Additional-cost Tier

PEBB is committed to providing high-quality medical benefit plans that encourage the right care at the right time.

Medical science has developed many new ways to treat disease and injury. But there is too much variation and overuse of some of these procedures. Medical evidence shows that more conservative, less invasive and less costly treatment options may be as effective as costly, surgical procedures. It’s important for you to talk with your provider and carefully consider all options.

The Additional-cost Tier encourages members to discuss treatment alternatives for certain procedures with their physicians. Certain procedures on the Additional-cost Tier benefits require a $500 copay that does not apply toward the annual out of pocket maximum. This $500 copay applies to specialist services and is in addition to any associated copays and/or coinsurance associated with anesthesiology, facility or other ancillary services. See your benefit summary for details.

Use the links below to learn more about the following Additional-cost Tier procedures:

Find shared decision support for other procedures and conditions. If you decide that the higher-copay treatment is the best option under the circumstances, the service will be covered as outlined in the benefit summary and member handbook or handbook addendum.