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Overview of the Four Available Individual Plans in King, Pierce & Snohomish

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Premera Blue Cross:    Benefit Summary      Provider Lookup      Partner Systems Available in Your County

Premera’s Personal Care Plans are managed care plans for members residing in King, Pierce and Snohomish counties and are the only Premera plans available in these counties.  These plans require you to select a partner system through which your primary care provider is contracted.  Your spouse and family can select different Partner Systems if they choose at the same cost and benefit.  Outside of Washington State you are covered for medical emergencies only.  Of the available individual plans, Premera offers the broadest access to providers but there is no access to Swedish, CHI Franciscan or Providence.   Most other hospitals are available within one of the six network options:  Evergreen Health, MultiCare, NW Physicians, Everett Clinic, UW Medicine & Virginia Mason (details on provider lookup).  Network options vary depending on county of residence and can be changed at any time.  Generally, all care is only received inside the chosen system.

 

Kaiser Permanente:  Benefit Summary    Provider Lookup      Online Enrollment

The Kaiser Permanente plans are HMO (Health Maintenance Organization) health Plans.  Kaiser acquired Group Health Coop in 2017.  Typically, the Kaiser plans are the least expensive option.  You must select a primary care provider and then receive a referral to see a specialist.  Most care is received at the Kaiser owned facilities (formerly GHC), however, there are circumstances where Kaiser providers perform services at outside hospitals.  Only Kaiser has the low-cost HSA compatible plans.  Only Kaiser allows you to enroll directly with them outside of the exchange.  If you are not subsidy eligible and would like an HSA plan or other Kaiser plan, Enroll Here.

Ambetter by Coordinated Care:  Benefit Summary    Provider Lookup

The Ambetter health plans are HMO (Health Maintenance Organization) health Plans.  You must select a primary care provider and then receive a referral to see a specialist.  Your PCP, also known as a personal doctor, is the main doctor you will see for most of your medical care. This includes your checkups, sick visits and other basic health needs.  Ambetter is the only plan in Snohomish county that does offer access to Swedish & Providence.

Molina Market Place:  Benefit Summary    Provider Lookup                NOT AVAILABLE TO SNOHOMISH COUNTY RESIDENTS

Like Kaiser and Ambetter, The Molina plans are HMO (Health Maintenance Organization) health Plans.  Molina offers just two plans, a Gold and a Silver, no Bronze plans.  You must select a primary care provider and then receive a referral to see a specialist.  Your PCP, also known as a personal doctor, is the main doctor you will see for most of your medical care. This includes your checkups, sick visits and other basic health needs.  Molina offers access to Swedish & Providence but is not available in Snohomish county.