PersonalCare Health Plans

  • You get a better healthcare experience with PersonalCare Plans– one where all of your doctors, hospitals, and specialists work together to streamline your care and keep costs as low as possible. These plans are available in King, Snohomish, and Pierce counties so you can find care right in your neighborhood.

    More about PersonalCare Plans

    With a PersonalCare Plan, you can expect

    • 2 fully covered visits with your primary care provider for most plans
    • Timely doctor appointments with specialist visits in 15 days or less
    • Preventive exams, vaccinations, and screenings at no cost
    • Teladoc® virtual care services so you can consult with a doctor anytime
    • Member discounts on fitness activities and more
    • A free, 24-hour NurseLine to help you find the best care option

    How your PersonalCare Plan works

    The PersonalCare Plan is a different kind of plan – one that’s based on accountable care, meaning everyone involved must meet a set of quality standards. We’ll match you with one of six PersonalCare Plan Partner Systems. Use the links to find providers within your partner system.

    Each system of hospitals, clinics, and doctors commits to working together with Premera to provide care that saves you time. Your Partner System is your central point of care, and your designated primary care provider (PCP) coordinates with specialists and hospitals in your Partner System to make sure everyone stays focused on your needs.

    If your doctor recommends care that isn’t available in your Partner System, they’ll 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.

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

    Switching your doctor is easy – sign in to your secure online account a new 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.