Plans and Service Areas

  • Premera Blue Cross Group Plans are available throughout Washington State under the Blue Cross brand (except Clark County).

    Premera Blue Cross Individual Plans are available in the following counties: Franklin, Grays Harbor, King, Kitsap, Pacific, Skamania and Wahkiakum.

    Premera Blue Cross Medicare Advantage plans are available in Island, King, Pierce, San Juan, Skagit, Snohomish, Spokane, Stevens, Thurston, Walla Walla and Whatcom.

    LifeWise Health Plan of Washington Individual Plans are available in the following counties: Adams, Asotin, Benton, Clallam, Clark, Columbia, Cowlitz , Franklin, Garfield, Grant, Grays Harbor, Jefferson, Kitsap, Okanogan, Pacific, Spokane, Thurston, Wahkiakum, Walla Walla, Whatcom, and Whitman.

    LifeWise Assurance Company Plans (Graduate Appointee Insurance Program and International Student Insurance Health Plan) are available throughout Washington State.

    Group plans

    • Premera Blue Cross
      • Preferred Provider Organization (PPO)—Your Choice, Your World
      • Exclusive Provider Organization (EPO)—Your Focus
      • Health Savings Account (HSA)—Your Future
      • Dental—Preference Flex Plus, Preferred Choice Dental, Willamette Dental
    • LifeWise Assurance Company
      • PPO and Dental—Graduate Appointee Insurance Program (GAIP)

    Individual plans

    • Premera Blue Cross
      • EPO and EPO/HSA—Preferred
      • Dental—Individual Pediatric Dental Plan
    • LifeWise Health Plan of Washington
      • EPO and EPO/HSA—Essential, Primary
      • Dental—Individual Pediatric Dental Plan, Family Dental Plan
    • LifeWise Assurance Company (International Student Insurance Health Plan)
      • PPO and Dental—International Student Insurance Plan (ISHIP)

    Medicare Advantage plans

    • Premera Blue Cross
      • Health Maintenance Organization (HMO)—HMO, Classic, Classic Plus, Total Health, Core, Core Plus
      • Dental—Optional riders on HMO and Core plans

    Networks

    For physicians and other providers, we offer the opportunity to participate in a variety of networks. We offer our members these network combinations:

    • Networks for Groups of 51 or more employees:
      • Premera Blue Cross—Heritage (medical)
      • Premera Blue Cross—Heritage Prime (medical)
      • Premera Blue Cross—Tahoma (medical)
      • Premera Blue Cross—Dental Choice (dental)
      • Premera Blue Cross—Willamette Dental Group (dental)
      • LifeWise Assurance Company—LifeWise Assurance Co (medical and dental)
    • Networks for Groups of 1-50 employees:
      • Premera Blue Cross—Heritage and Dental Choice (medical and dental)
      • Premera Blue Cross—Heritage Signature and Dental Choice (medical and dental)
      • Premera Blue Cross—Tahoma and Dental Choice (medical and dental)
    • Networks for Individual Plans:
      • Premera Blue Cross—Individual Signature (medical)
      • Premera Blue Cross—Dental Select (dental)
      • LifeWise Health Plan of Washington—LifeWise Primary (medical)
      • LifeWise Health Plan of Washington—LifeWise Health Plan of Washington Preferred (medical)
      • LifeWise Health Plan of Washington—Dental Value (dental)
      • LifeWise Assurance Company—LifeWise Assurance Co (medical and dental)
    • Networks for Medicare Advantage Plans:
      • Premera Blue Cross—Medicare Advantage (medical and dental)
  • Learn more about our PersonalCare Partner Systems Network.

    Premera only contracted with Accountable Health Systems (AHSs) for our PersonalCare Partner Systems network. An AHS (Partner System) can be defined as a set of healthcare providers-including primary care providers (PCPs), specialists, and hospitals-who work together collaboratively and accept collective accountability for the cost and quality of care delivered to a population of patients.

    We contracted with AHSs to enable members to receive medical care within a network of providers who are associated with and/or owned by an AHS that coordinates care from an integrated approach.

    The PersonalCare Partner Systems network supports Premera's PersonalCare Plans. PersonalCare Plans are PCP coordinated care individual benefit plans offered in Snohomish, Pierce, and King counties. PersonalCare Plans require a referral from the patient's partner system for specialty services. View a complete list of provider types and services that don't require a referral.

    • Partner systems are responsible for coordinating referrals for their PersonalCare Plan patients.
    • The partner system manages referrals within the system or its designated referral network. If the member is referred to a provider in the Partner System or the Partner System's designated referral network, the partner system doesn't send a referral to Premera.
    • Partner systems will send referrals to Premera when they refer a PersonalCare Plan member outside the system's network or designated referral network, but within Premera's Heritage Signature/Prime network.
      • If the referral is outside the Heritage Signature/Prime network, a prior authorization is also required
    • The partner system should contact the referring specialist(s) about the referral.
      • The partner system should discuss, but isn't limited to, the following information when referring a PersonalCare Plan patient to a specialist:
        • Patient's current treatment plan
        • Number of allowed visits to specialist
        • Whether the visit is to diagnose or diagnose/treat