Medicare Advantage Plan Changes for 2024

November 6, 2023

We’ve consolidated plans

Instead of six plans, there will only be three 2024 Premera Blue Cross Medicare Advantage plans:

• For Western Washington, we’re offering our HMO $0 and Classic HMO plans.
• In Eastern Washington, it’s HMO $0 and Total Health HMO.
• Walla Walla will have their choice of all three.  

Here’s what’s happening with the other plans:

• Peak+Rx (HMO) will be discontinued. Members will automatically be enrolled in the Medicare Advantage HMO plan.
• Sound+Rx (HMO) will be discontinued. Members will automatically be enrolled in Classic (HMO).
• Alpine will close with no automatic enrollment to another plan.

No referrals to Premera

If your patient needs to see a specialist, you’ll be happy to know they can see any in-network provider without a referral sent to Premera. The primary care provider is still responsible for communicating and arranging care with a specialist, but that process is just between the patient and their provider.

Any requests for out-of-network providers will still need to go to Premera for review.

New Tier 6 pharmacy

We’ve created a new tier-6 pharmacy benefit that will allow your patients to receive a 100-day supply of drugs for chronic condition at a $0 copay. These drugs can be purchased at any in-network pharmacy. To take advantage of the 100-day supply, providers will need to write an order for the 100-day supply. Here is a sample of the drugs on the list:

You can learn more about all 2024 Premera Medicare Advantage plans by visiting our Medicare Advantage Enrollment website.

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