• Premera-Designated Centers of Excellence

      If you need knee or hip replacement, you probably have a lot of questions:

      Can my surgeon fix the problem? Will there be complications? Will I feel better after surgery? Can I afford it?

      Premera-Designated Centers of Excellence has the answers:

      • You can feel confident. Each selected hospital has a proven record of outstanding care.
      • You can rest easy. Surgery is low-to no-cost to you.
      • You can stress less. Premera takes care of the details so you don’t have to.

      You can make a COVID-19 exception request if you have the following:

      • Medical conditions that would be exacerbated by increased exposure to COVID-19
      • Non-medical issues that would be exacerbated by increased exposure to COVID-19
       

      Meet your Premera care team and Providence St. Joseph Health

       

      Exclusive Providers

      Seven hospitals across Washington are Premera-Designated Centers of Excellence for total joint replacement. Each was chosen for its record of exceptional patient experience and surgical outcomes.

      Select a name below to learn more about the center of excellence:

      Total Joint Replacement locations map

      Simple pricing

      When you have total joint replacement at a Premera-Designated Center of Excellence, you get all this—at little to no cost:

      • Pre-operative visit and related care
      • Surgery and inpatient stay, including facility, profession charges, and related services
      • Post-operative visit and related care, such as basic labs, x-rays, clearance to travel
      Image explaining No-cost surgery: No deductible, no coinsurance, travel benefits
      Image explaining Low-cost surgery: Deductible applies, no coinsurance, travel benefits
      Image explaining getting surgery at a different type of facility: Deductible applies, coinsurance applies, travel benefits

      Getting there

      If you live more than 50 miles from your closest center of excellence, you can count on Premera to get you there. We’ll make the reservations for you and a companion and we’ll pay for it (up to IRS limits).*

      Premera will make reservations and pre-pay for:

      • Airfare—Round-trip, economy class, commercial airfare for two, plus one checked bag per person per flight
      • Ground transportation—Between airport, hotel, and hospital
      • Lodging—Hotel near the Premera-Designated Centers of Excellence

      Submit a claim form and we’ll reimburse you for:

      • Personal vehicle—Mileage in lieu of flight, parking fees at hotel and/or hospital
      • Alternate transportation—Round-trip, economy class, commercial train, bus, and/or ferry tickets for two

      *Subscriber is responsible for travel expenses in excess of IRS limits. See IRS Publication 502 for current limits for medical travel expenses.

      Personal Service

      For most people, having surgery isn’t a common experience. Getting from diagnosis to day of surgery can be a confusing and worrisome journey. With Premera-Designated Centers of Excellence, you have a dedicated support team to take care of the details so you can concentrate on getting better.

      Customer service
      • Answer your benefit questions
      • Locate the most convenient center of excellence for you
      • Make your travel arrangements, if necessary
      Personal health support
      • Answer your health questions
      • Coordinate your care with your center of excellence
      • Transfer your medical records
      Client program liasion
      • Answer your surgery questions
      • Guide you through the surgical process
      • Make sure you’re ready for surgery

      Frequently asked questions

      Premera recognizes certain facilities for higher efficiency and better patient outcomes in the delivery of specialty care. Identifying centers of excellence for select specialty services supports Premera’s vision to make healthcare work better.

      The seven hospitals designated by Premera as centers of excellence for total joint replacement are part of Providence St. Joseph Health (PSJH). PSJH was chosen from among nearly two dozen healthcare providers based on their combined score of cost and quality. Scoring parameters were defined by the Bree Collaborative, an organization that identifies ways to improve health care quality, outcomes, and affordability in Washington State.

      We believe the seven hospitals chosen as Premera-Designated Centers of Excellence offer the best quality and price for total joint replacement. You may choose to use a provider other than the seven centers of excellence but will be responsible for 100% of the cost of care.

      No. Starting in 2020, your Premera health plan covers total joint replacement ONLY at the seven Premera-Designated Centers of Excellence. If you choose to have joint replacement at another facility—even if it is in your plan network for other medical services—you are responsible for paying 100% of the cost of care.

      No. No matter where you live, an approved total joint replacement must be done at one of the seven Premera-Designated Centers of Excellence.

      You must coordinate your care and travel through Premera to receive the benefit, including low- to no-cost surgery.

      Even if you go to a participating surgeon at one of the seven centers of excellence, if you have not worked with Premera to coordinate your care and travel, your claims will not be processed correctly. You run the risk of having to pay the full amount of the surgery.

      Like the hospitals themselves, certain surgeons have been selected to participate in Premera-Designated Centers of Excellence. These surgeons were selected based on their proven quality of care. View a list of participating surgeons.

      Members on an HSA plan will receive a bill for any remaining balance of the annual deductible. Additionally, all members may be billed for services not included in the Premera-Designated Centers of Excellence benefit.

      See full language of the Premera-Designated Centers of Excellence benefit for complete pricing information.

      Premera pays for approved travel expenses up to the IRS limit. The subscriber is responsible for paying all travel expenses over IRS limits.

      Travel expenses that are not covered include:

      • Meals, groceries
      • Lodging at any establishment that is not a hotel or motel
      • Vehicle fuel
      • Alcohol or tobacco
      • First class airline fees
      • Entertainment, such as movies, visits to museums, or sightseeing
      • Costs for people other than the patient or their medically necessary companion
      • Costs for pets or animals, other than service animals, including pet kenneling while a member is hospitalized, traveling for services, or recovering.
      • Personal care items such as shampoo or toothpaste
      • Tourist items such as t-shirts/sweatshirts or toys
      • Hotel related expenses (laundry, phone, fax, internet, TV, movies, minibar, room services)

      See full language of the Premera-Designated Centers of Excellence benefit for complete list of covered and non-covered travel expenses.

      For more information about total joint replacement at Premera-Designated Centers of Excellence, please call 800-722-1471 (TTY: 711). Representatives are available 5 a.m. to 8 p.m. Monday to Friday (Pacific Time).