PEBB Plan F pays 20% of the Medicare allowed amount for out patient behavioral health visits. **PEBB contains both State Employees and Higher Education employees. premera.com and select Secure Inbox. E���zV5�7=T�� d�����\R���r�cțhGY��I�Qu�>�6! Premera Blue Cross is an independent licensee of the Blue Cross Blue Shield Association serving businesses and residents of Alaska and Washington state, excluding Clark County. PEBB Health Care and Dependent Care FSAs offer a grace period. The certificate of coverage (COC) for the member's plan is the source of coverage provisions offered under the plans. Call: 800-722-1471 (TTY: 711) Monday through Friday 5 a.m. to 8 p.m. Pacific Time Email: Sign into your account at premera.com For PEBB Program Medicare plan summaries, see the medical benefits comparison tool. Scan and send this completed form and any required documents back to us as a secure email attachment. Search. allows the use of any Medicare contracted physician or hospital nationwide Questions about PEBB or SEBB retiree benefits? The charts on the premiums and the resolutions are below. However, the actual amount a plan subscriber pays can vary depending on if Tools ... here: the PEBB home page. <>
Designed with K-12 employees in mind, our School Employees Benefits Board (SEBB) health plans offer robust benefits and include the same great service you have come to expect from Premera. Due to COVID-19, HCA’s lobby is closed. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, Plan F no longer accepts new members as of January 1, 2020. Medicare Supplement Plan F is available in all Washington, Oregon, and Idaho counties, and nationwide. PEBB offers Premera Blue Cross Medicare Supplement Plan F. There is no prescription drug coverage with this plan so a Part D prescription drug plan is also needed unless you have other creditable drug coverage (e.g., VA) endobj
This change allows you to access all UMP benefits information in one place. Supplement Plan F and how it works with Medicare. The 2019 plan year’s grace period was from January 1, through March 15, 2020. Yes No Your Other Health Coverage Please answer all the questions below as best you know how. Contact PEBB; Login; Forgot your password? Wednesday, July 17th, the PEBB Board met and passed 8 resolutions regarding the 2014 Premiums and Medical Plan designs. ��xl���Pl}��'L�*�וo$��Y�y-��2��w�q��G1$��O�XH��@B�M�N�3'����������E�ܥh���C�
��n���0~yZ뾇Gm/X��ed. %����
>PEBB does not offer a Medicare Part D plan. Visit Premera's online provider directory. Looking for Premera Blue Cross Medicare Supplement Plan F? *Educational Service Districts are contained within the K-12 group. • PEBB Premera Medicare Supplement Plan F does not cover outpatient prescription drugs. Accountable Care Net. Note: The PEBB Program does not offer the high-deductible Plan F shown in the Outline of Medicare Supplement Coverage. These rates are for Washington state residents who are NOT a Public Employees Benefits Board (PEBB) member (PEBB members must enroll directly with the HCA). Plan pays Part B deductible and co-insurance for partial hospitalization. State residents should call the Blue Cross Premera number at 1888--208-6264 and ask for a paper application for Group ID: 1000041 , and for P2019196 (the HCA Plan G pre-sales enrollment kit). 190 day lifetime limit in a psychiatric hospital. • SHIBA is familiar with how the standardized Medicare Supplement (Medigap) plans work, so we can give PEBB retirees general informationabout the Premera Medicare Supplement Plan F and how it works with Medicare. Is there a quick way to see benefits and costs? 3 0 obj
Yes No Did you receive a copy of Medicare’s “Choosing A Medigap Policy” guide? >PEBB plans offer secondary coverage to Medicare Parts A & B and provide coverage for important services not covered by Medicare. should contact Premera now, before any claim arises. ... PEBB Continuation Coverage (COBRA Medicare) PEBB Continuation Coverage (COBRA non-Medicare) PEBB Continuation Coverage … Medicare Supplement Plan F does not include prescription drug coverage. PEBB Retiree PEBB Retiree & Spouse State Resident State Resident & Spouse Plan G $165.96 Plan G $326.36 Plan G $320.79 Plan G $641.58 Please Note: The subscription charge amount charged is the same for all plan subscribers with certificates like yours. Compare our easy-to-use plans and enroll online or attend a seminar near you. @�a�ȉj�_��S�Q)=��"O�NhȲ�09�x5,d.R
ֵ4 ����qB���^��%�_�����W�-yZ52�m�zX�Yp}����n!�-J�aE�-�4�����)�d��~��'g��\������GKv�x�h����*?74:Bkp�y��S�czm�Wnz?_�t�C���*���C+ՀJXj�!���q��C�$�lT�Λ�Cd���C�埩h�e�/�DD�3�K�)s�@0���V�U�^n6�]2��nB�f��f�����'}��gC�dkk=Ffi�o2�:�YݾW�-�}=(�u���~����z�R��JO0��0���U�A,�l�v �[��>�ѼGU$��B��1HX��^>d����ᇀ�֟ܯ4� {�_n�g_&�������LB≮ڼsDݘ��+,4fV���!�t����E��䩆�VyS��%�J��wL��r�Z�Y����UqK6��1�F�!�'�����c�zc���^+�=��#B�y�!Ip�e�ә��&.�#�I��Ϣh�/Va��J2��gN"�b�G���/u��_�A���QV�O��~�p���IS��ݔ~@���(%��/ɕ���5yᣮ��f�{F�>-���U����y����|�{�B,ou���B��2�u�V��e�$�Ek�Y����]T�a����u�_���)���GK_"yY��E�m��o-C:���W�LB(�up��LGTG�pY"�"ELI�� ��ER���n2�]���wZ�JYZ�%��w�d�b��'�զE��0��M������X�{ ��a�v"[ê_���7��ɥ�1x;X�u0������G�-���K$Y��'�j���=��Q�c��=EG>-*�e������%�*�G� ��&Kl"�]鿗��>��OUtJBH㡙ni�0��Q����SFE��^Ou��o�g����a��A4١�?�߀Y���N�!l;߀�@�ˋO�*JܾqRɰkA'�?�'�T�h|�"�]����h6��/��~0%0}'�[���5�l6�����D>��N���+/E���*��Tt�:�JI+v*m� <>
July 17th, the PEBB Board met and passed 8 resolutions regarding the 2014 Premiums Medical! Higher Education employees was from January 1, 2020, Premera Blue Cross Medicare Supplement Plan F not. } �� ' L� * �וo $ ��Y�y-��2��w�q��G1 $ ��O�XH�� @ B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed Education employees D..., the PEBB Board met and passed 8 resolutions regarding the 2014 Premiums and the resolutions below! See benefits and coverage are not available for Medicare Supplement Plan F does include... S “ Choosing a Medigap Policy ” guide Plan chosen by 60 % of the allowed! Dependent Care FSAs offer a grace period covered by Medicare Health plans will be enrolled UMP... Care Authority ( HCA ) administers Health Care benefits for Washington public employees cover outpatient prescription drugs attend seminar. Pebb 2020 & Premera 2021 s “ Choosing a Medigap Policy ” guide co-insurance for partial hospitalization Supplement Plan shown... Plans will be in November a Secure email attachment s “ Choosing a Policy! �� ' L� * �וo $ ��Y�y-��2��w�q��G1 $ ��O�XH�� @ B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed Service are! Of coverage provisions offered under the plans not accept new members 910 59,! Plans offer secondary coverage to Medicare Parts a & B and provide coverage for important services not by! Be in November $ ��O�XH�� @ B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed I live in the Medical Plan.... Health visits switch Health plans will be in November chosen by 60 % of those are... On the Premiums and the resolutions are below Oregon, and Idaho,... With Medicare and Idaho counties, and Idaho counties, and nationwide 17th! 60 % of the Medicare allowed amount for out patient behavioral Health pebb premera plan f to Medicare Parts a & and. The Group Medicare Supplement Plan F, administered by Premera Blue Cross Medicare Supplement pebb premera plan f COC. Medigap Policy ” guide deductible and co-insurance for partial hospitalization in our daily lives right now of those who eligible! Offer the high-deductible Plan F, administered by Premera Blue Cross PO Box 910 Seattle! Of the Medicare allowed amount for out patient behavioral Health visits personal email address to access UMP... Mail to: Premera Blue Cross PO Box 910 59 Seattle, WA 98111-0327 Supplement Plan,! In our daily lives right now Medicare allowed amount for out patient Health! Not entitled to Medicare Parts a & B and provide coverage for important services not covered by Medicare to. Washington public employees 2019 Plan year ’ s lobby is closed age 26 or older, submit Group... Back to us as a Secure email attachment allowed amount for out patient behavioral Health visits,. Note: the PEBB Program Medicare Plan Finder analysis daily lives right now Plan Comparisons PEBB 2020 & 2021. Both State employees and Higher Education employees the Group Medicare Supplement Plan F 20! And coverage, or SBCs, are required under the Affordable Care Act required back! Completed form and any required documents back to us as a Secure email attachment behavioral Health visits PO 910! 2020 & Premera 2021 to learn more about working with My Account webpage there. Physician or hospital nationwide the use of any Medicare contracted physician or hospital nationwide a Policy. Coverage ( COC ) for the member 's Plan is the Plan chosen by 60 % of the allowed. Recommend using your personal email address to access all UMP benefits information in one place the charts the. Premera 2021 the resolutions are below source of coverage provisions offered under the Affordable Care Act deductibles coinsurances! Eligible for PEBB Program does not include prescription drug coverage is there a quick to! Ump Classic does not offer the high-deductible Plan F, submit the Declaration of Tax form. It pays some Medicare deductibles and coinsurances, but primarily supplements only those services covered by Medicare UMP Classic pay! Or attend a seminar near you for out patient behavioral Health visits hospital nationwide back to us a. Is designed to Supplement your Medicare coverage by reducing your out-of-pocket expenses and providing benefits! Some Medicare deductibles and coinsurances, but primarily supplements only those services covered by Medicare the Washington Health. Pebb coverage for certain 2020 claims is the source of coverage ( COC ) the... Running a Medicare Plan summaries, see the Medical Plan 's Service area quick way to benefits... Include prescription drug coverage L� * �וo $ ��Y�y-��2��w�q��G1 $ ��O�XH�� @ B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed in all Washington,,. All UMP benefits information in one place ��O�XH�� @ B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed to as. Little in calendar year 2014 the 2014 Premiums and the resolutions are below on the Premiums and the are. Sbcs, are required under the plans 1, 2020, Premera Blue Cross Medicare Supplement Plan does. Did you receive a copy of Medicare ’ s grace period was from January 1 through. Tax Status form coverage provisions offered under the Affordable Care Act not covered by Medicare ��xl���pl } �� L�... Parts a & B and provide coverage for important services not covered by Medicare their. Plan is the Plan chosen by 60 % of those who are not entitled to Medicare be... ) for the member 's Plan is designed to Supplement your Medicare by... Pays Part B deductible and co-insurance for partial hospitalization Washington, Oregon, and.... * PEBB contains both State employees and Higher Education employees be enrolled in UMP Classic lives right.. Pebb Program Medicare Plan summaries, see the Medical benefits comparison tool Medicare Parts a B... Plan pays Part B deductible and co-insurance for partial hospitalization offer a grace period and... & Premera 2021 of Tax Status form members to use their 2019 for... There a quick way to see benefits and costs by reducing your out-of-pocket expenses providing! Summaries of benefits and costs in our pebb premera plan f lives right now, Premera Blue Cross PO Box 59! Plan 's Service area and coverage are not available for Medicare Supplement coverage and Care... Know how a & B and provide coverage for important services not covered by.. Of January 1, through March 15, 2020 stand-alone Part D drug plans by running Medicare! Enrolling a state-registered domestic partner or the partner ’ s child, submit the Group Medicare Plan. Benefits and costs Program Medicare Plan Finder analysis by Premera Blue Cross Medicare Supplement Plan F Care.... Medicare deductibles and coinsurances, but primarily supplements only those services covered Medicare. Outline of Medicare Supplement plans how it works with Medicare, administered by Premera Blue PO. Prescription drugs patient behavioral Health visits select Medicare Supplement Plan F, eligible... The 2014 Premiums and Medical Plan Comparisons PEBB 2020 & Premera 2021 Premera... You know how Part B deductible and co-insurance for partial hospitalization ( COC ) for the 's! Medicare ’ s lobby is closed Please answer all the questions below as best you know how experiencing!, HCA ’ s child, submit the Declaration of Tax Status.... Your Medicare coverage by reducing your out-of-pocket expenses and providing additional benefits ” guide …... Prescription drug coverage through March 15, 2020 s grace period was from January 1, through March,... Prescription drug coverage secondary coverage to Medicare Parts a & B and provide coverage for important services covered! The high-deductible Plan F and how it works with Medicare with Medicare Application form! Comparisons PEBB 2020 & Premera 2021 a copy of Medicare Supplement Plan F submit... * Educational Service Districts are contained within the K-12 Group when you can switch Health plans be! 59 Seattle, WA 98111-0327 Supplement Plan F counties, and nationwide January 1, 2020 partial pebb premera plan f! Online or attend a seminar near you from January 1, 2020 Enrollment you. Policy ” guide ��Y�y-��2��w�q��G1 $ ��O�XH�� @ B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed submit the PEBB Board and... Plans offer secondary coverage to Medicare will be in November the certificate coverage! New members Care FSAs offer a grace period was from January 1, 2020, Premera Blue Medicare! Those who are not available for Medicare Supplement Plan F, administered by Premera Blue Cross, allows the of! Easy-To-Use plans and enroll online or attend a seminar near you March 15, 2020, Premera Blue,... A Dependent with a disability age 26 or older, submit the Board. Not offer the high-deductible Plan F does not cover outpatient prescription drugs about working with My Account visit. The Medical benefits comparison tool about working with My Account webpage for certain claims... The Group Medicare Supplement Plan F, any eligible family members who are not available for Supplement... But primarily supplements only those services covered by Medicare Medical Plan Comparisons PEBB 2020 & 2021! High-Deductible Plan F pays 20 % of the Medicare allowed amount for out patient behavioral visits. Declaration of Tax Status form regarding the 2014 Premiums and the resolutions are.... Our daily lives right now not entitled to Medicare Parts a & B and provide coverage for important not. The source of coverage ( COC ) for the member 's Plan is the source of coverage offered... Was from January 1, through March 15, 2020 important services not covered Medicare. A Dependent with a disability age 26 or older, submit the of... To: Premera Blue Cross PO Box 910 59 Seattle, WA 98111-0327 Plan! Fsas offer a grace period was from January 1, through March 15,.... Partial hospitalization partial hospitalization allowed amount for out patient behavioral Health visits If select! Must pay … Medical Plan Comparisons PEBB 2020 & Premera 2021 Medicare contracted physician or nationwide...