Knee and hip replacement

The Centers of Excellence (COE) Program covers single knee and single hip replacement surgery at low to no cost to qualifying Uniform Medical Plan (UMP) Classic and UMP CDHP members.

Premera Blue Cross administers the COE Program for UMP. For more information about the COE Program, call Premera at 1-855-784-4563  (TRS: 711).

Watch this video to learn what a UMP member experiences while participating in the COE Program.

 

 

HCA chose Virginia Mason as the provider for knee and hip replacement and began offering this benefit on January 1, 2017. Visit HCA’s COE page to read a summary of the first year’s results.

Learn more about this benefit.

Visit Premera's COE page

Am I eligible?

The COE Program is open to UMP Classic and UMP CDHP members who:

  • Are 18 years or older.
  • Are not enrolled in Medicare as their primary coverage.

Virginia Mason must determine if the COE Program is appropriate for you based on established medical guidelines for knee and hip replacement.

Note: The COE Program is not available to members enrolled in Medicare as their primary coverage or UMP Plus members. Medicare and UMP Plus members still have access to covered services related to joint replacement outside of this program. These services may be paid at the standard rate.

How much does this benefit cost?

For UMP Classic members, treatment under the COE Program is covered in full. For UMP CDHP members, treatment is covered in full after they meet their annual medical deductible.

To learn about your cost share for this benefit, read the "Joint replacement surgery" section in your UMP Classic or UMP CDHP certificate of coverage. 

If you live more than 60 driving miles from the COE location, you may qualify for assistance with travel and lodging expenses. To be covered, all travel arrangements must be made through Premera.

If you choose to drive, mileage reimbursements are determined by the IRS rates for medical mileage. If you choose to fly, you must travel to and from one of the airports listed on Premera's travel benefit page.

How do I get started?

If you are interested in participating in the COE Program, you may refer yourself, or your regular provider may refer you, by calling Premera at 1-855-784-4563 (TRS: 711).

After you apply, Premera will determine if you are qualified for the COE Program. If you are, Premera will refer you to Virginia Mason for further assessment. Premera will assist you in gathering your records so that the clinical teams at Virginia Mason can determine if surgery is appropriate. You may be required to follow a plan Virginia Mason gives you as a condition of approval for surgery.

Visit Premera's COE page for more information about the program's clinical review requirements.

Contact

Premera Customer Service
Phone: 1-855-784-4563 (TRS: 711)
Business hours: 7 a.m. to 5 p.m. Monday - Friday