Major Surgery

It is strongly recommend that you familiarize yourself with the Health & Benefit Fund’s schedule of benefits for surgery and hospitalization prior to scheduling your surgery.

Plan Checklist

• The Plan uses Magna Care – a Preferred Provider Organization (PPO) network of physicians, laboratories and hospitals.  Using a PPO facility and surgeon will generally result in your incurring the lowest possible out-of-pocket expenses for deductibles, co-insurance and co-payments. To find a PPO provider, call MagnaCare (Toll Free) at 1-877-335-4725 or visit their website, http://www.magnacare.com/providers/providers.aspx.
• Unless you are covered by Medicare, all non-emergency surgery must be pre-certified by calling MagnaCare (Toll Free) at 1-877-335-4725. When you call, be sure to have the name and social security number of the person having surgery, the name and phone number of the doctor performing the surgery, the name of the hospital where the patient will be treated, the date of the planned surgical or diagnostic procedure. Failure to follow pre-admission procedures may result in a reduction of your benefits. If the admission would have been approved by MagnaCare as medically necessary, you will be subject to a $200 benefit reduction However, any admission that would not have been approved as medically necessary by MagnaCare will not be a covered expense and you will be responsible for 100% of the non-covered charges.