Premera 2018

Premera on the Exchange

EPO = Narrow Networks
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As always, insurance information is provided for informational purposes only.  Final determination of claims and coverage is handled solely by your insurance payor.  Please verify all information directly with your insurance provider.

In 2018, Premera continues to use their "Exclusive Provider Organization" (EPO) plans.  And by "exclusive", they mean they exclude as many Doctors and facilities as they can in each network.  You need to take great care and carefully research whether the hospitals near you and your family are in these relatively narrow networks.

Fortunately, these EPO plans do provide benefits for patients at Specialty Natural Medicine, however with restrictions.

In particular, you will need a referral from your PCP in order to see Dr Janel or Dr Lang.  These programs also do not allow you to set Dr Janel or Dr Lang as your PCP.  Per the information from our phone discussions with Premera, your PCP can write a referral for a single visit or for coverage for the year.

 

This link provides some details on the Partner Networks in the EPO plans:

https://www.premera.com/wa/visitor/shop-for-plans/individual-and-family-plans/health-plans/plans-by-county/

 

Premera for Small Groups or via Employers

Wider Coverage and Networks

Premera offers some wonderful plans through private employers.  If you receive insurance through your employer, you should be able to see one of our physicians including as your PCP.

In addition, starting in 2018 Premera is offering small group coverage to companies with as few as a single employee.  Please note that significant restrictions apply including no coverage for sole proprietorship's.

Dr Janel and Dr Lang are in network in the following networks, including the Heritage networks (the widest Premera networks).

Premera Networks, effective January 1, 2018:

 

  • Global
  • Heritage
  • LifeWise Preferred
  • LifeWise Assurance Co.
  • Foundation
  • Heritage Prime
  • Heritage Signature
  • LifeWise Connect

 

If you are a small business owner interested in a small group plan, you may wish to contact ProPoint Services in order to get assistance with starting your health coverage plan.