The OIHCD Board understands that concerns around the availability of individual insurance is top of mind for islanders following Kaiser Permanente’s announcement they will not be offering individual or small group plans in San Juan County next year. Since learning about Kaiser’s decision, the District’s Superintendent has been staying in close contact with Premera’s Senior Network Executive (parent of the insurance company replacing Kaiser, LifeWise Health Plan of WA) to ensure residents of San Juan County experience minimal disruption with the changes taking place as of January 1, 2020.
We now know that the new LifeWise network specific to Individual exchange plans will include ALL San Juan County providers who are currently contracted with Premera. This means both the UW Medicine Orcas Island Clinic and Orcas Family Health Center will be in-network providers.
There is more good news!
While the new LifeWise specialty network is slightly more narrow than their traditional Premera network, an exception was made to enable patients receiving care from the UW Medicine Orcas Island Clinic to be referred into UW Medicine for specialty or hospital care, and be handled as in-network. This is very positive and will allow for improved continuity and coordination for UW patients needing higher levels of care.
As far as the rest of the network, the following facilities will be in-network: Island Hospital, Providence/St Joseph, Swedish, PeaceHealth, Seattle Children’s and Skagit Regional Hospital. Those facilities that will not be in the new LifeWise network are some of the larger hospital systems and providers, primarily in King, Snohomish and Pierce Counties. They include: Multicare, Virginia Mason, Overlake Hospital, The Everett Clinic, Evergreen Hospital, UW Medicine (except for patients receiving care from the UW Medicine Orcas Island Clinics) and Seattle Cancer Care Alliance.
We are awaiting more details on the Medicare offerings for next year and will share information as it becomes available. As always, please feel free to contact the Superintendent at firstname.lastname@example.org with questions or concerns. She can also be reached on her cell at 415.999.5611.