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We have thousands of healthcare providers in our networks. Networks vary by plan. For most accurate results, register or sign in, then search with the Find a Doctor tool.
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Health plans have a specific group of doctors, pharmacies, hospitals, and other healthcare providers you can use at a contracted price. This is your network. Premera networks are called Heritage Prime, Heritage Signature, and Global.
Since you pay for part of the costs of your medical care, it's important to know that you will almost always pay less when you see an in-network provider. Services from out-of-network providers may cost more, or may not be covered at all by your plan.
One danger of using an out-of-network provider is balance bills. "Allowed amounts," are set rates your in-network providers can charge for services and procedures. An out-of-network provider is not obligated to charge you the allowed amount.
So, if you have a procedure with an in-network provider who usually charges $200, but the allowed amount is $150, they can only charge $150. The doctor writes off the other $50.
If you have the same procedure with an out-of-office provider, the provider can balance bill you the $50. Your Premera plan will only cover the allowed amount (less copy and deductible).
It's important to know when visiting an out-of-network provider that you can be charged out-of-pocket expenses (costs not covered by your health plan), including your deductible and copay. Out-of-pocket expenses for out-of-network providers often do not apply to the annual out-of-pocket maximum. Your out-of-pocket maximum refers to the most you could pay during a coverage period for your share of the costs of covered services before your plan pays 100 percent of eligible expenses.
Out-of-network expenses could include: lab work, durable medical equipment (wheel chairs, orthotics, and braces), cpap (breathing machines), referrals to specialist, radiology (x-rays, ct scans, and MRIs), and physical therapy.
Confirm with your provider that the services you are receiving are in-network to avoid higher out-of-pocket costs.
If you have a doctor you like, use the Find a Doctor tool and filter by the network name associated with the plan you're interested in. You can search for your doctor or clinic by name.
Our Exclusive Provider Organization (EPO) plans use the Heritage Signature network, which includes major Washington healthcare systems Seattle Children's Hospital, MultiCare Health System, and UW Medicine. Premera members have access to top hospitals, including Virginia Mason Hospital & Medical Center, Overlake Hospital Medical Center, Northwest Hospital, and Evergreen Health.
PersonalCare Plans offer care from a partner system: The Everett Clinic, EvergreenHealth Partners, MultiCare Connected Care, Northwest Physicians Network, UW Medicine Accountable Care Network, or Virginia Mason Medical Center.
We will match you with a partner system and primary care physician after you enroll. To change your partner system call 855-494-1319. To change your primary care physician, log into your online account.
Specialty and other care outside of you partner system requires a referral. Emergency care is covered outside your partner system.
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