Knee or hip total joint replacement is a big decision that requires working closely with your regular health care provider. If the right move is surgery, we want you to have the information you need to make an empowered decision on where you go
for care.
A guide to your benefit through Premera Blue Cross
Premera is focused on helping each patient have a great treatment experience. We offer concierge service with specially trained, experienced representatives to help guide you through your care.
You may receive treatment at low to no cost to you if you:
- Are a member of these plans: UMP Classic, UMP Select, UMP Consumer-Directed Health Plan (CDHP), UMP Achieve 1, UMP Achieve 2, UMP High Deductible
- Decide on single knee or single hip total joint replacement surgery with specially chosen doctors at Virginia Mason (Seattle)
Note: For UMP CDHP and UMP High Deductible members, the surgery and related services are covered in full after you meet your annual deductible.
We recognize you have many options for knee or hip replacement. You may still receive joint replacement through other providers under your UMP plan. However, the COE Program offers you 100% coverage (minus the deductible for UMP CDHP and UMP High Deductible
members) for your joint replacement. If you qualify, the COE Program will also assist with travel and lodging expenses for you and a care companion*.
Qualifying for care
To help ensure that surgery is needed, and to encourage the smoothest recovery, knee or hip replacement surgery is recommended only for members who:
- Are 18 or older
- Have been diagnosed with osteoarthritis or another disabling condition that requires a single knee or single hip total joint replacement
Note: The COE Program is not available to UMP Plus members or UMP Classic members with Medicare as their primary health coverage.
To help ensure your safety and the best surgical results, the COE Program has pre-surgery requirements. These include:
- Having a body mass index (BMI) of less than 40
- Avoiding smoking for 4 weeks prior to surgery
- Maintaining a hemoglobin A1c level of less than 8% in patients who have diabetes
Read more about our surgery preparation and recovery guidelines.
COE Program highlights
| What’s covered |
What’s NOT covered
(but may be covered under your UMP benefits) |
| Pre-operative services (office visit, laboratory work, x-ray) |
Yes |
Care
received under your Virginia Mason prescribed plan for care that's necessary to become a surgical candidate under the COE Program
|
No |
| Hospitalization and surgery, including anesthesia |
Yes |
Physical therapy that's not provided during your hospitalization
|
No |
Post-surgical assessments
|
Yes |
Medications prescribed after discharge from the hospital |
No |
| Post-surgery physical therapy visit (in hospital) |
Yes |
Follow-up care other than the initial post-operative checkup at Virginia Mason |
No |
| Travel coverage |
Yes |
|
|
Centers of Excellence for Total Joint Replacement
| |
Virginia Mason Medical Center |
| Location |
1100 Ninth Avenue
Seattle WA |
| Hospital size (licensed beds) |
336 |
| Distance from Sea-Tac Airport |
15 miles |
| Lodging |
Inn at Virginia Mason
1006 Spring St.
Seattle WA
The Baroness Hotel
1005 Spring St.
Seattle WA |
| Lodging distance from hospital |
Located adjacent to hospital |
| Parking at hospital |
Yes, in parking garage |
| Other |
Virginia Mason is located in Seattle’s First Hill neighborhood, a residential neighborhood and a short walk from downtown Seattle shopping. |
Questions?
Find anwers to our most frequently asked questions about this program.
Concierge
Call our concierge desk at 855-784-4563 (TRS: 711).
You can find out more about your knee and hip replacement benefits through your UMP coverage.
Travel benefits
You and your care companion* have a range of travel benefits to support your COE experience, including flights and hotel at no cost if you live more than 60 driving miles from teh COE location
Check your travel benefits
For Medicare members: Members with Medicare as their primary health coverage are not eligible for the COE program.
*A care companion is a family member or friend who will care for you before and after your surgery. The concierge team will explain what is required for a person to be designated as care companion.