Quality

MSK surgeries can be costly, and outcomes vary greatly. We also know provider quality can be hard to find. That’s why we selected the highest quality, most cost-efficient providers for hips, knees and spinal surgeries based on internal and third-party quality data. This helps members achieve better care, cost savings, and a streamlined surgical journey.

Features:

Lower-cost surgeries

The Musculoskeletal Centers of Excellence Rider¹ offers lower-cost surgeries at participating Centers of Excellence. Professional and facility fees for eligible surgeries will be $0². Anesthesia fees are subject to deductible and plan coinsurance.

Coverage for facility travel expenses

If members need to travel to a facility that is more than 50 miles from their residence, the embedded travel rider covers IRS eligible travel expenses up to $1,000 per contract year for Covered Services provided by a Priority Health Centers of Excellence Provider.

• Prior Authorization is required
• Travel reimbursement is limited to reasonable expenses for transportation, meals and lodging related to Prior Authorized services³
• Amounts reimbursed for travel expenses do not apply to Member’s Deductible or Out-of-Pocket Limit⁴

¹Excludes PriorityIntegra

²PriorityHSA plans are subject to deductible

³Alcohol and tobacco expenses are excluded from coverage

⁴Eligible travel expenses reimbursements will track towards the PriorityHSA deductible, pursuant to IRS rules governing Health Savings Accounts