Make the
Most of Your
Coverage
SEIU 775 Benefits Group Healthcare Coverage
Learn how to make the most of your coverage, access care and get support for your health and well-being.
Coverage That Cares For You
Whether you have Kaiser or Aetna, your plan makes it easy to get care when you need it. Along with check-ups and treatment when you’re sick, you have access to mental health care, wellness coaching and tools to help you manage stress and build healthy habits. With Coverage for Kids, your children get these benefits as well.
All costs are for reference only. In the event of any discrepancies, official plan documents govern.
Use Your Coverage Checklist
Get Organized
Accessing your benefits starts here.
- Keep your insurance card in your wallet.
- Create an online member account for your medical plan.
- Choose a Primary Care Provider (PCP) if you don’t have one yet.
- Make a list of all your medications.
Use Your Medical Coverage
Routine care to keep you feeling your best.
- Schedule an annual check-up with your PCP.
- Schedule preventive screenings, like mammograms and colonoscopies.
- Stay up to date on vaccines, such as flu, shingles and COVID-19.
- Switch your prescriptions to mail-order to save money.
Keep Up with Vision, Hearing & Dental
Essential care to keep you seeing, hearing and smiling.
- Get dental cleanings and exams every 6 months.
- Schedule an eye exam and update glasses or contacts.
- Book a hearing screening through EPIC Hearing.
Stay Well with These Benefits
Services to build healthier habits, reduce stress and boost energy.
- Sign up for wellness coaching.
- Join fitness and lifestyle programs through your plan.
- Use your mental health benefits to manage stress.
- Schedule a massage, acupuncture or chiropractic appointment.
Medical Coverage
Once your provider mails your member ID card, you can use it to set up your online member account. From there, you can find providers schedule visits, message your care team, check test results and refill prescriptions.
If you didn’t receive your new member information and ID card, call MagnaCare at 1-877-606-6705.
Select your plan below to create your online member account.
If you need help setting up an online member account, call your plan’s member services number on your member ID card. Support is provided in many languages.
Dental Coverage
Dental care does more than protect your teeth. Cleanings and exams help prevent cavities, gum disease and other issues. A healthy smile can improve your comfort, confidence and long-term health. Whether you have Delta Dental or Willamette Dental, both plans include:
- Routine exams and cleanings at no extra cost.
- X-rays, sealants and fluoride treatments.
- Orthodontia benefits.
- Access to large provider networks.
Select your dental plan to learn how to get started.
Delta Dental
To get started, visit DeltaDentalWA.com and select Delta Dental PPO. There you can find an in-network dentist and create a MySmile® account to access your ID card, cost estimates and plan information. For questions, call 800-554-1907.
Willamette Dental
You can search for nearby dentists and read reviews at WillametteDental.com. To schedule appointments, call the Willamette Dental Group Appointment Center at 855-433-6825.
Free Primary Care Visits
Your Primary Care Provider (PCP) is your main doctor and first stop for most health needs. PCP visits include yearly check-ups, help with health questions and care when you’re sick. Your PCP can also refer you to specialists when needed.
Kaiser Permanente
There is no cost to see your primary care provider (PCP) in-person or virtually. Note that certain tests or lab services may be subject to a separate co-pay.
Kaiser Permanente of Washington
You can find a doctor on the KPWA member website. After logging in, use the Provider Directory to search for and select an in-network provider.
Kaiser Permanente Northwest
You can find a doctor on the KPWA member website. After logging in, use the Provider Directory to search for and select an in-network provider.
Aetna
There is no cost to see your primary care provider (PCP) in-person or virtually. Note that certain tests or lab services may be subject to a separate co-pay.
You can find a doctor on the Aetna member website. After logging in, go to “Find Care” to search for providers, clinics and hospitals near you and more. You can also call 1-888-982-3862 to find a doctor.
Once you have selected a doctor, you can schedule an appointment online or call your doctor’s office directly.
Urgent & Emergency Care
Urgent care is a low-cost option for non-emergencies like flu symptoms, minor injuries or infections when your PCP isn’t available. Emergency care is for serious or life-threatening issues like chest pain or severe injuries. Emergency room visits have a $200 co-pay.
Kaiser Permanente
See the standard co-pays for visit for Kaiser Permanente of Washington (KPWA) and Kaiser Permanente Northwest (KPWA).
Note that certain tests or lab services may be subject to a separate co-pay.
KPWA Medical Visit Co-pays (in-network) | |
|---|---|
Primary Care Provider / Online Visits | $0 |
Urgent Care Visits | $0 |
Emergency Room Visits | $200 |
Specialty Visits | $15 |
KPNW Medical Visit Co-pays (in-network) | |
|---|---|
Primary Care Provider / Online Visits | $0 |
Urgent Care Visits | $30 |
Emergency Room Visits | $200 |
Specialty Visits | $15 |
Aetna
Note that certain tests or lab services may be subject to a separate co-pay.
Medical Visit Co-pays (in-network) | |
|---|---|
Primary Care Provider / Online Visits | $0 Co-Pay |
Urgent Care Visits | $15 Co-Pay |
Emergency Room Visits | $200 Co-Pay |
Specialty Visits | $15 Co-Pay |
Prescription Benefits
Get the medications you need at low- or no-cost through your medical plan. Refills are simple to manage online, by phone or through your member app. Many long-term prescriptions are also available by mail-order delivery.
Kaiser Permanente
Transferring prescriptions is simple through your Kaiser Permanente account or by calling Member Services. Mail order offers the lowest cost and is available online, by phone, or in the app.
Rx Co-pays (30-day Supply) | Pharmacy | Mail Order |
|---|---|---|
Generic Contraceptives* | $0 | $0 |
Value-Based Drugs** | $4 | $0 |
Preferred Generic | $8 | $3 |
Preferred Brand | $25 | $20 |
Rx Co-pays | Pharmacy 30-day supply | Mail Order 90-day supply |
|---|---|---|
Generic Contraceptives* | $0 | $0 |
Value-Based Drugs** | $5 | $10 |
Preferred Brand | $25 | $50 |
Non-Preferred | $50 | $100 |
*Employees of religious-based organizations are exempt from contraceptive coverage under the ACA. Enrolled Kaiser Permanente members still receive contraceptives at no cost. **Value-based drugs are generic medications.
Aetna
Aetna partners with the Sav-Rx Pharmacy Network for prescription benefits. Use your Aetna ID card when filling prescriptions at any of their 75,000 in-network pharmacies. To manage refills or use mail-order delivery, visit savrx.com to create an account or call 1-800-228-3108 for support.
Rx Co-pays | Pharmacy 30-day Supply | Mail Order 90-day Supply |
|---|---|---|
Generic Contraceptives* | $0 | $0 |
Value-Based Drugs** | $4 | $8 |
Preferred Generic | $8 | $16 |
Preferred Brand | $25 | $50 |
Non-Preferred | $50 | $100 |
*Employees of religious-based organizations are exempt from contraceptive coverage under the ACA. Enrolled Aetna members still receive contraceptives at no cost. **Value-based drugs are generic medications.
Vision Benefits
Regular care can help you spot changes early and keep your eyes healthy. Your plan includes an eye exam and $600 for hardware (like lenses, frames and contacts) every 12 months. You can choose from a wide selection of quality eyewear and get free adjustments and repairs anytime.
Kaiser Permanente
Kaiser Permanente of Washington
covers one routine eye exam every 12 months at $0 co-pay for adults and children. Coverage includes frames, lenses, or contact lenses up to $600 every 12 months. Children can receive one fully covered pair of glasses each year, or contacts with 50% cost-sharing.
Kaiser Permanente Northwest
includes one routine eye exam every 12 months at $0 co-pay for adults and children. Members have coverage for frames, lenses, or contact lenses up to $600 every 12 months. Children can receive one pair of frames and lenses or contact lenses each year.
Aetna
Aetna covers one routine eye exam every 12 months with a $15 co-pay for adults and children. Coverage includes frames, lenses, or contact lenses up to $600 every 12 months. Children can receive frames and lenses or contact lenses with coverage up to $600 per year.
Mental Health
Your coverage includes therapy, counseling and mental health services at low- or no-cost. Support is available in person, online or by phone to fit your schedule. Whether you’re managing stress, grief or ongoing challenges, help is here when you need it.
Whole Health
From one-on-one wellness coaching to naturopathic care and lifestyle tools, these benefits support your health beyond doctor visits. They’re designed to help you manage stress, build healthy habits and support your overall well-being day to day.
Pain Relief & Recover
Access physical therapy, chiropractic care, massage and acupuncture to help relieve pain. These services support recovery from injuries, strain or the physical demands of caregiving. Your plan makes it easier to get care that keeps your body moving comfortably.
Chronic Conditions
If you’re managing a condition like diabetes, chronic pain or high blood pressure, your care team can help. Regular check-ins and treatment plans make it easier to stay healthy and prevent complications. Use your benefits to get ongoing support and monitoring.
Hearing Benefits
EPIC Hearing supports your hearing health with access to tests and affordable, high-quality hearing aids. You can receive free hearing tests through EPIC providers and access discounted, name-brand hearing aids. EPIC connects you to a large network of hearing specialists to help you find the care that fits your needs.
Family-building Benefits
Progyny provides access to fertility care, personalized care plans and adoption support, including a one-time allowance for eligible adoption expenses. You’re connected to a network of specialists and receive one-to-one guidance from a dedicated Patient Care Advocate to help support you through your family-building journey.
Keeping Active Coverage
How to Maintain Coverage
Work Your Required Hours
Work 80+ paid hours per month to maintain individual coverage. Work 120+ paid hours per month to maintain Coverage for Kids.
Report Your Hours On Time
You must report your work hours each month. Late or adjusted hours must be submitted to your employer within 60 days of the worked month.
Pay Your Monthly Co-premium
Your co-premium is your monthly payment ($25 or $125 with Coverage for Kids). It’s usually deducted from your wages, but if it can’t be, you’ll receive a letter and email with self-pay instructions.
How Work Hours Determine Coverage
Your coverage status is based on the hours you worked 2 months earlier. For example, the hours you work in January determine your coverage in March.
Use this chart to see how the month you work connects to the month your coverage applies.
Work Month | Coverage Month | |
|---|---|---|
January | March | |
February | April | |
March | May | |
April | June | |
May | July | |
June | August | |
July | September | |
August | October | |
September | November | |
October | December | |
November | January | |
December | February |
Grace Months
Unpredictable schedules can make it difficult to meet required work hours. The Grace Months benefit helps ensure continuous healthcare coverage, even when you’re unable to work as planned.
Each coverage year (August–July), you receive 2 Grace Months
that automatically extend your healthcare coverage for 1 month when your work hours fall below the requirement.
If you have Coverage for Kids,
this protection applies to your dependents too. If you meet the hours for your own coverage but fall short for Coverage for Kids, a Grace Month will be used to extend your children’s coverage for that month.
How Grace Months Work
- You get 2 Grace Months per coverage year (August–July).
- Each Grace Month extends coverage for 1 month if you don’t meet the required work hours. A Grace Month covers both you and your dependents’ coverage.
- Grace Months apply automatically—no action is needed.
- You can check your available Grace Months anytime by logging into your health benefits account.
When do my Grace Months reset?
They reset on August 1 of each year and are available as soon as you’re enrolled.
Do unused Grace Months carry over to the next year?
No. Each year on August 1, you receive 2 Grace Months. Unused Grace Months don’t roll over.
Can I use my Grace Months for consecutive months?
No, you cannot use Grace Months 2 months in a row.
What if I work enough hours for individual coverage, but not enough for Coverage for Kids?
In this case 1 Grace Month will be applied to extend your children’s coverage for that month.
If I use a credit, do I still pay my monthly co-premium?
Yes, you are still responsible for your co-premium that month.
Support Contacts
The support contacts below connect you with help when you need it. Your plan’s Nurse Help Line offers phone support from registered nurses who can answer questions and help you decide next steps.
Health Benefits Support Customer Service
Get help with questions about coverage, eligibility, applying and more.
Customer service is available Monday-Friday, 8 a.m. to 6 p.m.
1-877-606-6705
In-language support available.
Live Chat Support
Log in to your Health Benefits Account for chat support.
SEIU775BG-caregiver@magnacare.com
Can’t contact customer service during business hours?
Email and get a response within 2 business days.
Kaiser Permanente of Washington
New Member Services:
1-888-844-4607
myseiu.be/kp-new-member
Member Services:
1-888-901-4636
myseiu.be/kp-member
Mental Health Services
1-888-287-2680
myseiu.be/kaiser-bh
Nurse Helpline
1-800-297-6877
myseiu.be/kp-nurse
Member Language Assistance
1-888-901-4636
myseiu.be/kp-language
Kaiser Permanente Northwest
New Member Services:
1-888-491-1124
myseiu.be/kp-new-member
Member Services:
1-888-813-2000
myseiu.be/kp-member
Mental Health Services
1-855-632-8280
myseiu.be/kpnw-bh
Nurse Helpline
1-800-324-8010
myseiu.be/kp-nurse
Member Language Assistance
1-888-813-2000
myseiu.be/kp-language
Aetna
Member Services:
1-855-736-9469
Mental Health Services
1-800-424-4047
24 Hour Nurse Line
1-800-556-1555
Find the Right PCP
1-888-982-3862
Member Language Assistance
1-855-736-9469
myseiu.be/aetna-language
Dental
EPIC & Progyny
Confused by insurance terms like deductible or co-pay?
Get simple definitions of common healthcare terms to better understand your coverage and costs.
Health Benefits Account
Login or create an account to check your work hours, Grace Month balance, pay co-premiums, get live chat support and more in your health benefits account, managed by MagnaCare.
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