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Plan Documents
2020 Plan documents
Medicare Advantage (HMO)
2020 Annual Notice of Change – Premera Blue Cross Medicare Advantage (HMO)
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage (HMO)
Medicare Advantage Alpine (HMO)
2020 Annual Notice of Change – Premera Blue Cross Medicare Advantage Alpine (HMO)
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage Alpine (HMO)
Medicare Advantage Charter + Rx (HMO)
2020 Annual Notice of Change – Premera Blue Cross Medicare Advantage Charter + Rx (HMO)
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage Charter + Rx (HMO)
Medicare Advantage Classic (HMO)
2020 Annual Notice of Change – Premera Blue Cross Medicare Advantage Classic (HMO)
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage Classic (HMO)
Medicare Advantage Classic Plus (HMO)
2020 Annual Notice of Change – Premera Blue Cross Medicare Advantage Classic Plus (HMO)
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage Classic Plus (HMO)
Medicare Advantage Core (HMO)
2020 Annual Notice of Change – Premera Blue Cross Medicare Advantage Core (HMO)
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage Core (HMO)
2020 Annual Notice of Change – Premera Blue Cross Medicare Advantage Core (HMO) Spanish
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage Core (HMO) Spanish
Medicare Advantage Core Plus (HMO)
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage Core Plus (HMO)
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage Core Plus (HMO) Spanish
Medicare Advantage Peak + Rx (HMO)
2020 Annual Notice of Change – Premera Blue Cross Medicare Advantage Peak + Rx (HMO)
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage Peak + Rx (HMO)
Medicare Advantage Sound + Rx (HMO)
2020 Annual Notice of Change – Premera Blue Cross Medicare Advantage Sound + Rx (HMO)
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage Sound + Rx (HMO)
Medicare Advantage Total Health (HMO)
2020 Annual Notice of Change – Premera Blue Cross Medicare Advantage Total Health (HMO)
2020 Evidence of Coverage – Premera Blue Cross Medicare Advantage Total Health (HMO)
2020 Medicare Advantage summary of benefits
All plans
- Island, King, Pierce, San Juan, Skagit, Snohomish, Spokane, Stevens, Thurston, Walla Walla and Whatcom counties
All plans - Spanish
- Island, San Juan, Skagit and Walla Walla
Pre enrollment checklist
(English)
Pre enrollment checklist
(Spanish)
Durable medical equipment
Durable Medical Equipment
Durable Medical Equipment
(Spanish)