Benefits

Go to Benefit Details, where you will find what your plan covers.

You can find the status of your deductible and out-of-pocket maximum in your benefit details. With the app, you can view your individual and family deductibles for medical and dental on your phone at any time, from anywhere.

You can sign in and check your benefit details and your benefit booklet to learn which procedures need preapproval. We explain this further on the Preapproval page.

Just like members who don’t live in Washington or Alaska, you can sign in and go to Find Care to see providers in your network (be sure to set the search ZIP code to where you want to receive care). Your plan may also include virtual care options by telephone or video.

Seeing a different doctor to confirm a diagnosis or treatment plan is common and encouraged. If you want a second opinion for any reason, it is covered usually at the same cost share as any office visit.

Your health plan covers the routine medical costs of a qualified clinical trial. Depending on the specifics of the trial, this might include some investigative treatments. Make sure your provider checks with your health plan to see what parts of the clinical trial are covered.

To see your specific coverage, go to Benefit Details. You can also find helpful information on supplies, lab work, and medications on our Diabetes page.

Programs are included with plans as employers select them. Check your benefit booklet or ask your group administrator what is available to you under your plan.

You can sign in to see your benefit details and what is covered in your benefit booklet, and also go to Preventive Care for more information about the types of preventive care offered to men, women, and children. Generally, everyone has one preventive care visit that is fully paid each year.

Yes, and you can find helpful information, search for a provider, and find out about virtual care options on Mental Health.

Yes, this visit is usually done as part of the well-child exam. Ask your doctor to sign any forms you need.

Therapy to help gain functions that were injured or didn’t develop normally, such as speech, occupational, and physical therapy can be provided in a clinical or home setting. Sign in and go to your benefit details for information on any copays or coinsurance you are responsible for.

Many options for FDA-approved forms of birth control are covered without age restrictions, however, not every brand is covered. Learn more on Sexual Health & Family Planning.

Lesbian, gay, bisexual, and transgender people have a right to safe, affordable healthcare. Gender-affirming services are available on most health plans. Learn more on our LGBT Health page.

Yes, and if you are concerned that you might have been exposed to infection, it’s best that you get tested as soon as possible. Preventive STD tests are covered at 100% on most plans. Learn more on Sexual Health & Family Planning.

The answer is: It depends. You can read more on Sexual Health & Family Planning but you’ll find the information about your plan if you sign in and go to your benefit details.

We cover mammograms for men and women, subject to the terms of specific plans, based on what you and your healthcare provider decide is best for you, your risks, and preferences. Computer-aided and 3-D mammography are also covered. If the screening is done as a diagnostic test rather than preventive screening, it may be subject to copay and deductible. Sign in and go to your benefit details to see what your plan covers.

We offer support from prenatal to post-partum care. See the Pregnancy page for information on your resources and sign in to view your benefit details.

Premera provides coverage for CPAP machines and supplies when medically appropriate, although some details may vary from plan to plan. Learn about our CPAP program and coverage for sleep issues on our Sleep page and sign in to see your benefit details.