Medicare Advantage

2019 Premera Medicare Plans

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Premera Blue Cross is a health insurance company offering Medicare Advantage plans and Medigap supplement plans. Although Premera serves all of Alaska and most of Washington for health insurance, the Medicare coverage map is more restrictive. Premera Medicare Advantage plans are sold in only nine Washington counties: King, Pierce, Lewis, Skagit, Snohomish, Spokane, Stevens, Thurston and Whatcom. With the exception of Clark County, Medigap plans from Premera are available throughout Washington.

Premera is a member of the Blue Cross Blue Shield Association. The BCBS association of plans covers a significant portion of the Medicare Advantage market, dominating eight states in 2017 and within the top companies in 15 other states. In 2018, about 18,000 people had coverage through a Premera Medicare Advantage plan.

Over 2 million people throughout Alaska and Washington have healthcare coverage through one of Premera’s insurance products. In addition to Medicare Advantage and Medigap plans, the product lineup includes individual and group health plans and dental coverage.

Premera’s Medicare Advantage plans are designed with an HMO structure. Some include prescription drug coverage and vision care. Dental care is included in some plans, and Premera also sells separate dental riders. CMS gave Premera’s 2018 Medicare Advantage plans a star rating of 4.0. This is considered an above-average score. The company also sells Medigap plans A, F, high-deductible F, G and N, though availability varies by location.

A.M. Best gave Premera an “A-“ for its Financial Strength Rating in 2017 and an “a-” for its Long-Term Issuer Credit Rating. In late 2018, Premera closed a deal to acquire Soundpath Health, effective January 2019. As a result, Premera’s 2019 Medicare Advantage subscriber base will increase to about 37,000 people, securing the insurer as the largest local Medicare Advantage provider in Washington.

Premera Medicare Advantage in 2019

Premera Medicare Advantage offerings vary based on the county where you live, and pricing will vary based on age and gender. We’ve used information for a 65-year-old woman living in King County, Washington to give you an idea of the plan options and rates. Our example resident can choose from seven Medicare Advantage plans. Below, we’ve outlined three of those plans. Make sure you get a personalized quote for accurate pricing based on your info.

Premera Medicare Advantage (2019)
Medicare Advantage Peak + Rx HMO Medicare Advantage Sound + Rx HMO Medicare Advantage Charter + Rx HMO
Monthly premium $0 $40 $146
Copay (primary) $15 $10 $10
Deductibles $0 for medical $160 for drug (tiers 3-5) $0 for medical $160 for drug (tiers 3-5) $0 for medical $160 for drug (tiers 3-5)
Network In-network coverage only In-network coverage only In-network coverage only
Rx coverage? Yes Yes Yes
Rx cost $3 copay for tier 1 $2 copay for tier 1 $2 copay for tier 1
Special features Hearing aids, $120 for eyewear every two years; gym membership Hearing aids, routine dental, $120 for eyewear every two years; gym membership Hearing aids, routine dental, $120 for eyewear every two years; gym membership
Out-of-pocket max $6,700 $6,500 $4,900
CMS Star Rating 3.5 3.5 3.5

Premera Medigap in 2019

Premera also offers Medigap coverage in 2019. Medigap, also known as Medicare supplement insurance, covers gaps in original Medicare. If you have original Medicare and want or need to keep it instead of choosing Medicare Advantage, then you may want supplemental coverage to help with out-of-pocket costs.

All 10 Medigap plans (labeled A through N) are standardized by letter type at the federal level. Only Wisconsin, Minnesota and Massachusetts standardize their plans differently. Otherwise, Medigap plans will cover the same benefits (by letter) no matter where you buy one or which company you buy it from. For instance, Medigap Plan N in Maine will cover the same benefits as Medigap Plan N in Washington, whether you buy it from Aetna, Premera or another company. The difference comes in cost and company reputation.

To give you an idea of the costs of these plans, we’ve used our same example person living in King County, Washington. Keep in mind that your costs could vary depending on where you live, your age and gender, and when you sign up for Medigap insurance.

Premera Medigap Plan A

All Medigap policies cover the same four basic benefits, but Plan A only covers these basics whereas the other plans (B through N) cover additional benefits. Companies that sell Medigap policies are required to offer Plan A if they sell any other plan, which is why you’ll find Plan A from every Medigap insurer. Some companies price these higher than more comprehensive options. Even if you don’t need the added benefits that come with other plan types, note the cost difference. You might pay more for less coverage if you choose Plan A, though that’s not a guarantee. In King County, our 65-year-old resident would pay about $177 a month for this plan from Premera, which covers:

  • Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
  • Part A hospice care coinsurance or copayment
  • Part B coinsurance or copayment
  • The first three pints of blood

Premera Medigap Plan F

For less than $50 extra per month over Plan A, our 65-year-old in King County could buy Medigap Plan F from Premera. Medigap Plan F covers all of the Medicare supplement benefits available, including Part B excess charges and the Part B deductible, making this plan a good value since it leaves you with virtually no out-of-pocket costs for your covered care (aside from the monthly premium for the plan).

There’s also a high-deductible version of Plan F. This version covers the same features but requires you to meet a deductible before the company pays any benefits. That deductible, set at the federal level, is $2,300 for 2019. Our King County resident would pay $221 a month for the regular version of Plan F from Premera but just $94 a month for the high-deductible option. With this plan, you’ll have coverage for:

  • Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
  • Part A hospice care coinsurance or copayment
  • Part A deductible
  • Skilled nursing facility coinsurance
  • Part B deductible
  • Part B coinsurance or copayment
  • Part B excess charges
  • The first three pints of blood
  • 80% of foreign travel medical expenses (up to the plan limit)

Starting January 1, 2020, Medigap plans that cover the Medicare Part B deductible (Plans C and F) will be eliminated. If you buy Medigap Plan F before then, you’re allowed to keep it for as long as you like and as long as the company continues to support it. But no new policies will be sold after this date for Plans C and F. Premera doesn’t sell Plan C.

Premera Medigap Plan G

There’s a less expensive alternative to Plan F that covers just one fewer benefit. Medigap Plan G covers everything that Plan F does except for the Medicare Part B deducible. That deductible will be $185 for the year in 2019. Our 65-year-old living in King County would pay about $190 a month for Medigap Plan G from Premera, saving $31 a month over Plan F. The difference in price more than makes up for having to cover that Part B deductible out of pocket. Plus, this Medigap policy isn’t going away in 2020. With Plan G, you’ll find coverage for:

  • Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
  • Part A hospice care coinsurance or copayment
  • Part A deductible
  • Skilled nursing facility coinsurance
  • Part B coinsurance or copayment
  • Part B excess charges
  • The first three pints of blood
  • 80% of foreign travel medical expenses (up to the plan limit)

Premera Medigap Plan N

Several Medigap policies look the same at first glance. That’s the case with Medigap Plan N, which looks a lot like Plan G. But there are two important distinctions between these plans. One is that Plan N doesn’t cover Part B excess charges. Only Plans F and G cover these costs, which are assessed if you see a provider who doesn’t accept Medicare assignment (the Medicare-approved amount for services) and that provider charges you a higher fee than what Medicare allows. Without coverage for Part B excess charges, you’ll pay these costs on your own on top of the standard Medicare coinsurance rate. Note, though, that most people don’t have to worry about Part B excess charges. If you do, you’ll want a plan that covers them.

Plan N also requires you to pay copays for certain services under Part B. These include office visits to your doctor (up to $20 per visit) and emergency room care (up to $50 per visit if you don’t get admitted to the hospital as an inpatient). Plan G does not require any cost sharing. A 65-year-old woman living in King County, Washington, would save $15 a month by picking Plan N from Premera. It costs $175 a month and covers:

  • Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
  • Part A hospice care coinsurance or copayment
  • Part A deductible
  • Skilled nursing facility coinsurance
  • Part B coinsurance or copayment
  • The first three pints of blood
  • 80% of foreign travel medical expenses (up to the plan limit)

It’s easy to get lost in the alphabet soup of Medicare supplement plans. Medicare Advantage isn’t always black and white, either. If you’re wondering which plan makes sense for you, talk to us. We can get you the info you need to make a better choice about your Medicare coverage. For best results, get a personalized quote based on your needs to find out which plan is right for you.

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1-800-810-1437TTY 711
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