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Important Message About What You Pay for Vaccines - Our plan covers most Part D vaccines at no cost to you, even if you haven’t paid your deductible. Call Customer Service for more information.

Important Message About What You Pay for Insulin - You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on, even if you haven’t paid your deductible.

Community/Retail pharmacies can fill up to a 90-day supply (100 day supply for Tier 6).

Premera Blue Cross is an Independent Licensee of the Blue Cross Blue Shield Association. Premera Blue Cross is an HMO plan with a Medicare contract. Enrollment in Premera Blue Cross depends on contract renewal. This information is not a complete description of benefits. Call 888-868-7767 (TTY: 711) 7 days a week, 8 a.m. to 8 p.m. for more information. To join a Premera Blue Cross Medicare Advantage Plan, you must have Medicare Part A and Part B and live in the Premera Blue Cross Medicare Advantage service area (Cowlitz, Island, King, Kitsap, Pierce, Lewis, San Juan, Skagit, Snohomish, Spokane, Stevens, Thurston, Walla Walla and Whatcom counties in Washington). Members must select a Primary Care Provider (PCP) from the Premera Blue Cross Medicare Advantage Plans provider network. For accommodation of persons with special needs at sales meetings, call 888-868-7767 (TTY: 711) 7 days a week, 8 a.m. to 8 p.m. To request a copy of the Premera Blue Cross Medicare Advantage Evidence of Coverage, Formulary, or Provider and Pharmacy Directory, please call 888-850-8526 (TTY: 711), October 1-March 31, 8 a.m. to 8 p.m., 7 days a week, or April 1-September 30, 8 a.m. to 8 p.m., Monday through Friday. Benefits, formulary, pharmacy network, and/or copayments/coinsurance may change on January 1, 2024, and from time to time during the year.

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Premera Blue Cross complies with applicable Federal and Washington state civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation.

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