The Surest guide to cancer

You have so much to think about with a cancer diagnosis—the last thing you should have to worry about is your insurance. Surest offers comprehensive cancer care coverage. Use this guide to better understand cancer treatment options and your benefits on the Surest plan. You can also request a call from the Surest clinical team for help along the way.

For additional information on specific types of cancer, check out these guides:

• Breast cancer
• Prostate cancer
• Thyroid cancer
• Cervical cancer
• Skin cancer

What types of doctors might I see?

Several types of doctors and clinical professionals may be involved in your care. These providers are specialists in your diagnosis and care, including:

• Medical oncologists—specializing in the diagnosis and treatment of cancer
• Radiation oncologists—specializing in using radiation therapy to treat cancer
• Surgical oncologists—receive special training in cancer surgery

Search the Surest app or website for the type of specialty provider you may need. The copay for an office visit will vary based on the provider and the office location. Surest evaluates providers based on past performance for things like effectiveness and cost-efficient care. Those considered high value are often priced lower. Contact Member Services if you have questions about cost or coverage.

What types of tests might I need?

Laboratory tests: Urine and blood tests

Many urine and blood tests are covered at a $0 copay when done by an in-network provider. Search for the name of the test in the Surest app to view your copay.

The price for most advanced laboratory tests can be found by searching the name of the test in the Surest app. If you can’t find a specific test, call Member Services at the number on the back of your Surest member ID card for assistance.

If your labs are drawn during a provider visit, a copay for the provider visit will apply. You can find the office visit copay in the Surest app under the doctor’s name.

Laboratory tests: Genetic testing

Genetic testing is used to look for inherited gene mutations that might put someone at higher risk of getting certain kinds of cancer.

These tests may need authorization before the test is done. Your in-network provider will initiate this process with Surest.

Genetic testing prices will vary depending on the type of test and how it’s done. View your copay for in-network genetic testing in the Surest app by searching the name of the test.

Imaging tests

The cost for an in-network X-ray or ultrasound is a $0 copay. Prices for other imaging tests vary based on the location. Search the Surest app for the name of the imaging test to compare and identify lower-cost options. Note the copay is based on the exact location, not the health care system/group. Ask your provider to send your imaging test orders to the location you choose.

• CT scan: A computed tomography (CT) scan uses X-rays to make detailed pictures of parts of your body and the structures inside your body. During the test, you will lie on a table that is attached to the CT scanner. The CT scanner is a large doughnut-shaped machine.
• MRI: Magnetic resonance imaging (MRI) is a test that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. When you have an MRI, you lie on a table and your body is moved into the MRI machine, where an image is taken of the area of the body being studied.
• PET scan: Positron emission tomography (PET) scans use a doughnut-shaped special type of camera, and a radioactive substance called a “tracer” to look at organs in the body. A computed tomography (CT) scan is often done at the same time as a PET scan.
• Bone scan: A test that identifies new areas of bone growth or breakdown. During a bone scan, a small amount of radioactive substance (radionuclide) is injected into the bloodstream. A camera takes pictures of the location of the radioactive substance in the bone.

Biopsy

A biopsy is a sample of tissue collected from an organ or other part of the body. The sample is then examined by a doctor trained to look at tissue samples (pathologist). The procedure of collecting the sample of tissue or cells is also called a biopsy. There are many ways to perform a biopsy; your provider will talk with you about the type of biopsy that’s best for your care.

The copay for a biopsy procedure depends on the type and where it’s performed. Search for the name of the biopsy in the Surest app to see in-network locations and your copay.

Can I get help making decisions about treatments?

With an increasing number of cancer treatments available, it’s common to feel uncertain about your treatment plan and what’s ahead. Surest aims to help. Our Clinical Advocacy team is available to help you navigate important decisions.

We can also help find other doctors who specialize in your diagnosis or help you get a second opinion for your treatment plan. Don’t worry about offending your current provider team when seeking a second opinion. You’re taking an active role in learning more about your condition and most doctors encourage second opinions. The Surest team is here to support you. I'd like some help.

What are common treatments?

Surgery

Surgery is used to prevent, diagnose, stage, and treat cancer. Surgery can also relieve discomfort or problems related to cancer.

Search for the name of the surgery using the Surest app or website to find copays. You can compare copays among providers and locations. Share price information with your doctor to help decide where to have surgery. Many providers practice at multiple locations, so ask about location choices.

Radiation treatment

Radiation therapy uses high-energy particles/waves to destroy or damage cancer cells. Radiation may be delivered by a machine outside the body (external radiation therapy) or inside your body (internal radiation therapy).

Search for the specific type of radiation therapy using the Surest app or website to see options. The copay shown will be applied to each visit. Some types of radiation therapy may need prior authorization. Your in-network doctor will initiate this process with Surest.

Drug treatment

Drug treatments include chemotherapy, immunotherapy, hormone therapy, or targeted therapy. These medicines may be used alone or in combination and can be given by infusion, injection, or as pills.

• Injections and infusions can be given in the office, in an inpatient facility, or an outpatient setting. A copay will apply each time you go in for an infusion or injection. The copay amount is available on the Surest app by searching the name of the medicine.
• Sometimes an implanted port or central venous line may be needed for the delivery of your drug treatment. Search for the procedure on the Surest app to view your cost for this.
• The cost of pills will depend on the type of medicine. Search the name of the medicine in the Surest app to see your copay. You may be directed to an outside pharmacy site if your pharmacy information is separate from Surest. If you see that prompt, follow the directions to see your cost for the medicine.
• Some medications may need prior authorization. Your in-network provider will initiate this process with Surest, if needed.

What other services might be helpful?

Dietitian

A dietitian visit can be helpful if you have problems related to food and digestion. To see the cost for this service, look in the Surest app and search for “dietitian” or a specific provider name.

Home care

Home care (home health care) services are usually provided through a home health agency. Services may include care from nurses, therapists, social workers, and home care aides. Home care may also supply certain types of medical equipment for you.

• To receive home care services, your provider will place an order for the service
• Find the cost for a home care visit in the Surest app by searching “home health service” and select location to find in-network agencies

Acupuncture

Acupuncture is a form of traditional Chinese medicine and can help with symptoms such as pain, fatigue, nausea, or vomiting. Acupuncture uses very thin needles to influence energy flow; sometimes heat, pressure, or mild electrical current is used along with needles. The price for an acupuncture visit can be found by searching “acupuncture” in the Surest app.

Palliative care

The goal of palliative care is to improve the quality of life for people with a serious, life-threatening illness. The palliative care team helps with symptoms and side effects of the disease and treatment. They also work with you on any related psychological, social, or spiritual needs. It’s common to receive both palliative care and cancer treatment at the same time. To find the price for palliative care in the Surest app, search “palliative care.” Palliative care does not include respite care or hospice services. Contact the Surest Clinical Advocacy team for help accessing those services.

Support for stress, anxiety, and uncertainty

A cancer diagnosis often affects the emotional health of patients, families, and caregivers. You’re not alone. Talk to your provider and loved ones about how you are feeling. Surest provides comprehensive coverage for mental health care. Get more details with our Mental Health guide.

Surest is here to help.

The Surest clinical team is here to help you:

• Understand important decisions about your treatments
• Identify quality in-network doctors and facilities
• Share your preferences for care with doctors and other specialists on your care team
• Navigate your Surest benefits and understand costs for services
• Learn about resources and support groups with other people going through a similar challenge

I'd like some help.

Other resources you may find helpful

• Health Library
• CancerCare.org
• Cancer.org
• Clinical Trials member guide

FAQs

I’m new to Surest, how do I find out if my oncology team is in-network?

1. Search the Surest app for your providers’ names. If you find them, the corresponding copay for an office visit will also be displayed.
2. If you don’t see your provider, call Member Services at the number on the back of your Surest member ID card to confirm network status.
3. If your provider is not in-network and you are in active treatment, you can request a Transition of Care exception. This form is available in your Surest app or website under the “Plan Resources” or “Claims” sections. If approved, claims from that provider will be processed as in-network for a defined period of time. You can also move to an in-network provider to continue your care.

What’s included in the copay?

A copay is a specific dollar amount you pay for routine services, like a doctor’s visit. The copay for an office visit includes standard labs and X-rays. A surgery copay includes the surgeon, anesthesiologist, and facility fees.

Is there an out-of-pocket limit? What applies?

Yes. There is an out-of-pocket limit, or the most money you’ll pay in a given year for health care benefits your plan covers. Log into your Surest account for details. All copays count toward the out-of-pocket limit—from office visits to surgery. Paycheck deductions (premiums) don’t count toward out-of-pocket limits.

What should I do if my doctor doesn’t recognize Surest?

Not all in-network providers know our plan by name. Share your Surest member ID card with the office, which has the information they need to confirm coverage.

Can I have a case manager at Surest?

Yes, call Member Services at the number on the back of your Surest member ID card or request a nurse case manager by completing this form: I'd like some help.

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This content is not medical advice. You should always consult with your health care professional.

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