Tips for Using the Health Connect Plan
Here are some useful tips to help you get the most from the Health Connect Plan when your new plan year starts.
- Create an online account.
Access your Premera account to find in-network doctors, view your benefits and costs, get a personalized spending report, and access helpful tools for managing your health. Create your account if you don't already have one. You’ll need your Premera ID card handy to enter your member ID number. You’ll get your ID card in the mail about a month after you enroll.
- Partner with a doctor who is right for you.
As a member of the Health Connect Plan, you must select a primary care provider (PCP) for you and each member of your
family. If you don’t, one will be assigned for you; however, you can change your PCP at any time.
Your PCP should be your first point of contact for most of your health care needs. The PCP will help coordinate your care if you
need to see specialists and make sure all your providers are working together to help you stay or get healthy.
- Take advantage of free preventive care.
Get it on the calendar early in the year: make an appointment with your PCP for your annual preventive checkup. Regular preventive care is an important part of staying healthy. During your visit, your PCP can help you make a plan to reach your personal health and wellness goals, and conduct screenings to identify and avoid potentially serious health problems.
- Get an eye exam.
Vision benefits are included in the Health Connect Plan. One routine eye exam per calendar year is included in your plan and you can see vision-care providers in the Health Connect network or in the Extended
network; the coverage is the same. Members ages 19 and up receive $350 of vision hardware per calendar year, and children under age 19 receive one pair of glasses or a one-year supply of contacts.
- Get to know the network.
The Health Connect network is built around a select group of Eastside providers. Through this comprehensive network, you’ll receive most of your care, including PCP and specialist visits, as well
as any diagnostic services or therapies.
When you see a PCP or specialist in the Health Connect network, you pay only a copay for office visits. There is no deductible to satisfy and often no provider bills to manage. You may
pay coinsurance for diagnostic tests, such as lab tests or X-rays your provider orders.
In instances when a particular service is not available in the Health Connect network, you can receive care from an Extended network provider at the higher
benefit level. If that happens, your PCP will work with you to coordinate that care in the Extended network.
Some services you receive from a provider in the Extended network can be covered at the Health Connect network level of benefits if you get a waiver from your Health Connect Plan provider. There are also certain services you can receive at the Health Connect Plan benefit level without a waiver, whether you see a Health Connect or Extended network provider.
- Avoid using out-of-network providers because you’ll pay more out of pocket.
If you use out-of-network providers, you pay the annual deductible and then 50% of the allowable charges for most out-of-network services. Out-of-network
providers may not accept the allowable charge as payment in full. You are responsible for paying the difference between the allowable charge and the amount your out-of-network provider charges. Waivers will not apply. The only exception is in the case of an emergency—for a medical emergency, you should always go to the nearest facility and it will be covered at the Health Connect network level.
- Find a pharmacy.
You can fill prescriptions at any retail pharmacy within the Health Connect and Extended network, including the on-campus Living Well Health Center Pharmacy in Building 21. If you take medications on an ongoing basis, you may also take advantage of a mail-order option that delivers medications to you at home, saving you both time and money.
- Locate the closest urgent care facility.
For times when you need immediate care that’s not an emergency, an urgent care clinic is a great option. They offer walk-in and same-day appointments, including care on weekends,
evenings, and holidays. Find an in-network location that’s convenient for you before you need it.
- Download the Premera mobile app.
Use the app when you’re on the go for things like accessing your Premera ID card, finding nearby in-network providers, and viewing detailed claims information. Conveniently access virtual
care providers for primary care and mental health care on the Premera mobile app. Download the app now if you haven’t already. You can download it from the App Store or Google Play.
- Call for personalized help.
Your plan has a dedicated service center called the Health Connect Navigator, which can provide personalized assistance with many of your needs such as:
- Choosing a PCP or specialist
- Confirming plan benefits
- Connecting to the 24-Hour Nurse Line
- Getting answers to administrative questions, including bills
- Locating a clinic, urgent care center, or hospital
- Providing care management
- Help scheduling appointments
Call the Health Connect Navigators at 800-676-1411 (TTY: 711), 7 a.m.—7 p.m. Pacific time, Monday through Friday.
- Get advice over the phone from a nurse.
Sometimes talking to a health care professional on the phone about a concern can help you know what to do next. The 24-Hour Nurse Line is available all year long. To get connected
to a nurse, call the Health Connect Navigators at 800-676-1411 (TTY: 711).