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Care


Receive care from a broad network of providers you know and trust.

Our Medical Network

With thousands of local doctors in our Medicare Advantage network, you'll be sure to find a doctor who's right for you. Our plan service area includes these Washington state counties.

Western Washington
Whatcom, Skagit, Snohomish, King, Pierce, Thurston, Lewis, Island, San Juan, Kitsap and Cowlitz

Eastern Washington
Spokane, Stevens and Walla Walla

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Primary Care

Your primary care provider (PCP) is the main point of contact for your healthcare needs. Your PCP tracks your overall health, including:

  • Coordinating care
  • Monitoring your medications
  • Referring you to the right specialist

Referrals

Your PCP must give you approval in advance for: specialists, hospitals, skilled nursing facilities, and home health care agencies. This enables your PCP to coordinate your care and ensure you're getting the right care at the right time.

Prior authorizations

In some cases, your PCP will also need to request prior authorization (prior approval) for inpatient or outpatient procedures, which is common practice for most carriers. You can find a list of services that require prior authorization in your EOC.

Introducing Kinwell primary care  
Kinwell clinics are opening across Washington state and are exclusive to Premera members. The Kinwell experience includes:

  • Same- and next-day appointments available virtually or at one of our many clinics across Washington state
  • High-quality and patient-centered health care
  • Integrated preventive services and behavioral health care

Find out more at kinwellhealth.com. If you’re interested in switching to a Kinwell primary care provider, call customer service at 888-850-8526.

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Looking for a Primary Care Provider?


If you do not have a PCP or would like to change your PCP, call customer service and they can update it for you.

October 1 through March 31: 8 a.m. to 8 p.m., 7 days a week

April 1 through September 30: 8 a.m. to 8 p.m., Monday through Friday

Wellness Visits

Checkups are important. Getting an annual checkup or going in for a preventive visit is useful for everyone. Routine exams can help spot health issues before they begin. They can also identify problems early, before they become serious and difficult to treat. That's why Premera offers an annual physical exam and annual wellness visit at no cost, as part of your plan benefits.

An annual wellness visit is available at no additional cost and includes:

  • Review of your medical history, current medications, and treatment plans
  • Discussion of age-related concerns, such as memory loss, balance, and fall protection
  • Discussion about vaccinations and boosters
  • Lifesaving screenings for high blood pressure, colon cancer, and other cancers

In addition to your annual wellness visit, an annual physical exam is also available at no additional cost and includes a more comprehensive hands-on age and gender-appropriate examination than an annual wellness visit. It may also include lab work as needed (you may pay for part of the cost of some lab tests).

To make the most of these visits, download our preventive services checklist, medicine and supplement tracker, family history tracker, and be prepared with visit topics and questions


Preventive Services

Many preventive services are covered at no cost. Examples include:
  • You pay a $0 copay for each Medicare-covered preventive glaucoma and diabetic retinopathy screening once per year
  • Falls risk assessment
  • Bone density screening
  • Cancer screenings for breast, colon, prostate, and other cancers
  • Vaccinations for Hepatitis B, flu, COVID, and pneumonia
Talk to your PCP about any additional services they recommend. Review your Evidence of Coverage to see a full list of covered preventive services.
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