Tammy Burns is an experienced health insurance advisor specializing in Medicare and senior health issues, including Medicare Advantage Plans and prescription drug plans, as well as ACA certified for health insurance and other ancillary, life and annuity products.
Quick Premera Medicare Advantage Plans review: Premera is a regional health insurance provider serving Washington and Alaska with in-network providers, modest out-of-pocket costs, and average customer service ratings.
Premera is a regional health insurance provider that administers Medicare Advantage Plans in 14 counties in Washington and Alaska. It’s the largest health plan in the Pacific Northwest and provides insurance coverage for more than two million people. This nonprofit independent licensee of the Blue Cross Blue Shield Association has operated in Washington since 1933 and in Alaska since 1952.
Premera offers a wide selection of Medicare Advantage Plans, all of which provide benefits beyond those included in Original Medicare. In some cases, plan premiums are $0, meaning that you only pay the standard Part B premium for your coverage. All plans have networks made up of thousands of doctors, specialists, therapists, and hospitals. Because these plans only cover care you get from in-network providers, they’re not a good fit for everyone. It’s a good idea to review each plan’s out-of-pocket costs, coverage options, and copays to determine whether it meets your health care needs.
Pros and Cons of Premera Medicare Advantage Plans
What we like about Premera Medicare Advantage Plans:
- Affordable monthly premiums
- No annual deductible
- Low-cost telehealth visits
The drawbacks of Premera Medicare Advantage Plans:
- Plans are only available in 14 Washington and Alaska counties
- All plans are HMOs, which may limit your health care provider choices
What do Premera Medicare Advantage Plans Cover?
Medicare Advantage Plans, including those offered by Premera, are a way for you to get Medicare benefits. Like Original Medicare, these plans include hospital and medical coverage. In many cases, they have additional benefits, such as discounts for fitness and wellness clubs, prescription drug coverage, and dental or vision insurance. Premera’s Medicare Advantage Plans are all HMOs, meaning they only cover the services you obtain from in-network providers. Because they’re relatively limited, they generally have affordable premiums.
Premera Medicare Advantage Plan Options
Premera has several Medicare Advantage Plans available, although options may vary depending on where you live. All plans are HMOs and include medical and prescription drug coverage and fitness benefits. Some selections include optional dental coverage. In-office copays are generally affordable and telehealth visits tend to be even cheaper. Regardless of the plan you choose, there’s no annual deductible, and emergency room visits have a $90 fee that’s waived if you’re admitted to the hospital within 24 hours. Monthly premiums range between $0 and $5. Annual maximum out-of-pocket costs are as low as $5,000 or as high as $6,700.
Here are the Premera Medicare Advantage Plan options:
|Plan Name||Monthly premium||Annual deductible||Office visits||Telehealth||Emergency room||Annual maximum out-of-pocket cost|
|Premera Blue Cross Medicare Advantage Peak + Rx (HMO)||$0||$0||$15 primary care/$50 specialist||$10 primary care/$45 specialist||$90||$6,700|
|Premera Blue Cross Medicare Advantage (HMO)||$0||$0||$15 primary care/$45 specialist||$10 primary care/$40 specialist||$90||$6,300|
|Premera Blue Cross Medicare Advantage Sound + Rx (HMO)||$40||$0||$10 primary care/$50 specialist||$5 primary care/$45 specialist||$90||$6,500|
|Premera Blue Cross Medicare Advantage Alpine (HMO)||$42||$0||$10 primary care/$50 specialist||$5 primary care/$45 specialist||$90||$6,500|
|Premera Blue Cross Medicare Advantage Classic (HMO)||$55||$0||$5 primary care/$30 specialist||$0 primary care/$25 specialist||$90||$5,000|
*Based on pricing in Olympia, Washington
Premera Medicare Advantage Plans Reviews and Ratings
Premera has moderate scores across available consumer websites. In general, members give average approval ratings for the plan’s care and services, although many find customer service experience to be lacking.
Premera has a rating of C- with the Better Business Bureau and has closed 22 complaints in the last three years.
The National Committee for Quality Insurance has ratings for two Premera plans. Both plans have overall ratings of 3. across NCQA’s three categories, and both plans rate 3.0 in consumer satisfaction and treatment. One plan rates 3 in prevention while the other is given a score of 3.5.
Learn More From Our Sources
- Premera | Medicare Advantage Plans Last accessed May 2021
- Premera | About Premera Last accessed May 2021
- Medicare | How Do Medicare Advantage Plans Work? Last accessed May 2021
- Better Business Bureau | Premera Blue Cross Last accessed May 2021
- NCQA | NCQA Health Insurance Plan Ratings 2019-2020 – Summary Report (Medicare) Last accessed May 2021