How to Make Sure Your Health Plan Includes Swedish

How to Make Sure Your Health Plan Includes Swedish

With the Affordable Care Act, and all the changes taking place in health insurance, it can get a little confusing about how to choose a new plan — or if you even need to choose one. So we’d like to explain your choices, and let you know what to do to continue to receive care at Swedish with the best possible insurance benefits.

Do I need to choose a new health insurance plan?

If I need a new plan, when do I have to choose it?

How do I make sure my care at Swedish is covered?

Who are the insurance companies that include Swedish?

What if my insurance company doesn’t include Swedish?

Why is it important to choose a plan that includes Swedish?
If you’re a current Swedish patient, be sure to read this section.

What if I want to receive care at Minor & James Medical (a Swedish health partner)?

What if I want to receive care at a Providence clinic or hospital?

What if I have more questions?

 


Do I need to choose a new health insurance plan?

If you fall into one of these groups, you may need to choose a new health insurance plan:

  1. You don’t currently have health insurance
  2.  You have an individual plan, but your insurance company is ending that plan
  3. You’re insured under your spouse’s plan provided by his or her employer, but spouses won’t be covered in the future

If you currently have a health insurance plan through your work (known as a group plan), or if you’re on Medicare, there will likely be no major changes to your coverage, and you shouldn’t need to take any action. many work group plans require re-validation. To make certain you have coverage for 2015 ask your employer if re-enrollment is required. 

If you have more questions, please give our Customer Service Line a call at 206-701-7771 between 8 a.m. and 6 p.m. Mondays through Fridays.

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If I need a new plan, when do I have to choose it?

For Those Who Currently Have An Individual Plan

The Affordable Care Act (ACA) says that all insurance plans need to meet certain minimum requirements. For instance, health plans are required to cover you even if you have a medical condition at the time you sign up for coverage. Also, preventative care, prescription drugs, maternity care, and more now have to be covered on all plans.

For Those Who Don’t Currently Have Health Insurance

With the Affordable Care Act (ACA), everyone is required to have health insurance or risk paying a tax penalty. Fortunately, if you don’t have health insurance because you can’t afford it, you may be eligible for subsidized insurance plan through the Exchange (www.wahealthplanfinder.org) where the Federal government pays for part of the costs.

If you’re uninsured and getting new coverage, or if you were on your spouse’s company plan but are being dropped from that coverage, you can purchase a plan directly from a health insurance company, or you can go through Washington State’s Health Benefit Exchange. This exchange, which you’ll find at www.wahealthplanfinder.org was set up to make it easy for people to shop and apply for health coverage online. You can also go online to see if you qualify for a lower-cost, subsidized plan.

The open enrollment period extends from Nov. 15, 2014 through Feb. 15, 2015. To have your coverage start on Jan. 1, 2015 you must select a new plan (or renew your current plan) and pay your first month's  premium no later than Dec. 23, 2014 at 5 p.m. Open enrollment ends Feb. 15, 2015. All plans must be selected by Feb.15 with the first month's premium due by Feb. 23 by 5 p.m. for coverage to be effective March 1, 2015. 

Sign up early so your insurance starts on Jan. 1, 2015. And remember, the Affordable Care Act requires everyone have a health plan by the Feb. 15, 2015 deadline or risk a tax penalty.

If you have more questions, please give our Customer Service Line a call at 206-701-7771 between 8 a.m. and 6 p.m. Mondays through Fridays.

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How do I make sure my care at Swedish is covered?

For Those Who Currently Have an Individual Plan

To be absolutely certain your individual plan includes Swedish, you should contact your  insurance company. You can also get in touch with Swedish at 206-701-7771 and we can give you the information for most health insurance companies that include Swedish in their provider networks as well as letting you know if a specific doctor is on the plan.

For Those Planning to Purchase a New Plan Through the Washington Health Benefit Exchange

If you’re planning to purchase a plan at wahealthplanfinder.org,  you should note that not all plans offered include Swedish in their networks.

When a healthcare provider is “in-network” it means the insurance company will cover a higher amount of the charges. When a provider is “out-of-network” you will pay significantly more out of pocket. Additionally, some insurance plans don't cover services received out-of-network.

When you enroll in a new plan through the Washington Health Benefit Exchange and the www.wahealthplanfinder.org website, there are six plans that include Swedish in their networks:

  • Community Health Plan of Washington
  • Coordinated Care (Ambetter Plans)
  • LifeWise Health Plan of Washington (effective Jan. 1, 2015)
  • Moda Health Plan
  • Molina Healthcare
  • Premera Blue Cross (effective Jan. 1, 2015)

If you have more questions, please give our Customer Service Line a call at 206-701-7771 between 8 a.m. and 6 p.m. Mondays through Fridays.

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Who are the insurance companies that include Swedish?

For Those Who Currently Have an Individual Plan

Most insurance companies who offer individual plan coverage in Washington State include Swedish in their provider networks. For example, plans from Premera, LifeWise, and several other companies have Swedish “in network.” For a full list of health plans click here

To be absolutely certain that a plan you’re considering includes Swedish, you should contact your insurance company. You can also get in touch with Swedish at 206-701-7771, and we can give you the information for those health plans that include Swedish in their network.

For Those Planning to Purchase a New Plan Through the Washington Health Benefit Exchange

If you're planning to enroll in a new plan through the Washington Health Benefit Exchange and the www.wahealthplanfinder.org website you should note that not all the plans offered include Swedish in their networks. When a healthcare provider is "in-network" it means the insurance company will cover a higher amount of the charges. When a provider is "out-of-network" you can still go to this provider, but you will be required to pay a larger percentage of the bill. There are six plans that include Swedish in their networks:

  • Community Health Plan of Wash9ington
  • Coordinated Care (Ambetter Plans)
  • Lifewise Health Plan of Washington (effective Jan. 1, 2015)
  • Moda Health Plan
  • Molina Healthcare
  • Premera Blue Cross (effective Jan. 1, 2015)


If you’re not familiar with these companies, you should know that all of these organizations have a long track record of caring for Washington families. Coordinated Care is a subsidiary of Centene Corporation, a Fortune 500 company founded in 1984 that operates health plans in 19 states. Molina Healthcare is another Fortune 500 company, and was founded by an emergency room physician in 1980. It now provides healthcare to 1.8 million people throughout the U.S. Community Health Plan of Washington was founded more than 20 years ago, and is the only health plan in the state founded by local community health centers. They currently serve more than 300,000 individuals and families in Washington. Founded in 2002, LifeWise covers more than 100,000 people in the state of Washington. Moda Health has been caring for members for more than 57 years. today they serve more than 1 million members in Oregon, Washington and Alaska. Premera Blue Cross and its predecessors have helped people in Washington since 1933. Today, they serve 1.7 million members in Washington and Alaska.

If you have more questions, please give our Customer Service Line a call at 206-701-7771 between 8 a.m. and 6 p.m. Mondays through Fridays.

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What if my insurance company doesn’t include Swedish?

If you choose a plan where Swedish is not “in-network,” then you’ll pay significantly higher out-of-pocket costs for care received at Swedish. Additionally, some insurance plans don't cover servcies received "out-of-network." Generally, it makes the most sense to switch to a plan that does have Swedish “in-network” for your convenience and to receive the best benefits.

If you have more questions, please give our Customer Service Line a call at 206-701-7771 between 8 a.m. and 6 p.m. Mondays through Fridays.

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Why is it important to choose a plan that includes Swedish?

If you’ve been receiving care at Swedish, it makes good sense to continue your care here, so the same physicians, care teams, technology, and medical records are readily available to you.

An equally important reason to choose a plan that includes Swedish in its network, is that there will be a limit to the maximum amount you’ll be required to pay each year for your care here. For instance, once you’ve paid a certain amount in co-pays, co-insurance, and deductibles (that amount varies depending on the plan you choose), your insurance will take over and pay 100% of your bills — there will be no more out-of-pocket costs to you.

However, if you go with an insurance plan that does not include Swedish in its network, there is no limitation on your out-of-pocket expenses each year. For people with serious chronic conditions, like cancer or heart disease, the out-of-pocket costs could easily be many thousands of dollars.

Even if you’re in perfect health, choosing a health plan that includes Swedish is a smart idea. When Swedish is in your health plan’s network, you’re making literally thousands of the area’s top physicians and the latest medical technology available to you.

There’s also the convenience you’ll enjoy of being able to see a primary care physician at one of more than 20 Swedish and Minor & James clinics throughout the region. Swedish also has five hospitals and two care centers with emergency rooms in the Puget Sound area, including locations in Seattle, Ballard, Edmonds, Mill Creek, Issaquah, and Redmond.

Swedish has been taking care of Seattle-area families for 104 years. And there’s nothing we’d like more than to continue to serve you and your family.

If you have more questions, please give our Customer Service Line a call at 206-701-7771 between 8 a.m. and 6 p.m. Mondays through Fridays.

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What if I want to receive care at Minor & James Medical (a Swedish health partner)?

All of the information provided above applies to those seeking care at Minor & James Medical. If you have questions, please give the Swedish Customer Service Line a call at 206-701-7771 between 8 a.m. and 6 p.m. Mondays through Fridays.

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What if I want to receive care at a Providence clinic or hospital?

If you have questions regarding a Providence provider, clinic or hospital call the Customer Support Line at 1-866-747-2455 between 7 a.m. and 8 p.m., Monday through Friday between 9 a.m. and 2 p.m. on Saturdays. 

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What if I have more questions?

If you still aren’t 100 percent clear on all these changes (and we’d hardly blame you!), we’d be happy to answer your questions. Please give our Customer Service Line a call at 206-701-7771 between 8 a.m. and 6 p.m. Mondays through Fridays.


If you'd like some hands-on help with selecting a new insurance plan, come to a free, public event where Swedish can assist you in applying for coverage one-on-one via the Washington Health Benefit Exchange website. Events will be held on:

  • Wednesday, Dec. 17, 11 a.m. - 6 p.m., Swedish Cherry Hill, Education Center
  • Tuesday, Jan. 13, 11 a.m. - 6 p.m., Swedish Cherry Hill, Education Center
  • Wednesday, Jan. 21, 11 a.m. - 6 p.m., Swedish Mill Creek, Conference Center


If you're unable to attend, you can make an appointment to come in for one-on-one assistance by calling the Swedish Patient Financial Advocate Team at 206-386-6996 between 8:30 a.m. and 4:30 p.m., Monday through Friday.

For general questions call 206-701-7771 between 8 a.m. and 6 p.m., Monday through Friday (except some holidays.)

Health Insurance Questions?  We’re Happy to Help.

Get in touch with the Swedish Customer Service Line at 206-701-7771 between 8 a.m.-6 p.m. Mondays through Fridays (except some holidays.)


Free Help Sessions

Drop in enrollment sessions are being held at Swedish to assist those signing up for a new plan (or renewing one) through the Health Benefit Exchange.

  • Wednesday, Dec. 17, 11 a.m.-6 p.m., Swedish Cherry Hill
  • Tuesday, Jan. 13, 2015, 11 a.m.-6 p.m., Swedish Cherry Hill

If you can't attend, then make an appointment to come in for one-on-one assistance. Call Swedish today at 206-386-6996 between 8:30 a.m. and 4:30 p.m. Monday through Friday.