Support and FAQs

What is the Surest health plan and how does it work?

Surest is an employer‑sponsored health plan that works much like an online shopping experience. The plan is designed to show members cost and care options prior to a visit—with no deductible or coinsurance to calculate. Through the Surest app or website, members can access the national UnitedHealthcare network to find care, view copays, check ratings and reviews, and see what’s included in a visit. With this information, they can compare options and choose care that fits their needs and budget.

What does the Surest plan cover?

In-network preventive care • primary and specialty care • urgent, emergency, and hospital care • chronic care for long-term and recurring illnesses • pharmacy • mental and behavioral health services • maternity care • cancer care • substance use disorder • and more.

Where is the plan offered?

Surest is an ACA-compliant health plan for employers with 2+ employees. It’s offered through employers in 49 states, excluding Hawaii. Funding arrangements include self-funded, level funded, and fully insured.

How does this work with other health insurance?

If you have other insurance, call us at 866-683-6440 M–F from 6 am to 9 pm CT to discuss how the plan works with that coverage. Each insurance plan has its own design, and we can help you understand how the two plans might work together.

Is it true I don’t have a deductible? Or coinsurance?

Correct. There’s no deductible and no coinsurance to figure out. With a Surest account, members can see the price (copay) for care on day one.

Is this plan compatible with health reimbursement arrangements (HRAs), health savings accounts (HSAs), and flexible spending accounts (FSAs)?

Yes, you can submit expenses to your HRA and FSA for reimbursement. Because the Surest plan is not a high-deductible health plan (HDHP)—a requirement of contributing to an HSA—Surest members are not eligible to contribute to an HSA. They can, however, keep using funds in an HSA accumulated while on another plan.

I can’t find my condition, treatment, or provider using the Surest app or website. Does that mean it isn’t covered?

Not necessarily. Surest Member Services is available through chat, secure web form, or by calling 866-683-6440 M–F from 6 am to 9 pm CT.

Does the Surest plan cover pre-existing conditions?

Yes. A pre-existing condition is a health problem diagnosed or treated before your health insurance plan goes into effect. Common pre-existing conditions include high blood pressure, diabetes, cancer, and asthma.

If I was previously on a different health insurance plan and switched to the Surest plan, do I need new prior authorization for medical care or prescriptions?

Probably, yes. Unfortunately, we’re not able to transfer your existing prior authorization. We encourage you to fill prescriptions before the end of the plan year to allow time for your provider to submit a new prior authorization. Once you receive your Surest member ID card, call the number on the back to discuss prior authorizations. We recommend that you show your provider your new insurance ID card. Providers can call our pre-certification line to initiate a new request.

Is my provider or pharmacy in-network?

The Surest health plan accesses the broad, national UnitedHealthcare and Optum Behavioral Health networks—one of the biggest networks of doctors, hospitals, and clinics in the country. Check the Surest app or website or call Surest Member Services to confirm network status.

Can I keep my same primary care doctor? Am I required to have a primary care provider?

You’ll likely be able to keep your doctor, although you’re not required to designate a primary doctor with the Surest health plan. Use our search tool in the Surest app or website to find in-network doctors who meet your needs. You can also call Surest Member Services.

A provider who is not in-network may result in higher out-of-pocket costs. (Out-of-network prices tend to be higher than staying in-network.)

Do I need a referral to see a specialist?

No specialist referrals are needed.

What happens if my provider is out-of-network?

Compared to staying in-network, treatment from out-of-network providers may cost members more due to often higher out-of-network prices. It’s worth pointing out that some Surest plan designs don’t include any out-of-network coverage for services. Use the search feature in the Surest app or website to confirm network status before making an appointment.

Can I access the Surest plan from my cell phone?

Absolutely! We designed the Surest plan to fit your lifestyle. Download the Surest app, activate your account, then start searching.

Are my dependents covered if they live in a different state than I do?

If your dependents live in another state or are traveling, they can search for available in-network care using the Surest app or website. Virtual care may be an option, too.

How does Surest work with other health insurance?

If you have other existing insurance, call us to discuss how the Surest plan works with that coverage. Each insurance plan has its own design, and we can help you understand how the two plans might work together.

Does the Surest plan cover vaccines?

Yes. Preventive vaccines and administration is a $0 copay when in network. For out-of-network care, members pay the out-of-network preventive copay listed in the Surest app or website. Non-FDA authorized or approved vaccines are not covered under the Surest plan.

How are copays (prices) determined? What are Care Ratings?

We evaluate providers on services they offer based on their historical effectiveness and cost efficiency performance. Then, we assign higher Care Ratings—and lower copays—for higher provider performance. When you check prices before seeking or scheduling care—you have the potential to save money.

What medications are covered and how much do they cost?

Use the Surest app or website to check cost information in your plan’s formulary.

Does the Surest plan have an out-of-pocket limit? What does it include?

Yes, the Surest plan has an out-of-pocket limit that can provide a safety net. Prices (copays) for in-network covered services, including routine care, inpatient, outpatient, etc., count toward your out-of-pocket limit. Monthly premiums and out-of-network expenses don’t count toward out-of-pocket limits.

Is there an out-of-pocket limit if I choose out-of-network providers?

Yes. Prices covered for out-of-network services count toward your out-of-network, out-of-pocket limit, separate from your in-network, out-of-pocket limit.

What happens if I reach my out-of-pocket limit?

Your out-of-pocket limit is the most money you’ll pay in a given plan year for the health care benefits your plan covers. If you hit this number, your insurance company picks up the cost for covered services the remainder of the year, presuming you stay in-network.

Can Surest Member Services make a payment for a claim on my behalf?

Member Services can’t make a payment for you, but they can guide you through the steps to make a payment using the Surest app.

What if I need to request a refund?

Please email Claims-Support@uhc.com with your transaction details. Keep in mind that once your provider accepts the payment, they can’t issue a refund. You’ll need to work directly with your provider’s office for any refund after acceptance.

Why did I get a refund for a claim I paid in the Surest app?

If your provider doesn’t accept a payment within 30 days, Surest automatically refunds your money. To avoid delays, please confirm with your provider’s office to ensure your payment is completed.

Why can’t I make a payment for some of my claims?

In some cases, we may not have the most current billing information for your provider. When this happens, we’re unable to process payments on your behalf. This should be noted in the Surest experience with the status of “Payment options not available.”

How long will it take for my payment to process when I pay a claim via the Surest app

It can take up to 30 days for your payment to be processed.