How does Premera Blue Cross handle out-of-network services?

Asked 4 months ago
Premera Blue Cross has specific guidelines when it comes to out-of-network services that members should be aware of. Generally, Premera offers different plans that may include out-of-network benefits, but the coverage typically varies based on the member's specific health plan. When obtaining services from an out-of-network provider, members may face higher out-of-pocket costs compared to using in-network providers. It is important for members considering out-of-network services to understand that they may need to pay the provider directly and subsequently file a claim with Premera for reimbursement. The amount reimbursed will depend on the terms of the member's plan and the allowed amount for the services provided. Furthermore, Premera Blue Cross often encourages members to confirm whether certain services are covered and the details of their copayment, coinsurance, or deductible when using out-of-network providers by reviewing their policy documents. For the most accurate and specific information, including any potential changes, it can be helpful to look at the current web page for Premera Blue Cross.
Jeff Whelpley is the editor / author responsible for this content.
Answered Aug 11, 2025

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