Coming Soon! PCP Designation Will Help Members Access Care in 2026
Coming in March, Premera Blue Cross will be introducing primary care provider (PCP) designation for select small group and Premera Pathfinder (51+) plans. This feature will help members get faster access to high-value primary care and lower out-of-pocket costs.
Why it matters
Low engagement with primary care means missed preventive care, unmanaged chronic conditions, and higher downstream costs. PCP designation will give members an easy starting point and will encourage earlier, more frequent primary care visits.
For some members, when they see their designated PCP it will mean saving money. For example, small group members on a Choice Gold PPO (500, 1000, or 1500) plan will have a $15 copay for an office visit when seeing their designated PCP compared to $55 for a non-designated PCP.
How PCP designation will work
Members in select small group and Premera Pathfinder plans will automatically have a PCP designated to them in March. Members will be able to view or change their PCP anytime through their secure Premera account. Members who change their PCP, must select an in-network provider to receive the lower office visit cost share.
PCP designation will be determined by:
- Existing member-PCP relationship (provider must be in network)
- Proximity to Kinwell
- Providers within 10 miles of the member
What producers should know
- PCP designation supports better healthcare navigation and faster engagement for members new to their plan.
- PCPs play a central role in preventive care, screenings, care coordination, and long-term condition management—all key contributors to healthier members and lower overall cost of care.
- Members will always be able choose their own PCP, giving them flexibility and control.