Is a Premera Blue Cross Medicare Advantage Plan a good fit for you?
|Premera Blue Cross Medicare Advantage Plans come with no medical deductible and zero or modest premiums. However, out-of-pocket costs can stack up in some situations.|
|Medicare rating: 3.5 to 4 stars||A.M. Best financial strength rating: A||BBB rating: C-||NCQA rating: 3 stars||Consumer Affairs rating: Not rated||J.D. Power ranking: Not ranked in the top ten|
Premera Blue Cross is the largest health plan in the Pacific Northwest. This independent licensee of the Blue Cross Blue Shield Association offers Medicare Advantage Plans to 14 Washington counties. It features several options to accommodate a variety of customer preferences, but the selection is limited. It’s helpful to understand and compare the benefits and costs of these Premera plans so you can determine which best suits your needs before you enroll.
Premera Medicare Advantage Plans are comparable in their scope of coverage to other Medicare Advantage Plans, offering all the benefits of Original Medicare, along with coverage for additional health services. Medicare Advantage Plans, also called Medicare Part C, often include prescription drugs, vision, and dental coverage, and wellness programs. Your out-of-pocket costs depend on the plan you choose, as do rules for how you get services, such as whether you have to choose a primary care doctor or get a referral to see a specialist.
Your hospital and medical insurance are covered and you’ll get prescription drug coverage with most plans. Additional benefits from Premera Blue Cross Blue Shield Medicare Advantage Plans may include:
Premera has seven major Medicare Advantage Plans. Each plan is an HMO with no or a low premium and out-of-pocket costs. These plans require that you choose a primary care physician and other health providers in the plan’s network. You’ll likely need a referral from your primary care physician to see a specialist.
Premera’s Medicare Advantage Plans come with no annual medical deductible. In-person office visits range from $5 to $15 with a primary care physician and up to $50 with a specialist. Telehealth visits can be as low as $5 with a primary care physician and up to $45 with a specialist. Some plans have a $0 premium, while others can cost up to $191 per month. Annual maximum out-of-pocket costs range from $4,900 to $6,700.
Compare the 2022 Premera Blue Cross Medicare Advantage Plan options below:
|Plan name||Monthly premium||Annual medical deductible||Office visits||Annual maximum out-of-pocket cost|
|Premera Blue Cross Medicare Advantage Peak + Rx (HMO)||$0||$0
|$5 primary/$40 specialist||$6,700|
|Premera Blue Cross Medicare Advantage (HMO)||$0||$0
|$5 primary/$40 specialist||$6,700|
|Premera Blue Cross Medicare Advantage Sound + Rx (HMO)||$35||None||$0 primary/$45 specialist||$6,500|
|Premera Blue Cross Medicare Advantage Alpine (HMO)||$24
(does not include drug coverage)
|None||$0 primary/$45 specialist||$6,500|
|Premera Blue Cross Medicare Advantage Classic (HMO)||$55||None||$0 primary/$30 specialist||$5,000|
|Premera Blue Cross Medicare Advantage Charter + Rx (HMO)||$110||$0
|$10 primary/$35 specialist||$4,900|
|Premera Blue Cross Medicare Advantage Classic Plus (HMO)||$170||$0
|$10 primary/$40 specialist||$5,000|
*Based on pricing in Seattle, WA in 2022
|What we like about Premera Medicare Advantage Plans||The drawbacks of Premera Medicare Advantage Plans|
Premera Medicare Advantage Plans have a good reputation for medical care and customer satisfaction. While you’re limited to medical care from the Kaiser Permanente network, except in an emergency, you benefit from lower costs and no annual deductibles.
Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how Medicare, A.M. Best, the Better Business Bureau and more rate Premera’s Medicare Advantage Plans.
|Medicare rating: 3.5 to 4 stars||For 2022, Premera’s Medicare Advantage plans have an overall average rating range of 3.4 to 4 stars from the Centers for Medicare & Medicaid Services. Find each plan’s star rating on Medicare.gov.|
|A.M. Best financial strength rating: A||A.M. Best sets credit ratings for insurers. In April 2019, A.M. Best affirmed it’s A Financial Strength Rating (FSR) for Premera Blue Cross Blue Shield Medicare Advantage. An A rating indicates Premera has an excellent ability to meet financial obligations.|
|BBB rating: C-||Premera earned a C- rating with the Better Business Bureau. The BBB has closed 32 complaints against the company in the last three years. Most of the grievances involved billing issues.|
|NCQA rating: 3 stars||The National Committee for Quality Assurance rated two Premera plans. Each has an overall rating of 3 out of 5. Both plans rate 3 in treatment and customer satisfaction. One plan rates at 3.5 and the other rates at 3 in prevention. The NCQA has not accredited any of Premera’s plans.|
|Consumer Affairs rating: Not rated||Premera Blue Cross Blue Shield Medicare Advantage Plans are not rated or reviewed through Consumer Affairs.|
|J.D. Power ranking: Not ranked in the top ten||In its 2021 Medicare Advantage Study, J.D. Power measured Medicare Advantage Plan satisfaction based on coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. Premera’s plans did not appear on the list of the top 10 Medicare Advantage providers.|
LeRon Moore has guided Medicare beneficiaries and their families as a Medicare professional since 2007. First as a Medicare provider enrollment specialist and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.
Moore holds a bachelor’s degree from Southern New Hampshire University and is A+ Certified with a Medical Records Clerk Certification and Medical Terminology Certification from Midlands Technical College.
He’s passionate about educating, informing, and resolving issues concerning Medicare and Medicare Advantage Plans, and considers it imperative that he does all he can to educate and inform the senior community as much as possible about Medicare.