Updated April 29, 2024
Premera Blue Cross and MultiCare Health Systems continue their contract negotiations. The contract between the two organizations ends on May 31, 2024, which means if no agreement is reached, MultiCare clinics, hospitals, and providers will no longer be in-network for Premera members beginning June 1, 2024.
If a termination notice goes into effect, it would apply to all lines of business, including commercial, individual, UW student insurance, and Medicare Advantage plans. This does not impact members who have coverage through a Premera Medicare Supplement plan or are on the HMO plan with the Sherwood HMO network.
Update:
MultiCare sent emails April 27 to any Premera member that had a visit with a MultiCare provider. This included both current and past Premera members and Medicare Supplement members. Please note: This potential termination does not impact any Medicare Supplement member. Also, we’ve learned that MultiCare is currently making automated calls to members in Yakima. Premera is mailing letters today, April 29, with information on on-going care for our Yakima members. Our contract discussion with MultiCare continues and our current agreement runs through May 31, 2024. We are working hard to reach an agreement that benefits our members and MultiCare.
We’ve worked hard to reach an agreement with the MultiCare team. That said, MultiCare’s approach to these negotiations has been less reasonable than we would have expected given our history and partnership. We’re extremely disappointed with the posture and lack of progress in these negotiations.
We approached this negotiation with the same philosophy we always have:
- Use data to help make informed, fact-based decisions
- Fairly compensate the hospital system while remaining competitive in the market
- Keep costs low for our customers
As a reminder, rate increases impact not just Premera, but the communities and people we serve.
Per federal and Washington state regulatory requirements, member letters are being sent. On April 15, Medicare Advantage members that have seen a MultiCare provider began receiving letters notifying them of these negotiations. Then, on April 29, all remaining members that have seen a MultiCare provider will begin to receive letters.
If an agreement isn’t reached by May 31, 2024, we will work with members that may need ongoing support due to chronic or complex conditions to ensure their treatment isn’t disrupted.
As we’ve always said, these negotiations are not about Premera; they are about our customers. We serve as their advocate during these discussions as we work with provider partners on practical solutions to keep healthcare affordable and accessible.
To find more information about providers in your network, you can use our Find a Doctor tool or call the phone number on the back of your member ID card.
Frequently Asked Questions:
If an agreement isn’t reached by May 31, 2024, does this mean I need to find a new doctor or pay out-of-network prices?
In most areas, yes. If MultiCare goes out of network, you will need to find a new in-network provider to continue to typically be responsible only for cost shares and deductibles. An out-of-network provider doesn’t have a contract with Premera, and you may be responsible for all charges, including cost shares and deductibles.
What about emergency care?
After May 31, 2024, our members will still be able to receive emergency care at MHS emergency departments. Emergency care is always covered at the in-network cost. Wherever you receive emergency care, you are protected from surprise (or balance) billing by state or federal law.
What MultiCare facilities will this impact?
These contracts include clinics and facilities in King, Pierce, South King, Spokane, Thurston, and Yakima counties. This includes all MultiCare medical clinics, Indigo Urgent Care, and hospital facilities including:
- Auburn – MultiCare Auburn Medical Center
- Covington – MultiCare Covington Medical Center
- Olympia – MultiCare Capital Medical Center
- Puyallup – MultiCare Good Samaritan Hospital
- Spokane – MultiCare Deaconess Hospital
- Spokane – MultiCare Valley Hospital
- Spokane – Rockwood Clinic
- Tacoma – MultiCare Allenmore Hospital
- Tacoma – MultiCare Mary Bridge Children’s Hospital and Health Center
- Tacoma – MultiCare Tacoma General Hospital
- Yakima – MultiCare Yakima Memorial Hospital
- Indigo Urgent Care Clinics
What if a member is currently receiving care and their provider is no longer in the network?
Some members may be able to continue their care with their current MultiCare provider at the current in-network benefit level for up to 90 days if they’re receiving treatment for a covered service or for a complex or chronic medical condition. Such conditions include pregnancy or scheduled nonelective surgery. Members can contact customer service at the number on the back of their ID card for more information about this process.
MultiCare is the only hospital in my city. Where do I go?
For some of our members, MultiCare will remain an in-network hospital. The letters we’re mailing to our members will indicate if MultiCare is in-network for you or no longer contracted after June 1, 2024. You can also call our Customer Service team at the number on the back of your insurance ID card to verify if your provider will be in-network after June 1. MultiCare hospitals and providers are still in network until the contract ends on May 31, 2024, if we’re not able to reach an agreement.
Are there other hospitals I can go to?
In most instances, your plan network may include the following hospitals:
Pierce County
- CHI Franciscan Medical Centers, including:
- St. Joseph – Tacoma
- Saint Claire – Lakewood
- St. Francis – Federal Way
Thurston County
- Providence St. Peter – Olympia
- Providence Centralia – Centralia
- Mason General – Shelton
Spokane County
- Providence Sacred Heart – Spokane
- Providence Holy Family – Spokane
- Shriners Children’s – Spokane
How do I find a new provider?
- To find a new provider in your network, sign into your account on Premera.com. Under Find Care, search the Find a Doctor tool. Note that MultiCare providers will continue to be listed until they are out of network on June 1.
- If you need to find a new, in-network primary care provider, consider Kinwell primary care. Kinwell offers high-quality care just for Premera members in Washington. These clinics do have capacity for our members and appointments are available in-person or virtually. Find out more at kinwellhealth.com.
