Health Connect Plan

The Health Connect network is anchored in a select group of providers that take a personalized approach to healthcare from the following organizations:

Eastside Health Network:The Eastside Health Network (EHN) is a clinically integrated provider network that includes providers from dozens of local and independent practices, Overlake Medical Center and clinics, and EvergreenHealth. EHN offers:

Learn more about Eastside Health Network.

Microsoft Living Well Health Center: The Living Well Health Center (LWHC) is located on the Microsoft Redmond Campus and offers primary and preventive care services in addition to physical therapy, chiropractic services, wellness coaching, eye care, and a pharmacy.

Learn more about the Living Well Health Center.

Allegro Pediatrics: Allegro Pediatrics is a pediatric provider group with over 90 providers in 8 locations across the Eastside.

Learn more about Allegro Pediatrics.

Seattle Children’s Hospital: Health Connect Plan members have access to care at Seattle Children’s with a waiver from a Health Connect network provider.

Learn more about Seattle Children's Hospital.

• Primary care providers (PCPs) coordinate care with other Health Connect providers to make sure patients receive the right care at the right time and minimize unnecessary tests, treatments, and costs.
• When your patient needs care the Health Connect network can’t provide, submit a waiver for your patient to receive care outside of the Health Connect network (within the Heritage extended network, called the “Extended network”). You can find more information about the waiver process below.
• Health Connect specialty care providers are encouraged to refer patients back to their PCP with any additional waiver recommendations to ensure services are coordinated through the PCP and provided within the Health Connect network if possible.

Member ID cards have the Microsoft logo and the name of the Health Connect Plan in the upper right-hand corner of the card. Always verify eligibility and benefits before seeing Premera Health Connect Plan patients using our online eligibility and benefits tool.

Providers who aren’t contracted with the Health Connect network but are part of Premera’s Heritage extended network can see Health Connect Plan members without a waiver from a Health Connect provider. Without a waiver however, services won’t be covered at the Health Connect benefit level but at an extended network level with higher out-of-pocket costs for the member.

Providers who aren’t in Premera’s Heritage extended network are considered out of network and Premera won’t cover their services. Patients may be 100% responsible for the cost of this care.

Health Connect Plan members can see any provider in the Health Connect network at the Health Connect Plan benefit level (the lowest out-of-pocket cost the plan offers). If a member requires care outside of Health Connect Network (but in the Heritage extended network), they can work with their Health Connect provider (PCP or specialist) to submit a waiver for coverage of the needed services. With the waiver, the member will pay at the Health Connect Plan benefit level. If a member sees a provider in the Heritage extended network without a waiver, they’ll pay at the higher extended network cost.

All providers outside the Health Connect network and Heritage extended network are considered out of network and services aren’t covered.

How to submit a waiver:

• Microsoft’s onsite clinic, the Living Well Health Center, and Allegro Pediatric providers must submit waivers using Premera’s online waiver tool. You can find a training video on how to use the online tool under the ‘resources’ side bar on the top right-hand corner of this page.
• EHN providers will submit waivers through the regular EHN process.
• You must submit waiver requests before the patient’s visit to the Heritage extended network to have the service covered at the Health Connect Plan benefit level.
• Waivers submitted after the service is provided won’t be approved and will be covered at the extended network benefit level.

Services that don’t need a waiver:

Health Connect Plan members can see any provider in the Heritage extended network for the services listed below without a waiver and be covered at the Health Connect Plan benefit level. View detailed list of services.

• Patients have access to a 24-hour nurse line at no cost.
• There are 12 urgent care centers in the Health Connect network that members can use with a $40 copay.
• Health Connect Plan members can go to an urgent care center outside of the Health Connect network, but will pay a higher cost for services.

Below is a high-level snapshot of Health Connect Plan member benefits.