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.
You’ll see terms like PPO (preferred provider organization), EPO (exclusive provider organization), and HMO (health maintenance organization) to describe the network.
Finding in-network doctors
At Premera, our network is filled with 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. 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 plans, the network is called Heritage Signature.
We have expanded our network to include Seattle Children’s Hospital, MultiCare Health System, Swedish Health Services, and UW Medicine (includes the University of Washington Medical Center and Harborview Medical Center). Premera members will continue to have access to other leading hospitals, including Virginia Mason Hospital and Medical Center, Overlake Hospital Medical Center, Northwest Hospital, Evergreen Health, CHI Franciscan Health, Providence Health & Services, and more.
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 for 2015 individual plans ended February 15. But you may be able to enroll or change plans now if you experience a qualifying life event.