This post explains how Lantern works, who is eligible, what types of procedures are covered, and what practices should understand when patients ask about surgical options under the State Health Plan.
What Is Lantern?
Lantern is a surgical care program included with the State Health Plan that helps match members with carefully vetted surgeons for planned, non‑emergency procedures. Members enrolled in the Plan are automatically enrolled in Lantern and do not need to take additional steps to sign up. There is no premium for the benefit; the cost is covered by the Plan.
Lantern is not available to members whose primary coverage is Medicare or to certain high‑deductible health plan participants. Members are not required to use a Lantern surgeon, but choosing a surgeon within Lantern’s Network of Excellence allows them to take advantage of the enhanced benefits associated with the program.
The Lantern Difference
A key feature of Lantern is its Network of Excellence™. Surgeons and facilities in this network are individually vetted based on licensure, board certification, fellowship training, malpractice history, reputational review, and outcomes data. Lantern reports complication rates of less than one percent, which is significantly lower than typical industry benchmarks.
Members are also supported by a dedicated Lantern Care Advocate. Care Advocates help explain the benefit, identify appropriate surgeons, coordinate appointments, and support members throughout the entire surgical journey so they can focus on recovery rather than logistics.
Covered Procedures and Costs
Lantern covers more than 1,500 planned, non‑emergency surgical procedures across a wide range of specialties, including orthopedics, spine, cardiac care, bariatric surgery, gynecology, general surgery, gastroenterology, ENT, and interventional pain management. Effective January 1, 2026, bariatric procedures are required to go through Lantern’s Network of Excellence.
When members use a Lantern surgeon, the core components of surgery—including the surgeon, hospital or surgery center, anesthesia, and inpatient stay—are covered at no cost to the member under Lantern, depending on the member’s plan. Some services before and after surgery, such as physical therapy, home health, advanced imaging, and durable medical equipment, are not covered by Lantern and remain subject to standard plan benefits.
Meaningful Savings and Travel Support
Lantern participants may experience meaningful savings. On average, members save between $2,000 and $4,000 per surgery, although actual savings vary based on the procedure and plan design.
If a member needs to travel to receive care, Lantern may cover certain travel‑related expenses, including mileage, lodging for trips over 100 miles, airfare for trips over 200 miles, and a daily per diem for meals and incidentals for the member and one companion. Travel arrangements are coordinated in advance by the Care Advocate.
How Members Use Lantern
For members, accessing Lantern starts with a single phone call. Members are encouraged to contact Lantern if they believe surgery may be necessary, have been advised to have surgery, or already have a procedure planned. A Care Advocate then helps guide them through surgeon selection, scheduling, and next steps.
Additional information for members is available on the State Health Plan website at www.shpnc.gov .
Information for Providers Interested in Becoming a Lantern Surgical Provider
Lantern partners with surgeons, hospitals, and ambulatory surgery centers performance and patient outcomes. Lantern partners with surgeons, hospitals, and ambulatory surgery centers across the country through its Network of Excellence™ .
Surgeons and facilities that participate in Lantern’s Network of Excellence may receive referrals for planned, non‑emergency procedures and work closely with Lantern’s clinical and operational teams. Lantern also notes that it emphasizes clear, transparent reimbursement and aims to reduce administrative burden for participating providers.
Providers in this network are individually vetted based on procedure‑specific experience, credentials, and quality outcomes. Lantern describes its approach as “specialist‑first,” focusing on partnering with providers who consistently demonstrate strong clinical performance, evidence‑based practice, and a commitment to delivering exceptional patient care.
Providers or facilities interested in learning more about joining Lantern’s Network of Excellence can find additional information and submit an inquiry through Lantern’s specialist page at lanterncare.com/specialists .
Bottom Line
Lantern is a key part of the State Health Plan’s approach to improving surgical quality while lowering costs for members. By guiding members to highly vetted surgeons and supporting them throughout the surgical process, Lantern helps reduce complications, improve outcomes, and minimize financial burden.
Practices that understand how Lantern works are better positioned to answer patient questions and help members navigate their surgical benefits with confidence.
How Practice Support Can Help
The Practice Support Coaching Team can help practices understand how Lantern fits within the State Health Plan, support staff education, and answer workflow questions when patients raise questions about surgical care.
