Open Enrollment for 2022 is here. Find your best plan by December 15. Joining us today is Kristin Meadows, President and CEO of LifeWise Health Plan of Washington and Vice President and General Manager, Individual Market for Premera, Blue Cross to tell us more about plans available this year.
GeekWire: First off, congratulations on being named President and CEO of LifeWise Health Plan. Could you briefly tell us about the relationship and the difference between Premera Blue Cross and LifeWise Health Plans?
Kristin Meadows: Yes. LifeWise Health Plan of Washington is a subsidiary of Premera Blue Cross. And LifeWise is the company that serves our individual market in Washington state. The individual market is where customers do not get their insurance through an employer group. LifeWise plans are available in all Washington counties except Franklin, Grays Harbor, Kitsap, and Pacific when open enrollment begins November 1. LifeWise is the only carrier in Washington to provide coverage on the Washington State Exchange broadly across the state. It serves those customers that don’t have access through their employer to get health insurance.
GW: Awesome. Thank you for that. Let’s start with Premera’s business plans for GeekWire’s, entrepreneurs, and small to mid-size businesses. What does Premera offer and what plan attributes should they look for, for their employees?
KM: It doesn’t matter where you live or where you work in the state; you can find a plan through Premera Blue Cross or LifeWise Health Plan of Washington. If you need a little bit of help, we have lots of resources to walk you through the decision-making process on our website. Also, you can outreach to a salesperson that works at Premera or LifeWise or you can work with a producer or broker who can help you navigate finding the right plan and access that best fits your needs or those of your family.
The other piece is just within the last 18 months, you’ve seen some changes in the way healthcare is delivered and an area where Premera, LifeWise, and our providers have really leaned in is providing virtual care. And so based on convenience, you can now get access to healthcare without ever having to leave your home.
In addition to that, we have coverage for preventative care without any out-of-pocket costs. So that means, you make your overall health a priority, get your appointment scheduled if that’s been something you’ve set aside with the pandemic and make sure that you’re establishing that relationship with your primary care provider. It is important to get your preventative screenings, immunizations and other proactive healthcare needs taken care of as you head into a new calendar year.
GW: Let’s elaborate there a bit. Have you noticed members resisting getting that preventative care over the last 18 months and how would you encourage members or increase their comfort level that it’s okay to get back out and see their primary care physician or get those preventative screenings that are so necessary?
KM: Well, the good news is we are seeing people go back to see their doctor and to get their screenings. We definitely saw this decline in 2020. If folks haven’t taken that step yet, the best thing to do is go to our website and makes sure you have a primary care provider. You can also call us, and we’re more than happy to help you with that search.
Making that first appointment with your primary care doctor, something I just did a few months ago, will provide you with peace of mind. It is important to remember that there are so many options now for how you visit with your doctor. You can go into the office or do your visit virtually. That’s the good news about taking that first step.
If you don’t have a primary care doctor right now, make sure you’re getting help finding one. You can talk to friends, you can talk to family, you can give us a call. You can go to our website. If you have a doctor, carve out a couple minutes to make the appointment. After that phone call, you’re going to feel lot better about the options you have to either visit the doctor virtually or, or visit the office.
GW: How does Premera and LifeWise help connect members with the right providers or specialists, if needed?
KM: We’re here to help. And so people go through the process of figuring out the right care for them in a variety of different ways. We want to make sure that every touch point, whether it’s landing on our website, or talking to customer service, or giving that primary care doctor a call, that you are not burdened by referrals. You have access to our entire system, and you can navigate it with freedom, meaning there aren’t gatekeepers along the way to slow down your process of getting the right care at the right time.
There are a lot of resources online about what preventative care might be appropriate for you right now. The other thing is preventative care very often doesn’t have out-of-pockets cost. It is important to remember that when you do make that visit, it’s unlikely that you’re going to have to pay even a copay. If you do have questions and you’re not sure what the costs are associated with the care you need to get, that’s why we’re here to help.
GW: Excellent. Thank you. We’ve talked a lot about primary care, certainly the last 20 months have increased awareness and importance for mental health, behavioral health, what options are available to members for those services?
KM: First, I’ll say it’s great to see that people are accessing those types of resources. We’ve definitely seen it in terms of what we refer to as utilization. So, it’s been, sort of a silver lining if you will, with the pandemic. Your mental health is just as important as your physical health. I cannot stress that enough.
For behavioral health, we offer both office and virtual care options. You can access services like Doctor on Demand, which is an app-based version for getting medical and mental health services. We also have services called Workit Health and Boulder Care where you can address anxiety, depression, addiction, all digitally if that’s the path that’s best for you. We want to encourage people to reach out and know that there are options to make sure they’re getting their mental health needs addressed while they’re getting their physical health needs as well.
GW: Excellent. We’re rapidly approaching open enrollment season. Is there anything new and exciting that people seeking health plans this fall for coverage to begin in 2022 should be aware of, or looking into?
KM: There are two things. We try to maintain what’s working for our customers and part of that is making sure that preventative care has full coverage or fully covered. We have pharmacy services, specifically generic drugs that are offered at a low co-pay or no cost at all with LifeWise Health Plan of Washington. We’re making sure that people get the lowest cost possible when they see the doctor or when to go to the pharmacy. So that means that they’ll be guaranteed when they show up at the pharmacy with their LifeWise ID card in hand, they’ll get the lowest cost for the prescription that they’re getting.
I think too, we have, it’s zero copay/no copay at all for some of those at base care, like Doctor on Demand services. We try to remove the barriers. Those are some of the new things, but also some of the things we try to maintain year over year with our benefits line.
GW: We’ve talked about cost, and it sounds like there’s some great options for low cost, no cost coverage. Are there plan attributes or rewards offered to members for seeking that preventative care?
KM: The primary focus for LifeWise Health Plan of Washington, and Premera Blue Cross, whether you are a small employer or you’re purchasing insurance on your own, is that we want to make sure that primary care is the most important piece to your overall health. The reward is that you shouldn’t have to pay a lot of out-of-pocket costs when you do seek those services. And when you do go, we want to make sure that you have options like virtual care, with no restrictions in terms of referrals, $0 dollar copays when you use those services like Doctor on Demand. All those are important first steps in establishing the relationship with your primary care doctor, understanding your needs with preventive health and that’s where we want all customers to start, because it’s the most important with the overall healthcare journey.
GW: Wonderful. LifeWise and Premera offer a great opportunity for cost savings, for freedom of choice and ease to navigate the healthcare system. Not only for the individual, but if you are the person within the company that is sharing choices and options with their employees, you’ve simplified that for both the administrator and the employee.
KM: That’s right. I couldn’t have said it any better than you did. Thank you.
GW: Well, thanks. As you know, GeekWire covers technology, the technology scene and everything that it influences here in the Pacific Northwest and beyond. Are there certain technological advancements that you are seeing in healthcare delivery that our audience can get excited about?
KM: It is absolutely the virtual services. It’s hard to believe, but prior to the pandemic, we had maybe 1% to 2% of our members accessing virtual care. So I think what happened over the last 18 months, whether it’s in the healthcare industry or other business models, we demonstrated the possibility of responding with speed to where the customer need is. And so now we’re not going to turn away from that. We’re going to keep moving in the direction of health plan technology and virtual care is one step in that direction with primary care, preventative care. I think our partners in our community on the provider side are also looking at other ways we can deliver care in the home where it’s most convenient for the member and the patient. And that’s a really big deal.
GW: Since we’re in our home so much more than we used to be. It’s awesome to believe that not only can we get food delivered and our packages within an hour, but now we can actually get access to healthcare in our home. That’s wonderful.
KM: I’m a working mom and the convenience of being able to access services I need, or that my family needs from my phone is life changing in a way. And there’s a comfort level and the technology are getting better and better. So that’s a good thing. Also, virtual care provides a vital service for rural communities. People who live in rural areas may not have access to a brick-and-mortar office, and having virtual care options breaks down some of those access barriers.
GW: We’ve talked about physical care, pharmacy, and mental health, are vision and dental services also available?
KM: Yes, that’s correct. You’ve got your physical needs taken care of your mental health, my least favorite thing to do is probably go to the dentist, but do make that appointment. Sometimes twice year at this point in life. So dentist pediatric vision is covered on the individual market. We just want to make sure head to toe, you’ve got everything you need.
GW: Excellent news, so throughout the state of Washington, you offer access to care and a broad provider network. Those in our audience interested in choosing health plans should first go to Premera’s website?
KM: That’s correct. You can go to our website and select the option “Find Care.” You can look up based on the services, you’re trying to receive, a specific doctor, primary care and really see more than one option in many cases. Whether it’s in that office or through virtual services, there’s always going to be a doctor that you can get access to through our broad network.
GW: Open enrollment starts November 1st. What’s the deadline?
KM: Yes, it starts November 1st. And if you’re looking for coverage, starting on January 1st, the deadline is December 15th, but open enrollment actually goes into January. If you do complete your research all the way through January 15th, that means your health plan wouldn’t be effective till February. So you just want to make sure that if you need coverage by January 1st, you’re working with us, going to our website, giving us a call, working with a producer prior to December 15th.
GW: What would be the reason to go to a producer as opposed to going directly to Premera?
KM: The beauty of working with a producer is really getting help through a big decision in your life. Depending on where you are at with your healthcare journey, or maybe your healthcare needs have changed and you just want to make sure that you’re understanding the options available and because we offer significant choice finding the right plan fit, a broker or producer can really help. You can also find a broker by visiting Premera.com
GW: Thanks, is there any other information that our audience would find helpful during this year’s open enrollment?
KM: I think one thing that’s new in 2021 in Washington on the individual market are the portfolio plans called Cascade Care. Cascade Care is offered through LifeWise, and other carriers. Those plan designs are all about affordability and access, which means that they tend to have lower copays or lower deductibles. If you have people looking for a plan and they see Cascade Care plans, that means it’s a specific plan design meant to bring more certainty about what your out-of-pocket costs are at a lower cost point for the member.
GW: Excellent, our key takeaway for our audience in Washington state – to learn more about Cascade Care plans, individual market plans, family plans and business plans, can start their journey by visiting Premera.com.
Thanks to Kristin Meadows, LifeWise and Premera Blue Cross for providing helpful information to guide decision-making in health care coverage this fall.