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  • Welcome WEA Select Enrollees

    Welcome WEA Select Enrollees

    Open Enrollment is August 22 to September 30, 2016

    At Premera, our purpose is to improve customers' lives by making healthcare work better.

  • WEA Select medical and vision plans

    Reviewing your coverage each year is the best way to make sure you've got the health plan that best meets your healthcare needs. WEA Select Plan summaries and rates can be found on the Medical and Vision pages.

    2016-2017 Plan Changes

    Please review the 2016-17 benefit changes or the 2016-17 Summary of Benefits and Rates.

    Changes to Premera's Heritage Prime Network affects WEA Select Health Plans

    On November 1, 2016, the WEA Select EasyChoice B plan will change from the Premera Heritage network to the Heritage Prime Network. Heritage Prime includes major medical facilities and providers across Washington that work closely with Premera to manage healthcare costs and quality.

    To help ensure Heritage Prime continues to offer the best combination of choice and value, there will be a change starting in the New Year. This will affect WEA Select EasyChoice B and Basic Plans.

    Some doctors, hospitals and clinics in the Swedish, Providence, and CHI Franciscan Health systems will no longer be in-network for Heritage Prime as of January 1, 2017. WEA enrollees who choose to get medical care from these groups could have no coverage or have higher out-of-pocket costs. Several exceptions have been made in specific areas to address potential access issues. See more about the Heritage Prime Network.

    New Specialist Copay

    All WEA Select Medical Plans, except the QHDHP, now require a separate copay for office visits with a specialist. This copay applies each time you see a specialist, as well as when you receive outpatient rehabilitation services. When medically appropriate and to lower your out-of-pocket cost, we encourage you to obtain care from a provider type listed below. These provider types are not considered specialists and are subject to the lower non-specialist copay:

    • Family practice physician
    • General practice physician
    • Pediatrician
    • Physician assistant
    • Internist
    • Gynecologist
    • Obstetrician
    • Naturopath
    • Advanced registered nurse practitioner (ARNP)
    • Chiropractor
    • Acupuncturist

    The specialist copay will apply to all other provider types, excluding mental health services.

    Pre-approval for Outpatient Rehab Services begins November 1

    Your WEA Select Medical Plan covers benefits for outpatient rehabilitation (rehab) services. Benefits for this type of care restore or improve lost bodily functions caused by illness or injury. Starting November 1, 2016, outpatient rehab services will be reviewed and pre-approved by eviCore healthcare.

    Outpatient rehab services that will be reviewed:

    • Physical therapy
    • Occupational therapy
    • Massage therapy

    Prior authorization will not be required for spinal manipulations, acupuncture, or speech therapy.

    See a list of other services that will not require prior authorization and further information about the review process and what you can expect.

    Read the FAQ for more information.

    Enhanced Community Health Benefit now includes massage

    Beginning November 1, 2016, you will have a unique benefit that covers wellness programs such as:

    • CPR
    • Parenting classes
    • Weight management
    • Back pain prevention

    Have you been using the outpatient rehabilitation benefit for stress reduction? Your Community Health benefit now includes massage therapy, which provides up to $250 per calendar year for wellness programs. The benefit is subject to your plan's deductible and coinsurance. No referrals or pre-approvals are required.

    To get reimbursed for Community Health Benefit services, you must submit a claim form and the provider's bill.

    The Community Health Benefit Flyer will provide more information.

    Enrollee discounts on massage therapy visits

    Your Enrollee Discount Program offers up to 10%-30% off for services, including massage therapy. Ask your massage therapist if he or she participates in the discount program, or to find a participating therapist, call Premera's Select Customer Service at 800-932-9221. You can also log in to your account on premera.com/wea and use the Find a Doctor tool.

    1. Enter “Massage Therapy” in the top search box
    2. Select a provider from the list
    3. Look for “Discount” in the location Amenities box at the bottom left of the provider's profile page. If you don't see a Location Amenities box or “Discount,” the therapist doesn't participate in the discount program.