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Premera Blue Cross launches virtual primary care health plan

The plan is available at a lower premium than standard PPO plans, and offers a specialist referral process.

Susan Morse, Executive Editor

Premera Blue Cross has launched its first virtual care health plan for member access to primary care providers.

Washington state employers can purchase the Premera NOW plan for availability on Oct. 1. While open enrollment varies by employer, many will hold open enrollment this fall for a Jan. 1, 2021, start date.

The plan is available at a lower premium than standard PPO plans.

Members may access a virtual primary care provider at any time, for a zero copay, through an app operating on 98point6. This is an on-demand, text-based primary care service platform from independent company 98point6.

An automated assistant gathers information on symptoms, including photos if needed. A 98point6 board-certified physician then reviews the case and provides diagnosis and treatment privately over in-app messaging.

If necessary, the service can also make a referral for an in-person appointment with an in-network specialist. The member then receives a summary of the virtual visit.

WHY THIS MATTERS

Telehealth has become the standard of care during the coronavirus pandemic as the Centers for Medicare and Medicaid Services in March allowed for more than 80 additional services to be furnished via telehealth. Providers were able to bill at the same rate as an in-person visit during the duration of the public health emergency.

Traditionally, telehealth is reimbursed at a lower rate.

The announcement by Premera Blue Cross is an early look at how insurers may incorporate more telehealth benefits into their benefit design coverage for 2021.

THE LARGER TREND

Premera Blue Cross, which serves the Pacific Northwest, announced in March that it would expand telehealth services at little or no cost to its members in response to the COVID-19 pandemic. It waived cost sharing for all telehealth solutions for a limited time.

ON THE RECORD

"The COVID-19 crisis has made it clear that virtual care is here to stay. By providing convenient and affordable, on-demand access to healthcare, we have an opportunity to create an experience that truly puts the customer at the center of all we do. With Premera NOW, we are making it easy to navigate the healthcare system of today and tomorrow," said Rick Abbott, VP of product and market solutions for Premera.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com