Medicare Advantage Plans

If you want to represent Premera’s 2019 Medicare Advantage Plans, follow the steps below to become certified.

America's Health Insurance Plans (AHIP): Complete the 2019 AHIP Medicare Advantage certification. Once you complete the certification, log in to Premera AHIP to send your scores automatically to Premera.

2019 Premera Medicare Advantage certification: Contact your FMO or a Premera sales representative for information on how to access our training program.

• We’re one of the largest: We have more than 16,000 doctors and specialists in our Medicare Advantage provider network.
• What sets us apart: Our network is the same for all our Medicare Advantage plans, regardless of the county where the member lives.
• Tools for client conversations: To help you talk with your clients about Premera's network, use this quick guide and our online Find a Doctor tool.

Watch our recorded webinar for a 45 minute overview of 2019 Medicare Advantage product details.

Resources for all counties

This material can be used with customers in all of Premera’s service area, which includes 9 counties: King, Lewis, Pierce, Skagit, Snohomish, Spokane, Stevens, and Thurston.

• 2019 Medicare Advantage Enrollment Application
• Pre-enrollment checklist Helps your clients understand important information about their benefits and Medicare Advantage rules
• Low Income Subsidy Chart Shows your client if their income level will qualify for a government-paid subsidy that could help reduce their premium costs
• Guide to online resources List of commonly requested items available for free and how to find them
• 2019 Star Ratings
  • For plans: Alpine, Charter + Rx, Peak + Rx, and Sound + Rx
  • For plans: HMO, Core HMO, Classic HMO, Classic Plus HMO, and Total Health HMO

County-specific resources

This material should be used only with customers in the counties shown below.

King, Pierce, Snohomish, and Thurston

• Benefit Highlights brochure
• Tri-fold brochure
• Sales presentation
• Summary of Benefits for:
  • HMO, Classic HMO, Classic Plus HMO
  • Peak + Rx, Sound + Rx
  • Alpine, Charter + Rx

Lewis

• Benefit Highlights brochure
• Tri-fold brochure
• Sales presentation
• Summary of Benefits for HMO and Classic HMO

Spokane and Stevens

• Benefit Highlights brochure
• Tri-fold brochure
• Sales presentation
• Summary of Benefits for HMO and Total Health HMO

Skagit and Whatcom

• Benefit Highlights brochure
• Tri-fold brochure
• Sales presentation
• Summary of Benefits for Core HMO

For Whatcom only

• Summary of Benefits for:
  • Peak + Rx, Sound + Rx
  • Alpine, Charter + Rx

We want to make it easy for you to visit a customer with a complete enrollment kit –everything you need to enroll a client in a Premera Medicare Advantage plan in one place. We offer three kinds of enrollment kits, which all contain the same materials, to share with your clients.

• Send digital copies to your customers: These are ideal for clients who prefer to view information online. These pdfs can be sent via email and allow the customer to quickly click on what they want.
  • For customers in King, Pierce, Snohomish, or Thurston county
  • For customers in Lewis County
  • For customers in Skagit or Whatcom county
  • For customers in Spokane or Stevens county
• Print your own: This handy guide provides all the links you need to print your own enrollment kits for customers in all 9 counties.
• Order printed copies: Use the Medicare Advantage Producer Supply Order Form to have enrollment kits printed and delivered to you. The initial order for supplies has been submitted by your FMO. Use this form for additional orders going forward.

• Scope of Appointment Form
• Enrollment Form
• Electronic Funds Transfer Form
• Plan Change Form
• Producer of Record Change Form
• Optional Dental Enrollment Form

Customizable

Personalize these with your contact and sales event information.

• Sales event flyer

Other material

• Lead card

Video

Medicare Essentials Video: Introduce prospective clients to Medicare basics at your sales seminars

• Find a doctor, dentist or hospital
• Find a pharmacy
• Formulary (list of covered drugs)

• HMO
• Core HMO
• Classic HMO
• Classic Plus HMO
• Total Health
• Peak + Rx HMO
• Sound + Rx HMO
• Alpine HMO
• Charter + Rx HMO

Here’s what we send customers when they enroll in a Premera Medicare Advantage plan.

• Member Booklet for members new to one of the following plans: HMO, Core HMO, Classic HMO, Classic Plus HMO, or Total Health
• Member Booklet for members new to one of the following plans: Peak + Rx HMO, Sound + Rx HMO, Alpine HMO, or Charter + Rx HMO
• Guide to Online Resources
• Silver&Fit Enrollment Flyer
• Notice of Privacy Practices
• Mail Order Pharmacy Form and Instructions

• Medicare & You -This government handbook from the Centers for Medicare and Medicaid Services (CMS) currently shows Soundpath Health and Premera plans separately. We are working with CMS to correct the handbook.
• Other Medicare Publications
• Washington State Statewide Health Insurance Benefits Advisors (SHIBA) Help Line

To submit paper Medicare Advantage applications for January 1, 2019 and later effective dates:

• Email to premera_applications@advantasure.com or
• Fax to 800-381-4837

2018 Star Rating Information

• For plans: Alpine, Charter + Rx, Peak + Rx, and Sound + Rx
• For plans: HMO, Core HMO, Classic HMO, Classic Plus HMO, and Total Health HMO

Western Washington Medicare Advantage Plans

• Benefit Highlights Brochure: Western Washington Plans
• Summary of Benefits: Western Washington Plans

Spokane Medicare Advantage Plans

• Benefit Highlights Brochure: Spokane County Plans
• Summary of Benefits: Spokane County Plans

Dental Plans

• Optional Dental Plan Enrollment Form
• Network Dental Flyer

2018 Enrollment Kits

• To order, use the Medicare Advantage Producer Supply Order Form

Sales forms

• Scope of Appointment Form
• Enrollment Form: Western Washington Plans
• Enrollment Form: Spokane Plans
• Electronic Funds Transfer Form
• Plan change form: Western Washington Plans
• Plan change form: Spokane Plans
• Producer of Record Change Form

Customizable flyers

Personalize these with your contact and sales event information.

• Sales Event Flyer
• Enrollment Reminder Flyer
• Start Your Medicare Journey Flyer

Presentations

• Western Washington Sales Presentation
• Spokane Sales Presentation

Flyers and Brochures

• Medicare Advantage HMO Plan Flyer
• Medicare Advantage Classic and Classic Plus HMO Flyer
• Medicare Advantage Total Health HMO Flyer (Spokane only)
• Tri-fold Brochure: Western Washington Plans
• Tri-fold Brochure: Spokane County Plans

Other

• Large Meeting Sign
• Lead Card

Videos

Medicare Essentials Video: Introduce prospective clients to Medicare basics at your sales seminars

Premera provides these documents to members in welcome kits:

• Member Welcome Booklet: Western Washington
• Member Welcome Booklet: Spokane
• 2018 Durable Medical Equipment Flyer (EOC) (EOC)
• CVS Mail order form
• Drug List (Formulary)

Evidence of coverage

• Evidence of Coverage: HMO
• Evidence of Coverage: Classic HMO
• Evidence of Coverage: Classic Plus HMO
• Evidence of Coverage: Total Health (Spokane only)

• Medicare and You - government handbook from the Centers for Medicare and Medicaid Services
• Other Medicare Publications
• Washington State Statewide Health Insurance Benefits Advisors (SHIBA) Help Line

To submit paper applications for January 1, 2018 (and after) effective dates:

• Email to premera_applications@visianthealth.comor
• Fax to 1-800-381-4837