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Answers to Your Questions

Please note: Please refer to your benefit booklet for more complete details. If you have not received a copy of your benefit booklet, please check with your employer.


Please note: Some groups may have a different contact phone number. Please confirm your contact number on the back of your ID card before calling. For more detailed information about your benefits, please refer to your Benefit Booklet or contact Premera customer service.

Customer Service

· 1-800-722-1471 toll free

· TTD for hearing-impaired: 1-800-842-5357


How do I obtain an ID card?

If you have not received an ID card by the 15th of the month of your coverage effective date, please check with your employer or call BSI at (425) 771-7359


How do I select my doctor? Can I choose any doctor or practitioner?

You can reduce your out-of-pocket expenses and paperwork by using Premera's contracted network of physicians, hospitals and other providers. Your benefits also include specialist care without referrals (in most cases) and emergency care worldwide.

Your benefits and out-of-pocket expenses often depend on which providers you choose. Your health plan offers you access to a network of doctors, hospitals and other health-care professionals.

Find your doctor - use the Find a Doctor section, where you can search for doctors and other providers by name, location, specialty and other criteria. Be sure to choose Heritage Plus/Plus 1 when selecting a network.

 You can save time and money by choosing to see a network provider when you need care.

  • You get the highest level of benefits and lowest out-of-pocket costs. You're responsible only for your coinsurance, copayment, deductible and any charges not covered by your health plan. If you decide to see a non-network provider instead of a network provider, your out-of-pocket expenses may be higher and, depending on your plan, services may not be covered.
  • Since in-network providers are familiar with your network, they can help you make informed decisions to get the health care you need while keeping your out-of-pocket expenses to a minimum.

Please check your Benefit Booklet for further details about using network and non-network providers . If you need care that you or your physician believes is not available in your plan's network, please call Customer Service at 1-800-722-1471.


Do I need a referral to see a specialist?

You have the freedom to see specialists without referrals (in most cases). Premera's provider networks include a wide variety of specialists. They bill Premera directly and accept its allowable charges as full payment, saving you time and money.

Please note: many services require your provider to obtain prior authorization.  Please visit Premera's website for more information


How do I file a claim for reimbursement?

When you receive care from network providers, they will process your claims directly with Premera, so you don't need to handle any paperwork. However, if you receive care from a non-network provider, you may have to pay the provider for the service and then file a claim with Premera for reimbursement.

To file a claim for reimbursement, simply follow these steps:

  1. Complete and sign Premera claim reimbursement form (medical/vision/dental) or the Prescription Drug claim reimbursement form.
  2. Attach an itemized bill from the provider for the covered service.
  3. Mail your claim to the address shown on the form.

 Please see your Benefit Booklet for more details on filing claims. Please contact your employer if you have not received your benefit packet.


If I have a health question, can I speak to a nurse or other health professional?

The 24-Hour NurseLine is a benefit of your Premera plan that is available to you at any time, free of charge.

The number to call is located on the back of your ID Card. Call any time day or night with questions regarding a symptom, illness or injury, or with general health and lifestyle questions. All calls are completely confidential.

Registered nurses will take your call and respond quickly with information about:

  • Fevers
  • Earaches
  • Pregnancy
  • Back pain
  • And much more!

Because the NurseLine is part of your benefits package, there is no charge for calling. The NurseLine is another part of Premera’s effort to provide all members with peace of mind.

Please note:

  • In case of emergency, please dial 911 immediately.
  • The 24-Hour NurseLine cannot answer questions about your plan benefits.
  • Call the Customer Service number listed on the back of your ID Card for benefits information. Some groups may have a different contact phone number. Please confirm your contact number on the back of your ID card before calling. For more detailed information about your benefits, please refer to your Benefit Booklet. If you have not receive your Benefit Booklet, please contact your employer.

               

What if I need care while I’m traveling?

Your HealthChoice Premera plan offers specific levels of health-care benefits wherever you live or travel, across the country and worldwide. Your BlueCard benefits are indicated by a suitcase symbol on your member ID card.

Please refer to your Benefit Booklet for details about your BlueCard program benefits. Of course, if you believe you have a medical emergency, call 911 or seek emergency care immediately, no matter where you are.


The BlueCard PPO Program

With this program you have access to a national and worldwide network of Blue Cross Blue Shield plan contracted health-care providers. As a member of Premera Blue Cross, you have access to the BlueCard Program no matter where you live or travel, across the country and worldwide. Here's how:

Find a nearby BlueCard provider:

  • Call the BlueCard Provider Locator number on the back of your member ID card.
  • You can also use the Premera Provider Directory available at www.premera.com. Make sure you choose the PPO network option if your card shows the PPO letters.

Visit the Blue Plan provider and show your member ID card. The provider will verify your Premera membership and coverage.

After you receive medical attention, the provider will submit the claim to the local Blue Cross or Blue Shield plan, and they'll route it to us. You're responsible only for the out-of-pocket expenses you would normally pay under the requirements of your plan, as if you were at home.

Please note: Some groups may have a different contact phone number. Please confirm your contact number on the back of your ID card before calling. For more detailed information about your benefits, please refer to your Benefit Booklet or contact Premera customer service.


Does my plan offer services to help me manage my health?


Collaborative Programs that Support the Patient-Doctor Relationship

Care Facilitation Healthy Connections programs are a series of programs that help members take a more active role in managing their overall health and enable us to assist physicians in providing the highest quality care. To facilitate patient-provider health care decisions, Premera acts as a resource to support those decisions with information and data.

Care Compass 360

Care Compass 360 covers everything from providing assistance with hospital discharge planning to coordinating care on complex medical cases. We strive to ensure that members get care in the most appropriate setting.

For more information, please visit: https://www.premera.com/stellent/groups/public/documents/xcpproject/mwa_care_facilitation.asp

View the Care Compass 360/Teledoc here



How do I get a prescription filled?

Choice in Filling in Your Prescriptions

Your health plan gives you access to Premera’s comprehensive, nationwide network of retail pharmacies and access to a convenient mail order pharmacy, Medco By Mail.

You can also order your Specialty drugs for the treatment of complex or rare conditions through Premera's Specialty Pharmacies, Walgreens or Accredo Health Group (a Medco company).

Retail Pharmacy

Premera’s nationwide retail pharmacy network offers you choice and convenience.

  • Select from more than 60,000 retail pharmacies in the Premera Custom Network administered by Medco. Use the Provider Directory to find participating retail pharmacies, or call the toll-free Pharmacy Locator line at 1-800-391-9701.

Mail Service Pharmacy

If you take long-term medication, using mail service through Express Scripts may save you money and provide the convenience of delivery through the mail.

  • Use the Express Scripts pharmacy service for new and refill prescriptions
  • Register with MyPharmacyPlus to access convenient and easy to use services

Specialty Pharmacy

If you take Specialty drugs,  Accredo Health Group (an Express Scripts specialty pharmacy) or Walgreens Specialty Pharmacy can provide additional services and clinical support. More information is available on Premera's website by clicking here.

Premera pharmacy forms are available here.

More pharmacy information is available here.

Premera Customer Service

· 1-800-722-1471 toll free

· TDD for hearing-impaired: 1-800-842-5357



As an AWB HealthChoice member, are special discounts available to me?

Your medical coverage through AWB HealthChoice gives you special discounts from leading health-related companies

The Extras! program offers you the chance to receive special savings on a variety of health-related products and services - all you need is your Premera ID card.


Discounts include:

These savings are available to most members of Premera Blue Cross. Please contact the participating companies directly to receive your discounts.

Fitness and Weight Management – 10% to 60% off

Eye Care Services and Hardware – Up to 45% off

Alternative Care Services – 10% to 30% off

Family Safety Products – 20% to 45% off

Health and Beauty Products – 15% off

Hearing Aids and Screenings – 25% to 58% off

 

Visit the Extras! program here to learn about available special offers, get a list of participating companies and their contact information, and enjoy the special savings that come from being a member of AWB HealthChoice.