Health plans have a specific group of doctors, dentists, pharmacies, hospitals, and other healthcare providers you can use at a lower-cost, in-network level. This is known as the provider network, or just the network.
Since you pay for part of the costs of your medical care, it’s important to get your care from providers who are in your network. You will almost always pay less if you use an in-network provider, rather than an out-of-network provider.
Finding in-network doctors
At Premera, our network includes thousands of providers who deliver high-quality healthcare for lower costs. Our
Find a Doctor tool lists all the doctors and other healthcare providers who are in-network for our health plans.
Provider networks vary from plan to plan. You'll see terms like preferred provider organization (PPO) and PersonalCare Plan to describe Premera's networks. (PersonalCare Plans are available only in King, Pierce, and Snohomish counties.)
To use the
Find a Doctor tool, it’s very important to know the name of the provider network for the plan you’re interested in. For Premera’s individual PPO and HSA (Health Savings Account) plans, the network is called Heritage Signature.
PPO and PersonalCare Plans
The network for PPO plans includes major Washington healthcare systems including Seattle Children’s Hospital, MultiCare Health System, Swedish Health Services, and UW Medicine. Premera members have access to leading hospitals, including Virginia Mason Hospital & Medical Center, Overlake Hospital Medical Center, Northwest Hospital, Evergreen Health, CHI Franciscan Health, Providence Health & Services, and more.
PersonalCare Plans offer care from your chosen partner system. The primary care doctor (also known as a primary care provider, or PCP) you choose from within the partner system coordinates your care, providing referrals when needed. The partner system choices currently include EvergreenHealth Partners, MultiCare Connected Care, Northwest Physicians Network, UW Medicine Accountable Care Network, and Virginia Mason.
Do you already have a doctor?
When selecting a health plan, it’s important to consider whether its network includes healthcare providers that will meet your needs. If you already have a regular doctor, you might want to see if that doctor is in the network.
With the Find a Doctor tool, you can search for providers by location, specialty, gender, languages spoken, and more. You can also call us at 800-722-1471 with any questions.
Open enrollment is much shorter than last year—individual plans are available now through January 31, 2016.
Have questions? We can help. Call us at 877-PREMERA (877-773-6372)