We Are Expanding Our In-Network Providers

  • General News
    Published April 28, 2020

    Starting April 21, 2020, Premera Blue Cross is expanding telehealth access options for mental health and substance use disorder. Three in-network provider options have been added to help support your customers during the COVID-19 pandemic.

    What's new:

    Doctor On Demand – Video-based mental health therapy

    Boulder Care – Video-based treatment for opioid use disorder

    Workit Health – Video-based treatment for alcohol use disorder

    In addition to new providers, Premera added new covered services for care delivered virtually. Telehealth is now covered for:

    • Applied behavioral analysis (ABA)
    • Partial hospitalization programs (PHPs) for mental health and substance use disorders
    • Intensive outpatient programs (IOPs) for mental health and substance use disorders

    This helpful telehealth grid outlines all your client's options.

    Customers may begin treatment with existing in-network providers or our new telehealth providers without a referral. Member cost shares are waived for all telehealth services. Access to these new providers and the waiving of member costs shares are available through June 30, 2020 with the potential to extend the duration based on business and epidemiological considerations.

    Who is eligible for this continued expansion?

    • All fully insured groups, self-funded groups who have opted into the telehealth expansion, individual, grandfathered, non-grandfathered, associations, and OptiFlex customers are eligible for this benefit.
    • Medicare Advantage, Medicare Supplement, FEP, Shared Administration, and Self-funded groups that opted out of the telehealth expansion aren't eligible for this network expansion.

    Other resources your clients can use

    • Many in-network providers, including local counselors, therapists, psychologists, psychiatrists, and facilities are offering care virtually during this time.
    • Customers can also receive care from Teladoc for participating groups.
    • If customers have already established care with an in-network provider or provider group, they may reach out to them to learn more about telehealth options for medical care and behavioral health care. To find an in-network provider, use the Find a Doctor tool on premera.com.
    • Some customers may also have access to behavioral health care through an employee assistance program (EAP).

    Important information to note:

    • Currently, you may experience increased wait times with these telehealth resources.
    • If a telehealth provider charges you a copay, deductible, or coinsurance for telehealth services through June 30, 2020, Premera or the telehealth provider will reimburse you when the claim is processed.
    • Telehealth providers can't diagnose COVID-19 or order any COVID-19 testing. They may be able to assist with a review of symptoms and recommendations on next steps.
    • Only providers seen in-person can diagnose the COVID-19 virus. Testing can also be performed at drive-through locations.

    For more information about this in-network expansion and how Premera is responding to COVID-19, contact your Premera representative.

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