Primary Care Provider (PCP)

Staying healthy and getting care is more important than ever and to get the most from your Premera health plan is to see an in-network primary care provider (PCP). If you don't have a PCP on file, we've selected an in-network PCP for you in your area. Now, next time you need care, you know where to go. However, regardless of your assignment, you have the freedom to change your in-network primary care provider for care at any time.

FREQUENTLY ASKED QUESTIONS

Below are answers to some common questions.

Why was I assigned a primary care provider (PCP)?

We want you to get the most out of your benefits. If your plan has a PCP copay, you'll pay less when you see your designated PCP. Even if your plan does not offer a PCP copay, having an assigned PCP can help you get care quickly when needed since you'll know where to go.

What are the benefits of having a PCP?

It saves you money. On most plans, you'll get a lower copay when you see your designated PCP (HSA plans subject to deductible and coinsurance).
It saves you time. When you have a PCP or primary care clinic as your medical "home base," you know exactly who to call—no searching online frantically for an available clinic or urgent care center.
They're very good at what they do. PCPs are experts in a broad range of health care services especially when it comes to preventive care, chronic diseases, and overall wellness. Providers can provide one-stop preventive care through proactive health screenings and lifestyle plans so you can enjoy your best life.
You'll have a trusted health partner to guide you. A PCP is by your side throughout your healthcare journey. This close relationship allows your PCP to search for trends in your health history and identify health risks early on before they become more serious.
Fewer hospital and ER visits. Studies show that people who see a PCP regularly are less likely to be hospitalized for serious health issues and have fewer trips to the ER during their lifetime.

Why was my PCP reassigned?

If you've been reassigned to a new PCP, it means your previous provider is no longer in network or no longer practicing medicine. We do our best to incorporate historical data in our assignment and may not always accurately capture a previous PCP you've seen before.

How do I view or change my PCP?

Sign in to your account at premera.com/sign-in. Go to the My Account menu, then Primary Care Provider, to see your designated PCP. If you would like to change your PCP, please call customer service 807-607-0546.

How can I schedule an appointment with my new PCP?

Once you have identified your assigned PCP, get started by calling your PCP's office. Let them know if you are a new or returning patient, and they will work with you to schedule an appointment based on your availability.

I called my PCP assigned, and they are not accepting new patients — what do I do next?

We know PCP availability can change, and if your assigned PCP is not accepting new patients, you can search for PCPs accepting new patients in our secure portal. Sign in to your account at premera.com/sign-in, go to the Benefits menu, and select Find a Doctor > Find a doctor.

Do I need a referral from my PCP to see a specialist?

You can see any in-network specialist; no referral needed.

Do I need to see the specific PCP listed above to get the PCP copay, or can I see any PCP at that clinic?

If your plan has a PCP copay, you can see any PCP at the clinic listed and receive the PCP copay.

Why was I assigned a PCP at this point in the year?

We wanted to allow time for customers to select their PCPs. Staying healthy and getting care is more important than ever, so we've assigned PCPs to those who have not yet selected a PCP.

Can I see my new PCP virtually?

It depends on the provider. Some PCPs offer virtual visits via phone or video—you can ask when you call to make an appointment.

Have more questions or need assistance?

Call customer service at 807-607-0546 (TTY:711), Monday through Friday, 8 a.m. to 6 p.m. Pacific Time.

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