Open Enrollment FAQs

  • Answer a few questions in our shopping tool to find your estimated tax credit, a plan match, and then apply.

    To make your first payment:

    Current customers, you’ll receive an invoice in early December with instructions for how to pay. Submit your payment by December 31, 2017 for a January 1 start.

    New customers, you'll have two options when you enroll: pay now or later. If you choose to pay later, you'll receive an invoice that will give you the option to pay by check or pay online. You'll need the system ID from the invoice slip to make your payment.

    No, your plan doesn't cover out-of-area providers, except in emergency situations. PersonalCare and Exclusive Provider Organization (EPO) plans offer in-network coverage with contracted Washington providers.

    You also have access to the 24-Hour NurseLine and Teledoc® virtual care services, so you can get care even if you're away from home.

    Premera has partnered with eviCore Healthcare to provide medical necessity management for certain outpatient rehabilitation services, such as physical therapy, massage therapy, and occupation therapy. Determining medical necessity helps our customers get the most effective care for their condition helps us manage your monthly premiums.

    If you live in King, Snohomish, or Pierce county, we match you with a Partner System based on what's closest to your home address. If you'd rather get your care in another Partner System, please call customer service. We'd be happy to set you up with the Partner System you prefer. Within that Partner System, you can choose a doctor you like to be your primary care provider.

    If you need to make plan changes, check eligibility or change your personal information (address, email, phone number), please contact Washington Healthplanfinder. They'll share that information with us.

    It's up to you, but health savings accounts come with certain tax advantages, and help you save for medical expenses. Learn more about getting started.

    A grandfathered plan is an individual health plan purchased on or before March 23, 2010. This type of plan is exempt from many changes required by the Affordable Care Act.

    If you're enrolled in a grandfathered plan, you don't need to do anything. Your plan will renew automatically on January 1, 2017. However, if your health needs have changed, you can check out our 2018 plans.

  • King, Snohomish, and Pierce county plans

  • The PersonalCare Plan, available in King, Snohomish, and Pierce counties, is designed to offer a better healthcare experience-one where all of your doctors, hospitals, and specialists are encouraged to work together to make sure you get the care you need, when you need it, and at a lower cost. For this to work, customers get coordinated care within a Partner System of trusted local providers, which is held accountable for your care. Everyone in the Partner System has agreed to uphold our high standards for quality care.

    We need you to choose a primary care provider. Sign into your online account and select a doctor in your partner system.

    We recommend signing into your Premera account and choosing a new doctor in your Partner System. Every provider in our Partner Systems agrees to uphold Premera's high standard for care.

    Alternatively, you can continue to see your doctor, but you'll be responsible for the cost of care.

    Yes, you can change your Partner System or primary care provider as your needs change.

    Switching your primary care provider is easy - sign in to your online account and select a doctor within your Partner System. The change will be effective the same day. If you'd like to change your Partner System, please call the customer service phone number on the back of your ID card. Keep in mind, changing Partner Systems requires you to change your primary care provider too.

    Non-emergency medical care outside of your Partner System is not covered on the PersonalCare Plan. (Example: If you want to see a doctor for strep throat or a sinus infection while traveling out of state, the visit won't be covered.) If you need non-emergency care while traveling out of state, try Teladoc® virtual care services for only the cost of a copay.

    Yes! Your Partner System is your central point of care and your primary care provider coordinates with specialists and hospitals in your Partner System to make sure everyone stays focused on your needs. If you need care that’s not available in your Partner System, your doctor will complete a referral for you to see another provider in the Heritage Signature/Heritage Prime Network. If you receive care outside of your Partner System without a referral from your doctor, you may have to pay the full cost out of your own pocket, with the exception of medical emergencies.

    It's a good plan for you if… You live in King, Snohomish, or Pierce counties and:

    • See a doctor more than a couple of times a year,
    • Might see a specialist or manage a health condition, and
    • Value having access to top hospitals.

    It's not a good plan for you if… You or your dependents live outside of King, Snohomish, or Pierce counties part of the year, or you travel frequently. Outside of your Partner System, you only have access to emergency coverage and Teladoc® virtual care services.

    • Selecting a primary care doctor is required.
    • Referrals from your primary care doctor are required.
    • 2 doctor visits (beyond preventive care) are fully covered for most plans.
    • A health savings account (HSA) is not an option with this plan.