PREMERA CUTS TIES WITH PROVIDENCE – WHAT THAT MEANS FOR YOU

Premera Blue Cross recently announced a major change coming in its in-network providers. Will you be affected? Read about the change and what you can do.

Change is brewing, and it comes in the form of Premera Blue Cross.

As of January 1, 2017, Premera Blue Cross will no longer support Providence Health & Services as in-network providers. As the Northwest’s largest insurance provider, Premera’s move is significant: thousands will inevitably be affected. Providence comprises significant healthcare across the Northwest, including Providence Health and Services, Swedish Health Services, Pacific Medical Centers and Kadlec Regional Medical Center. In fact, since Providence took over Swedish in 2012, Providence has grown into the Northwest’s third-largest medical provider.

So, what’s next? Right now, nothing. While Providence is indeed large, it is only the third-largest healthcare provider in the region. Some of the many award-winning options, Evergreen, UW Medicine, and Virginia Mason, offer a robust range of services at in-network prices. Plus, Virginia Mason is the official healthcare provider of the Seahawks – what more do you need?

You have a few months to soak it in. Come November, you’ll be able to compare and review the updated Premera Blue Cross network; you can also take the opportunity to review competing health insurance providers and their networks. Most importantly, you have the entire Open Enrollment period (November 1, 2016 through January 31, 2017) to weigh your options and decide the best health insurance for you, your family or business.

Will it still be a happy new year? Absolutely. You’ll greet 2017 prepared with either a new health insurance plan or a new plan for in-network providers.

Prescriptions are Not for Medication Only

Prescriptions are no longer limited to medication – in today’s ever-changing insurance world, you may need a prescription for a service, too.

It’s a journey I just experienced myself: One round of Capture the Flag and my daughter now needs a physical therapist. The answer? Despite being on a PPO medical plan, the insurance carrier wants a “plan of care” in place, plus a prescription written for that plan. Thus, we need a prescription – not a referral.

No longer a simple PT appointment to soothe an ankle, we first had to set up a routine doctor appointment. The doctor prescribed PT, and we sought a PT provider in-plan. Was it a challenge? Maybe at first.

The majority of prescriptions you’ll continue to receive will of course be medication – pills, shots, injections and more. However, treatment and extended care plans are now being routed in the prescription process. The requirement and term may have changed, but the medical support you’ll find is as solid as ever.