Heritage Signature (for individual plans) network

Heritage Signature (for individual plans) network

THIS PROVIDER NETWORK IS AVAILABLE TO INDIVIDUALS WITH A PREFERRED HEALTH PLAN

With a Preferred Health Plan from Premera, you have our commitment to help make healthcare work better?an important part of that commitment is providing you with access to safe, quality care. With our Heritage Signature (for individual plans) network, you get access to more than 37,000 providers.*

Key benefits ? Customers with the Heritage Signature (for individual

plans) network will have access to more than 37,000 providers across Washington state. These providers share our commitment to safe, quality care. ? Except for emergencies, care outside of the individual plan's network is not covered. ? A customer's out-of-pocket costs will be lower if they choose a doctor or hospital within their network. ? Customers can find in-network doctors and hospitals by using the Find a Doctor tool on .

*This number is an estimate of the individual providers based on their National Provider Indentifier (NPI) that have contracted with Premera Blue Cross. In-network providers subject to change.

038537 (09-25-2018)

HERITAGE SIGNATURE (FOR INDIVIDUAL PLANS) NETWORK

Partial provider list as of September 2018*.

EASTSIDE KITSAP COUNTY LEWIS COUNTY OLYMPIA

SEATTLE

SNOHOMISH COUNTY SOUTH KING COUNTY

SPOKANE and surrounding area

TACOMA (Pierce County) TRI-CITIES/ WALLA WALLA

YAKIMA

Hospitals Practices Hospitals Practices Hospitals Practices Hospitals Practices Hospitals

Practices Hospitals Practices Hospitals Practices

Hospitals

Practices Hospitals Practices Hospitals

Practices Hospitals Practices

IN NETWORK

EvergreenHealth Medical Center, Overlake Hospital, Swedish Issaquah

EvergreenHealth Medical Center, Overlake Medical Clinic, Children's University Medical Group, OIMA (Overlake Internal Medicine Associates), Swedish Physicians

Harrison Medical Center**

Harrison Medical Center**, The Doctors Clinic**, Franciscan Medical Group**

Morton General Hospital, Morton Medical Center, Providence Centralia Hospital, Steck Medical Clinic

Morton Medical Center, Providence Medical Group, Steck Medical Clinic

Capital Medical Center, Providence St. Peter Hospital

Capital Physicians

Virginia Mason, Northwest Hospital & Medical Center, Seattle Children's Hospital, UW Medical Center, Harborview Medical Center, Seattle Cancer Care Alliance, Swedish Health Services (First Hill, Cherry Hill, Ballard, Mill Creek, and Redmond campuses)

Polyclinic, Virginia Mason, Northwest Medical Clinics, Children's University Medical Group, Swedish Physicians1, Providence Health Systems1, Pac Med (in network)

Cascade Valley Hospital, EvergreenHelath Monroe, Providence Regional Medical Center Everett, Swedish Edmonds Campus

The Everett Clinic, Western Washington Medical Group, Cascade Valley Physicians, Edmonds Family Medicine

Valley Medical Center (Renton), MultiCare Auburn Medical Center

Valley Medical Center, MultiCare Professional Groups

Rockwood Health System Deaconess Hospital and Valley Hospital, Providence Sacred Heart Medical Center, Providence Holy Family Hospital, Providence St. Joseph's Hospital (Stevens County), Providence Mount Carmel Hospital (Ferry County), Inland Health Services/ St. Luke's Rehab

Multicare Rockwood Clinic, Cancer Care Northwest, Columbia Medical Associates, Spokane Digestive Disease Center, Providence Health & Services PMG (Providence Medical Groups), includes Stevens County and Ferry County providers

MultiCare including Tacoma General, Mary Bridge, Good Samaritan, Auburn Medical Center

Multicare Professional Groups

Kadlec Regional Medical Center, Providence St. Mary Medical Center, Providence SE Washington (Providence Medical Group Walla Walla County - in network), Trios Health (formerly Kennewick General Hospital), Walla Walla General Hospital

Kadlec Clinic, Trios Health (formerly Kennewick General Hospital), Tri-City Orthopaedic Clinic, Walla Walla Medical Group

Yakima Valley Memorial Hospital, Astria Health Center (formerly Yakima Regional Medical and Cardiac Center)

Yakima Memorial Physicians

* This is not an exhaustive list of all practices and hospitals participating in the Heritage Signature EPO network throughout Washington. This list is subject to change.

**Although Harrison Medical Center, The Doctors Clinics, and Franciscan Medical Group in Kitsap County are affiliated with CHI Franciscan Health, they will remain part of the Heritage Signature (for individual plans) network to ensure members have in-network options for care.

1 Swedish/Providence is not a PersonalCare Partner System

038537 (09-25-2018)

Discrimination is Against the Law

Premera Blue Cross (Premera) 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. Premera does not exclude people or treat them differently because of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. Premera provides free aids and services to people with disabilities to communicate effectively with us, such as qualified sign language interpreters and written information in other formats (large print, audio, accessible electronic formats, other formats). Premera provides free language services to people whose primary language is not English, such as qualified interpreters and information written in other languages. If you need these services, contact the Civil Rights Coordinator. If you believe that Premera has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation, you can file a grievance with: Civil Rights Coordinator Complaints and Appeals, PO Box 91102, Seattle, WA 98111, Toll free: 855-332-4535, Fax: 425-918-5592, TTY: 711, Email AppealsDepartmentInquiries@. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at , or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Ave SW, Room 509F, HHH Building, Washington, D.C. 20201, 1-800-368-1019, 800-537-7697 (TDD). Complaint forms are available at . You can also file a civil rights complaint with the Washington State Office of the Insurance Commissioner, electronically through the Office of the Insurance Commissioner Complaint Portal available at , or by phone at 800-562-6900, 360-586-0241 (TDD). Complaint forms are available at .

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An independent licensee of the Blue Cross Blue Shield Association

037397 (07-01-2021)

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