Lantern Surgery Benefit
Please note that Medicare Primary and HDHP members are not eligible to participate in this benefit.
The State Health Plan is excited to be partnering with Lantern, a trusted provider that helps connect Plan members to a high-quality, carefully selected surgeon when you need a planned, non-emergency procedure. There will be no cost ($0) for the surgery for members who use a Lantern provider —no deductibles and no copays.
Lantern surgeons are individually vetted and among the best in their field. A dedicated Lantern Care Advocate will work to match you with an excellent surgeon in the Lantern network as close to your home as possible. When close to home isn’t possible, there is a travel benefit members may utilize (see below for details).
Commonly covered procedure categories:
- Spine
- Orthopedic
- Joint
- Ear, nose, & throat
- Cardiac
- Gynecology
- General surgery
- Gastrointestinal
- Spine & ortho injections
- Urology
- Bariatrics*
*Beginning Jan. 1, 2026, Bariatric surgery will only be covered by the Plan if it is performed by a Lantern surgeon.
Members need to call Lantern at 833-916-3826 to determine if a surgery is covered. Lantern will be sending all eligible members an ID card that you can keep in your wallet as a reminder of this great benefit. When you use a Lantern provider, you will utilize this ID card.
If you do have to travel to receive care from a Lantern provider, some of your travel may be covered. Lantern will send members a prepaid card to use for:
- Daily allowance for meals or other needs (up to $35/day)
- Ground transportation (up to $100)
- Hotel accommodation
- Airfare available if necessary
Lantern Travel Benefit
| Description | 0 - 99 Miles | 100 - 199 Miles | 200+ Miles |
|---|---|---|---|
| Travel incentive - Hotel | Hotel expenses covered | Hotel expenses covered | Hotel expenses covered |
| Travel incentive - Airfare | Airfare expenses not covered | Airfare expenses covered | Airfare expenses covered |
| Travel incentive - Car | $25 mileage reimbursement | $50 mileage reimbursement | $100 mileage reimbursement |
| Travel incentive - Per Diem | $35 per diem for expenses | $35 per diem for expenses | $35 per diem for expenses |
| Companion Coverage | Hotel/transportation costs for companion covered | Hotel/transportation costs for companion covered | Hotel/transportation costs for companion covered |
Frequently Asked Questions
Personalized guidance to help members choose a Lantern surgeon. Consultations and appointments with your Lantern surgeon. Anesthesia, procedure, and hospital or surgery center fees. Step-by-step support from a dedicated Care Advocate. Medicare-eligible members are not eligible to participate in this benefit.
If members need a preplanned, non-emergency surgery, make Lantern your first call. Call a Lantern Care Advocate at (833) 916-3826. Medicare-eligible members are not eligible to participate in this benefit.
No, but if members see a non-Lantern surgeon the applicable cost share will apply based on the plan in which a member enrolled. Beginning Jan. 1, 2026, Plan members will be required to use a Lantern provider for bariatric procedures.
Members are automatically enrolled at no extra cost — the Plan already covered it. And the best part, there will be no cost for your surgery. Medicare-eligible members are not eligible to participate in this benefit.
A Lantern Care Advocate will: provide personalized support throughout the surgical journey, handle scheduling and paperwork. Lantern will also serve as a go-to resource before, during and after your procedure.
Emergency surgeries, cosmetic procedures and some medical equipment aren’t included. Certain tests, imaging or therapy may not be fully covered — but a Lantern Care Advocate will explain your options.
Yes. If your spouse or dependents are on your plan, they’re covered too.
If your surgeon is in the Lantern network, you can still use them for surgery — but you must call Lantern before your procedure to ensure your procedure is eligible for this benefit. If your surgeon isn’t in Lantern network, Lantern can show you comparable options close to home or you can choose to pay the applicable cost share amount for a non-Lantern surgeon.
Travel costs may be covered for out-of-town surgery, including transportation, lodging and daily expenses. Call a Lantern Care Advocate at (833) 916-3826 to learn more.