The special enrollment period for Individual ACA- compliant metallic plans runs from April 1 through December 31, 2014. Individual consumers may apply for coverage from Premera Blue Cross during special enrollment periods when qualifying events occur until the next open enrollment period in the fall. For more information, we created a Frequently Asked Questions (FAQ) document for you.
Premera is introducing Prior Authorization as part of our efforts to help our members receive high quality cost-effective care consistent with clinical best practices. Prior Authorization requires members to make sure their provider requests an authorization in advance for certain services.
Effective September 1, Prior Authorization will apply to fully-insured large groups (51+) as they renew and enroll, both grandfathered and non-grandfathered. It will also apply to Self-funded Groups and National Accounts as they renew and enroll, and Self-funded Groups choose how the member penalty is applied if Prior Authorization is not obtained.
Prior Authorization will apply to Small Groups (1-50 employees) and Associations beginning January 1, 2014.
For more information about Prior Authorization, read the Producer Bulletin June Edition.
Use our new wellness program to:
At Premera, our members’ health and controlling rising healthcare costs are our top priorities. Our intuitive and easy-to-use online resources help members effectively evaluate and manage all their healthcare options.
Take a quick tour of the secure member website or download the brochure Connecting your health and benefits
Check out Premera’s official news hub, where you’ll find news, health and wellness tips, information about healthcare benefits, how they work and more.
For example, did you know Premera is the first health plan in the country to collaborate with sleep specialists to launch a program that encourages in-home sleep studies? Hear from Dr. John Espinola, Vice President of Medical Services and others about the effectiveness of the program – including the member’s comfort and wallet.
Cost and quality transparency tools to help our members
We want to help and support our members to become empowered consumers, as they take on more responsibility for decision-making and how their money is spent.
That's why we are offering our members online transparency tools that allow them to easily compare costs and quality to make informed decisions about their healthcare, removing the guesswork.
We provide members with tools to:
Check out this flyer for more information on these online tools.
Preventive Services Lists
For non-grandfathered members, many preventive services received in network are covered in full as part of healthcare reform.
Preventive Care Services - non-grandfathered PlansPreventive Care Services - grandfathered plans
Find out if providers are in the Heritage Signature Network on the new metallic plans.
Juice: iPhone App to Kick Start Healthy Habits
Juice, an iPhone app, is the first in a series of consumer mHealth apps. The app helps you assess energy zappers and provides all kinds of tips – including mood, stress and life balance! Check out the Juice video for a quick introduction. Then give it a try and let us know what you think!