December 1, 2017
2017 Medicare Advantage plans have no out-of-network benefits
We no longer offer the HMO-POS (Health Maintenance Organization - Point of Service) plan for 2017. For 2017, we have three HMO plans. This means our plans have no out-of-network benefits except for emergency or urgently needed services. If a member sees an out-of-network provider, they may be responsible for the cost of their care. When referring Medicare Advantage members, confirm that the provider is in our Medicare Advantage network. Check our Medicare Advantage directory for a current list of our in-network providers and facilities.
Diabetic glucose monitors and supplies
For our 2017 Medicare Advantage plans, Premera will only cover glucose monitors and supplies from the Medicare list of preferred manufacturers and products. We won't cover other brands or manufacturers unless there is a medical need to use a different product. Review this list with your patients to ensure they're using the preferred brands. If the patient is using a different brand, we ask that you transition them to products from the preferred list.
Medicare Advantage network changes
Effective Jan. 1, 2017, Franciscan Health System will not be a part of our Medicare Advantage provider network. Be sure to check our provider directory before referring your Medicare Advantage patient to ensure that their services are covered by in-network providers and facilities.