Health Plan - Highmark Delaware
Announcement
The State Employee Benefits Committee (SEBC) believes in providing high quality care to members at an affordable cost. Effective July 1, 2023, bariatric surgery coverage will be available exclusively through the SurgeryPlus benefit. This assures State of Delaware Aetna and Highmark Delaware members will have access to surgeons and facilities that meet strict SurgeryPlus credentialing guidelines, leading to the highest quality care possible.
Outpatient Surgery
Save time and money by having your outpatient surgery services completed at in-network non-hospital affiliated Ambulatory Surgery Centers (ASCs). These facilities provide similar quality as hospital affiliated locations and are often more convenient.
Freestanding Ambulatory Surgery Center Locations
Highmark Delaware Comprehensive PPO Plan
| Site of Care | Average Cost Per Visit | Your Cost Per Visit |
|---|---|---|
| Note: Prior authorization is required for certain outpatient surgical procedures. | ||
| In-network non-hospital affiliated Ambulatory Surgery Center (ASC) |
$1,786 | $50 copay |
| In-network hospital affiliated facility | $4,413 | $150 copay |
Highmark Delaware First State Basic Plan
| Site of Care | Average Cost Per Visit | Your Cost Per Visit |
|---|---|---|
| Note: Prior authorization is required for certain outpatient surgical procedures. | ||
| In-network non-hospital affiliated Ambulatory Surgery Center (ASC) |
$1,786 | 10% coinsurance (after plan year deductible is met) |
| In-network hospital affiliated facility | $4,413 | 10% coinsurance (after plan year deductible is met) |
Additional benefits for non-emergency, planned surgeries are available through SurgeryPlus.
