Getting the Most out of Your Benefits

Health and Wellness Support Beyond Medical Coverage

Premera Blue Cross offers special perks through the Member Discounts Program.

The program is separate from your medical benefits plan. These member discounts are just another way Premera supports the health of you and your family beyond providing medical coverage.

Popular discount categories include:
• Diet, nutrition, and supplements
• Eye care services and hardware
• Fitness clubs and gyms
• Health products and devices
• Hearing aids and screenings
• Newborn services and products

You and your covered dependents can take advantage of discounts that stretch your dollar and meet a variety of health needs—vitamins and supplements, electric toothbrushes, products to baby proof your home, weight loss programs, and more.

Go to premera.com/discounts for more details. Offers might not be available in all locations. Please check with the company offering the discount before making your purchase.

On the Mend with Outpatient Rehab

Premera’s Outpatient Rehabilitation Management program makes sure you get the best care—and the right kind of care—after an illness or injury.

Outpatient rehabilitation, or rehab, benefits are part of every Premera plan. They include therapy you get outside of a hospital admission:

  • Massage therapy
  • Physical therapy
  • Occupational therapy

Ensuring your best care
Premera reviews treatment plans for outpatient rehab that are developed by therapists to make sure you’re getting care that’s both effective and medically necessary. We want you to:

  • Get the right care for your condition
  • Avoid paying for services that don’t help you recover
  • Have benefits available when you need them

What to expect
When your doctor refers you for outpatient rehab:
1. Your therapist assesses your condition and treats you at your first visit. The first 6 visits you need to treat your condition must be medically necessary, but do not need review by eviCore – Premera’s medical review partner.

2. If additional visits are needed beyond the initial 6 to treat the same condition, your therapist tells eviCore about your condition, gets authorization for additional visits, and creates a treatment plan.

3. eviCore’s medical professionals review the plan using medical best practices and clinical
guidelines to determine the medical necessity, and best duration of care.

4. Once your treatment plan is approved, you can proceed with your next visit.

Most plans are reviewed within 24 hours.

Denied? Don’t despair.
If your treatment plan is denied:

  • Your therapist can revise and resubmit the plan
  • Your therapist can review the plan with an eviCore therapist or medical director
  • You may appeal the decision