit assisted by or through Care Coordination. As with any inpatient or outpatient surgeries, preauthorization is required to avoid a benefit penalty.

If you or a covered dependent need a nonemergency surgery, contact Member Services at (855) 979-5192 to ask if that surgery qualifies for bundled surgery services and which providers are approved for that type of surgery.