Open Enrollment FAQs

To make your first payment:

Current customers, continue to make you monthly premium payments. You’ll receive your next enrollment year’s invoice in early December.

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, or pay by phone. You'll need the payment ID from the invoice slip to make your payment.

• Online
  • Personal credit card – Visa, MasterCard, Discover
  • Personal checking or personal savings account
• Phone (interactive voice response)
  • Personal credit card – Visa, MasterCard, Discover
  • Personal Checking Debit Card
• Mail – Personal check, cashier’s check or money order

Note: Submitting a binding payment through your bank’s online bill payment feature is not an option

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 Teladoc^® virtual care services, so you can get care even if you're away from home.

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.

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, 2019. However, if your health needs have changed, you can check out our current 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.

Your primary care provider will not be listed on our ID card, but your Partner System is named. You'll want to receive all care in your Partner System. To select 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 primary care provider anytime and your Partner System at the beginning of a month.

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.