Our range of metallic plans offers you plenty of options to find the right balance between your budget and your healthcare needs. And to learn more about our qualified high-deductible plans that can be paired with tax-advantaged health savings accounts (HSAs).
All plans have the same benefits. The amount you pay for your medical care will vary depending on the plan you choose.
Online tools—Access to our secure website that includes tools to help you assess, manage and improve your health. Our secure website offers a health assessment, treatment cost estimator, claims status, your plan benefits, symptom checker and several other useful tools.
Nationwide network coverage—Premera members also have access to the nationwide BlueCard® provider network if you need care outside the Northwest.
10 Essential Benefits
Healthcare reform says all health plans must include ten essential benefits. The basic benefits include:
- Outpatient Care - the kind you get without being admitted to a hospital
- Emergency Services - for issues that could lead to death or disable you if you do not treat them.
- Inpatient Care - covers room and board, tests, drugs, and care from doctors and nurses while admitted, which may include organ and tissue transplants, and hospice and respite care.
- Maternity and Newborn Care - care before and after your baby is born
- Mental Health and Substance Use Disorder Services - this includes behavioral health treatment, counseling, and psychotherapy.
- Prescription Drugs - covers retail, mail order, and specialty drugs.
- Rehabilitative and Habilitative Services - services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
- Laboratory Services - covers lab tests, X-ray services, and pathology, and imaging and diagnostics such as MRI, CT scan, and PET scan.
- Preventive and Wellness Services - including mammograms, colonoscopies, vaccines. Covered in full if you use in-network providers for care such as routine physicals, screening, and immunizations. Disease management coordinates care for diabetes, asthma, and other conditions.
- Pediatric Services - including dental care (preventive, basic, major) and vision care (eye exam, lenses, and eyewear).