Frequently Asked Questions

You will get your digital ID card shortly after we receive your first payment from you or your employer. We will only mail a hardcopy of your ID card to you if you request it.

An online account will help you simplify and streamline the management of your plan and care, at any time and from anywhere. With an online account, you can get quick access to your benefit information, view your claims, and make one-time or recurring payments, if needed.

Register for an online account

Sign in or create an online account and follow the detailed instructions on the homepage. Or call customer service 800-817-3056 and speak to someone directly about opting into paperless today.

No. If you previously created an online account for your LifeWise plan, you do not need to create another one. You can continue to use the same online account.

To change your PCP, call customer service at 800-817-3056.

We will mail your first monthly bill, also called an invoice, as soon as we receive your enrollment. Your invoice will include your payment options and your subscriber ID, which you’ll need to make payments online or by phone.

The quickest way to make your first payment is to pay by phone or create an online account.

You have four options!

Pay online, one-time, or autopay

1. Sign in to your online account. (Create an account if you have not yet done so.)
2. Once signed in, use the payment buttons to make a one-time payment or to manage recurring automatic payments (autopay). Make sure to enable pop-ups or the payment system will not function properly.

Automatic payments must be set up by the 23rd of the month in order to draft the following month's premium payment on the 28th.

To update your autopay payment method, sign in to your account. Select the "Manage Recurring Payments" button on the right side of the page, and then select "EDIT" on your existing autopay to update or add a new payment method. Remember, only the subscriber on your plan can set up or update autopay.

Pay by check

1. Write your member ID on your check.
2. Detach the payment coupon portion of your invoice (at the bottom of page 1) and include it with your check. Use the enclosed envelope.
3. Mail payments to:
   LifeWise Health Plan of Washington Member Premiums
   PO Box 840535
   Los Angeles, CA 90084-0535

Pay by phone

Call 866-327-8016 to use our automated payment system. Have your subscriber ID handy. You can also call the customer service number on the back of your ID card. Please follow the phone prompts to make a payment. (Our customer service representatives cannot take your payment.)

Pay with your bank’s bill pay system

1. Access your bank’s online bill pay system. Have your subscriber ID handy.
2. When setting up your bank bill pay, select LifeWise Health Plan of Washington.
3. When prompted, select this exact address:
   LifeWise Health Plan of Washington
   PO Box 840535
   Los Angeles, CA 90084-0535

Important: This address must be selected in order for your payment to be successfully processed.

If you were previously advised that bank bill pay was not available, please know that you can now use bank bill pay to pay your monthly premium if your bank offers this service.

There are some restrictions on who can pay your monthly bill from LifeWise.
LifeWise cannot accept payment from a sole proprietor or business account—even if it’s your own. We also cannot take payment from an employer, a charity, or a healthcare provider for individual health plans, except as required by law. These payments will be returned, and you will need to resubmit payment using an accepted method.

The following people or organizations can pay your monthly bill:

• You – through a personal account, not a business account.
• A member of your family, such as a spouse or parent.
• An Indian tribe, tribal organization, or urban Indian organization.
• State and federal government programs and their grantees.
• Ryan White HIV/AIDS Programs (and their community-based organizations like Evergreen Health Program).
• LyfeBank.
• Pierce County Project Access (if you purchased your plan through WA Healthplanfinder).

Failure to comply with these guidelines could leave you open to IRS penalties; contact your tax or legal advisor for more information. Your payment will be returned to you, and you’ll need to find another way to pay your bill. If you're unable to pay with an accepted method, your plan could be canceled due to non-payment. If your plan is canceled, you may not be able to enroll again until the next open enrollment period.

Please note: We are currently complying with recent requirements from our regulatory entities regarding grace periods. Current information may differ from the information you see here.

• Your payment is due on the first of each month.
• If you receive a subsidy to help pay for your plan, you have a 90-day grace period.
• Your coverage is good through the last day of the month for which Premera receives a subsidy payment. You may not have access to your benefits during months two and three of your grace period.
• If you do not receive a subsidy, including off-exchange plans, you have a 30-day grace period.
• If you voluntarily cancel your plan, you may not be able to enroll in another plan until the next open enrollment period, unless you have a qualifying life event.
• If you have an unpaid health plan premium and choose to reenroll with LifeWise, you may have to pay unpaid health plan premiums from the past 12 months.

• Based on your current income, you may qualify for an advance premium tax credit (subsidy) to help pay your monthly premium. You may also be eligible for low-cost or no-cost coverage from the state.
• Start by reporting your change in income to Washington Healthplanfinder or by calling their customer support at 855-923-4633.

To remove pop-up blockers, please refer to the browser you’re currently using and follow the steps to disable pop-up blockers:

iPhone or iPad IOS

1. Open the Settings app in iOS and go to Safari.
2. Under the General Safari settings, toggle the switch next to Block Pop-ups to select the OFF position. This will disable the pop-up blocker.

Chrome

1. Click the Chrome menu button.
   Note: The button is on the upper-right of the browser and is indicated by three dots.
   
2. Select Settings.
3. At the bottom of the page, click Advanced.
   Note: If Advanced is already selected, additional options will be available below it.
   
4. Under Privacy and security, click Site settings.
5. Click Pop-ups and redirects.
6. Click Blocked (recommended).
   Note: After the pop-up blocker is disabled, the option will show as enabled and display Allowed.

Safari

1. Open Settings.
2. Scroll down and select Safari.
3. Under General, you'll find the toggle switch for Block Pop-ups. Use it to enable or disable pop-up blocking.
4. Go back to Safari and reload the website that requested pop-up access. It should now be able to open a new pop-up window in Safari and display the content.

Firefox

1. Click the Open menu button (three bars) in the upper-right corner.
2. Click Options or Preferences.
3. Select Privacy & Security on the left.
4. Uncheck Block Pop-up windows to disable the pop-up blocker.
5. Close and relaunch Firefox

We want you to get the most out of your benefits. If your plan has a PCP copay, you’ll pay less when you see your designated PCP. Even if your plan does not offer a PCP copay, having an assigned PCP can help you get care quickly when needed since you’ll know where to go.

We wanted to allow time for customers to select their PCPs. Staying healthy and getting care is more important than ever, so we’ve assigned PCPs to those who have not yet selected a PCP.

• It saves you money. On most plans, you’ll get a lower copay when you see your designated PCP (HSA plans subject to deductible and coinsurance).
• It saves you time. When you have a PCP or primary care clinic as your medical “home base,” you know exactly who to call—no searching online frantically for an available clinic or urgent care center.
• They’re very good at what they do. PCPs are experts in a broad range of health care services especially when it comes to preventive care, chronic diseases, and overall wellness. Providers can provide one-stop preventive care through proactive health screenings and lifestyle plans so you can enjoy your best life.
• You’ll have a trusted health partner to guide you. A PCP is by your side throughout your healthcare journey. This close relationship allows your PCP to search for trends in your health history and identify health risks early on before they become more serious.
• Fewer hospital and ER visits. Studies show that people who see a PCP regularly are less likely to be hospitalized for serious health issues and have fewer trips to the ER during their lifetime.

If you’ve been reassigned to a new PCP, it means your previous provider is no longer in network or no longer practicing medicine. We do our best to incorporate historical data in our assignment and may not always accurately capture a previous PCP you’ve seen before.

Sign in to your account and go to the My Account menu, then Primary Care Provider, to see your designated PCP. If you would like to change your PCP, please call customer service 800-817-3056.

Once you have identified your assigned PCP, get started by calling your PCP’s office. Let them know if you are a new or returning patient, and they will work with you to schedule an appointment based on your availability.

PCP availability can change. If your assigned PCP is not accepting new patients, you can search for PCPs who are accepting new patients in our secure portal. Sign in to your account, go to the Benefits menu, and select Find a Doctor > Find a doctor.

No. You can see any in-network specialist without a referral.

If your plan has a PCP copay, you can see any PCP at the clinic listed and receive the PCP copay.

It depends on the provider. Some PCPs offer virtual visits via phone or video. You can ask when you call to make an appointment.

• Hospital admission for prenatal, childbirth, and newborn care.
• Emergency admission to hospital.
• Office visits to a primary care doctor, family doctor, or specialist.

Yes. Providers who are in the LifeWise network are familiar with the process for securing preapproval. They can contact LifeWise on your behalf. In-network doctors have all of the medical information needed to ask that your medical service be reviewed and approved for coverage. Always ask your healthcare provider about requesting preapproval before you schedule a service or procedure.

If your doctor gives you a service that requires preapproval without requesting it, you may have to pay part or all of the cost, above your usual cost shares. For complete information about your plan's medical benefits and preapproval requirements, read or download your benefit booklet.

Yes. Use our Covered drug lists to see if a drug falls into one of four Prior Authorization categories: Formulary Exception (non-formulary), Quantity Limit, Step Therapy, and Preapproval.

To request a prior authorization review, the pharmacy or the provider must contact our pharmacy services center at 888-261-1756or submit a pharmacy prior authorization request fax form for a specific drug. Sometimes a pharmacy can also do a one-time override for urgently needed medication.

Learn more about emergency overrides

Note: For drug review requirements specific to a customer's plan, Members can log in to My Rx Choices via MyPharmacyPlus™ to view drug review requirements specific to their plan.

Apple Health is available to those under a certain income level. You must also be a citizen or legal resident of five years under the age of 65. You can find all of the eligibility requirements on Washington Health Care Authority's website.

The Washington Health Care Authority has started reaching out to people who are losing their coverage to notify them of their options. Letters will be sent asking recipients to get in touch to find out if they still qualify for Medicaid, also known as Apple Health in Washington state.

Yes. If you recently became ineligible for Apple Health or Medicaid due to a redetermination, you likely qualify for the SEP period during which you can enroll in a LifeWise plan. Special enrollment periods allow individuals and families to buy health insurance outside of open enrollment. LifeWise offers Cascade Care plans that are designed by the Washington Health Benefit Exchange to provide the benefits you need while keeping your out-of-pocket costs down.

The Department of Health and Human Services (HHS), a federal agency, determined COVID-19 to be a public health emergency (PHE) starting in January 2020. HHS indicated the PHE would end on May 11, 2023. The Families First Coronavirus Response Act (FFCRA) allowed most Apple Health clients to continue receiving Apple Health coverage for the duration of the PHE, also known as “continuous enrollment.”

Certain eligibility and verification factors were also relaxed. Apple Health no longer terminated clients who failed to renew or complete an eligibility review. If a client’s eligibility is terminated for any other reason, HCA and DSHS reopened coverage, unless the client passed away or moved out of state. New changes in December 2022, Congress signed into law the Consolidated Appropriation Act, of 2023, which separates the continuous enrollment requirement from the PHE. This requires Washington state to begin redeterminations on 04/01/2023, even if the PHE continues.

In WA state, beginning 4/01/2023, WA state staff will begin requesting verification of income, resources, and other eligibility factors, unless staff can verify through electronic data sources. Some terminations resume on 4/30/2023, but more likely on 5/31/2023.

LifeWise is part of a family of health plans with deep roots in Washington state. We care for more than 2.2 million people. We also have an A credit rating, so you know you can trust us with your financial investment in your health.

We are committed to caring for communities in Washington state and providing more access to affordable healthcare. We deliver low-cost options, virtual care so you can get the care you need without leaving your home, and access to primary care, urgent care, mental health therapy and substance use disorder treatment from wherever you feel the safest and most comfortable.

Choosing the right health plan for you and your family can be a challenging experience, especially when you don’t have an employer kicking in for the monthly premium payments or a human resources team to answer your questions. At LifeWise, you’ll have us on your team. Our goal is to give you the confidence and certainty you need to make the right healthcare decisions.

LifeWise offers Cascade Care plans across most of Washington state. Cascade Care aims to increase the availability of quality, affordable health coverage in the individual market, and ensure residents in every Washington county have a choice of a qualified health plan. Cascade Care plans offer more coverage and ways to save than non-Cascade Care plans. They are available through Washington Healthplanfinder.

Cascade Care Select offers a new way to save on premiums. LifeWise offers Cascade Care Select in 19 counties, including Adams, Benton, Chelan, Clark, Cowlitz, Douglas, Ferry, Island, Klickitat, Pend Oreille, Pierce, San Juan, Skagit, Skamania, Spokane, Thurston, Wahkiakum, Whatcom, and Yakima. These plans are designed by the Washington Health Benefit Exchange. Many services are covered at a flat-dollar co-pay, making these plans a good choice if you want to know upfront what you will pay for a service.

Yes. Kinwell Clinics are located across Washington state and are exclusively available to LifeWise and Premera Blue Cross members. Kinwell offers primary care, virtual care, and behavioral health. Find a Kinwell clinic near you.

Support is easy to find online and over the phone through LifeWise of Washington at: 800-817-3056. Our customer service representatives are available between 8:00 a.m. – 6:00 p.m. PST, Monday through Friday. Our knowledgeable team can help answer questions and explore your plan options.

You can also reach out to Washington Healthplanfinder at: 855-923-4633 or http://www.wahealthplanfinder.org/. They have enrollment partners statewide ready to assist you.

Digital health messages are a new way for you to interact with LifeWise. It lets you receive information in a manner that many people prefer these days: a text-based messaging system. Every time you receive a new text message from us, it takes you to your own personalized and secure communication channel.

This complimentary service helps you stay informed and aware of healthcare updates. We will notify you with a text when you have messages that need your attention. After authenticating once with your date of birth, you'll have secure access to personalized care information quickly and easily from your phone.

Some messages may include member benefits, tips to save money on your health care and friendly reminders about your health – like when it’s time for an annual visit or screenings and much more. LifeWise will only notify you when there are helpful messages related to your healthcare. Typically, you will receive 1-2 messages per month. This feed is for private, one-to-one communications. Messages from LifeWise will always come from "51987.”

While we offer this service at no charge, standard message and data rates may apply depending on your mobile carrier plan. You can opt out of receiving notifications at any time by going to the most recent message you received, and text STOP.

Sign up here

For verification purposes. When you receive your first text message and click on the link to access your personalized feed, you will be asked to verify yourself by entering your date of birth. This request will be asked only once. If you get logged out of the system by clearing your internet cache or for other reasons, we will ask you to re-authenticate by providing your date of birth.

Yes. Digital health messages are a HIPAA-compliant communication platform meant to allow you to have peace of mind that your information is secure all while receiving information in a timely more effective manner given your preference. We've partnered with a third party to provide these updates.

The link is active for 72 hours upon receipt of the text message. If you access the link after this timeframe, you may receive a notification that your auth link has expired. You can click the resend auth link button at the bottom of the screen, and you will receive a new text message with a new, personalized link to access your message feed.

No. The link can only be accessed on a smart device that is linked to a mobile number and can receive SMS.