• Our Most Frequently Asked Questions

    I didn’t purchase a new health plan by March 31st, what do I do? 

    Unfortunately if you did not purchase a new health plan by March 31st, it’s too late for you to buy a health plan. The next opportunity to buy a plan is during the open enrollment period starting November 15, 2014 for a January 1, 2015 effective date.

    Can I still change my plan? 

    Whether you purchased your plan through the Washington Healthplanfinder or direct from us, you can only make changes outside of the open enrollment period if you have a qualifying event.

    Can I make changes to my plan outside of open enrollment? 

    Only in certain circumstances. One of the new rules starting in 2014 is that you can only join or make changes to a plan during the open enrollment period. There are some exceptions though: if you get married, have a child or lose your job, for example, you'll be able to make changes to your plan.

    What is a Qualifying Event? 

    A qualifying event is a significant change to your life like getting married, having a child or losing your job.

    When is the next Open Enrollment Period? 

    November 15, 2014 to February 15, 2015

    I bought a new health plan. How do I know I’m covered? Will you confirm what Health Plan I purchased? 

    You should receive a welcome kit with a cover letter explaining your new plan and how to use it. You will also receive a welcome email with links to valuable resources. Please call us at 800-722-1471 with any questions about your health plan.

    I thought I had cancelled my old plan, but I still received a bill. What should I do? 

    In some cases, your cancellation may not have been received and processed in time to stop your bill going out or your account being debited. If you received a bill for a plan that has been cancelled, you do not have to pay this bill and it won’t affect your credit rating.

    I have Automatic Funds Transfer (AFT). I cancelled my old plan but my bank account was still charged for it? What should I do? 

    We’re sorry your account was debited for your cancelled plan. Call us at 800-722-1471 and we will make sure you get a refund as soon as possible.

    I would like to cancel my Automatic Funds Transfer (AFT), how do I cancel it? What date do I need to cancel by?

    Call us at 800-722-1471 and we can take your cancellation over the phone.

    You can also mail your cancellation request to:

    Mailing address:
    PO Box 91120
    Seattle, WA 98111

    To ensure prompt cancellation of your AFT, please submit your notice at least 20 days prior to your next scheduled transfer. Most transfers take place on the last Thursday of every month. We recommend submitting your cancellation by the fifth of every month in order to cancel for the following month.

    I need to visit the doctor, but I don’t have my ID card. What should I do? 

    Doctors and hospitals can confirm your coverage directly with us. You can still get care if you need it, even if you don’t have your ID card. You can also call us at 800-722-1471 and we’ll give you your ID number.

    You can use your ID number to log into our member portal and print off proof of coverage or use our mobile app.

    My name, or other personal information, is wrong – what do I do? 

    If you enrolled in a plan through Washington Healthplanfinder, you will need to contact them to update your details. We aren’t able to make any changes to information held in their systems.

    If you enrolled directly with us, call us at 800-722-1471 and we can update that information for you.

    What do I pay when? What do you pay? 

    When you join Premera you become a member. Like most memberships there are monthly rates, included services and discounted services. Visit Health Plan Basics for a breakdown of costs.

    I purchased my new health plan through Washington Healthplanfinder and received my first bill. Where do I send payment? 

    You can send your payment directly to the Washington Healthplanfinder. Payment instructions are included with your bill.

    It is possible, although not recommended, to send your payment directly to Premera. However, this may cause delays in Washington Healthplanfinder posting payments to your account. This is because Washington Healthplanfinder holds all payment information for members who purchase through their system.

    What is the difference between the Explanation of Benefits (EOB) Premera sent me and the statement I received from my Provider? 

    After you see a doctor they send us a claim. We apply your benefits to that claim to determine who pays what for your medical care. Our way of describing all this to you comes in an Explanation of Benefits (EOB). Visit Health Plan Basics for more information.

    How do I know I’m using the right lingo? What should I say? 

    Yes. Here are a few common terms you should know to get started and use your plan.

    • Allowable Charge:In-network providers agree to charge this amount for services or supplies.
    • Coinsurance: Your share of the fee for a service. If your plan’s coinsurance share is 20%, you pay 20% of the allowable charge and your plan benefit pays the other 80% of the allowable charge
    • Copay: A flat fee you pay for a specific service, such as an office visit, at the time a service is rendered. Copays apply toward deductible and out-of-pocket maximum.
    • Deductible: The amount of money you pay every year before the plan begins to pay for certain services. If your annual deductible is $2,000, you pay for all of your care that year until you have paid out $2,000. You can find your deductible amount on your plan ID card.
    • Out-of-Pocket Maximum: A preset amount of cost share paid by you annually. After you have paid this amount, your plan pays 100% of the allowable charge for covered care.
    • Primary Care Provider: Designated provider that helps coordinate your care. You can choose a different primary care provider for each family member from: physicians and internists, physician assistants, and nurse practitioners; ob/gyns and women’s health specialists, pediatricians, and geriatric specialists; or naturopaths. You can change your primary care provider at any time.

    Where can I find more information online? 

    For more information you can follow our blog, Premera News. You can also learn more about Healthcare Reform in Health Plan Basics.