Insurance Plans Accepted by Swedish

Plans assigned to: Seattle Medical Group (Seoul), PSW, OCN, ICW^A,K

_{A. Specialty care only. Primary care is not covered by this plan.}

_{K. Specialty care requires approval from your Independent Physician Organization group before scheduling.}

Group/Employer/Health Insurance Marketplace plans

Aetna Whole Health- Puget Sound
Aetna Standard Plans Open Choice PPO
Aetna Standard Plans Managed Choice POS
Aetna Standard Plans Select
Aetna Standard Plans Affordable Health Choices
Aetna Standard Plans (Voluntary Plans)
Aetna Open Access Plans Choice POS II
Aetna Open Access Plans Select
Aetna Open Access Plans Elect Choice EPO
Aetna Open Access Plans Managed Choice POS
Aetna HealthFund Plans Choice POS II
Aetna HealthFund Plans Open Access Elect Choice EPO
Aetna HealthFund Plans Open Access Managed Choice POS
Aetna HealthFund Plans Open Access Aetna Select
Aetna HealthFund Plans Open Choice PPO
Aetna Premier Care Network Plus
Aetna Premier Care Network^Q

Medicare Advantage plans

Aetna Medicare PPO Choice
Aetna Medicare PPO Eagle
Aetna Medicare PPO Preferred
Aetna Medicare PPO Select
Aetna Medicare PPO SmartFit

Aetna Medicare HMO-POS Elite^B,D
Aetna Medicare HMO-POS Extra Value Plus^B,D
Aetna Medicare HMO-POS Platinum Plus^B,D
Aetna Medicare HMO-POS Prime^B,D
Aetna Medicare HMO-POS SmartFit Elite^B,D
Aetna Medicare HMO-POS Value^B,D
Aetna Medicare HMO-POS Value Plus^B,D

_{B. For primary care coverage on this plan, you must update your insurance plan to list a Swedish primary care clinician as your PCP.}

_{D. For specialty care, a referral is required if you receive primary care from a clinician outside of Swedish Medical Group.}

_{Q. The following specialty care services are not covered by this plan: cardiology, cardiothoracic surgery, gastroenterology, general surgery, neurology, neurosurgery, orthopedics, otolaryngology/ENT, and plastic surgery.}

All Group/Employer/Health Insurance Marketplace plans through Regence

Group/Employer/Health Insurance Marketplace plans

Cigna Open Access Plus (OAP)
Cigna Exclusive Provider Organization (EPO)
Cigna Preferred Provider Organization (PPO)
Cigna Medical Indemnity
Cigna Medical Network Plan
Cigna Medical Network Plan POS
Cigna Medical Network Plan Open Access POS
Cigna HMO
Cigna HMO POS
Cigna HMO Open Access
Cigna HMO Open Access POS
Cigna SureFit Plans

Medicare Advantage plans

Cigna Preferred Medicare HMO^B,D
Cigna True Choice Medicare PPO

Excluded plans (we do not accept)

Not accepted: Cigna Local Plus
Not accepted: Cigna Local Plus In-Network

_{B. For primary care coverage on this plan, you must update your insurance plan to list a Swedish primary care clinician as your PCP.}

_{D. For specialty care, a referral is required if you receive primary care from a clinician outside of Swedish Medical Group.}

Group/Employer/Health Insurance Marketplace plans

CHPW Cascade Select Gold^A
CHPW Cascade Select Silver^A
CHPW Cascade Select Bronze^A

Medicare Advantage plans

Community Health Plan of WA MA Freedom Plan HMO^AA
Community Health Plan of WA MA HMO Plan 1,2,3 & 4^AA
Community Health Plan of WA Dual Plan (HMO D-SNP)^AA
Community Health Plan of WA Dual Select (HMO D-SNP)^AA

Medicaid

CHPW Apple Health (HMO)^A

_{AA. Specialty care only. Primary care is not covered by this plan unless you already have a Swedish PCP assigned.}

Group/Employer/Health Insurance Marketplace plans

Ambetter Coordinated Care Cascade Gold
Ambetter Coordinated Care Cascade Silver
Ambetter Coordinated Care Cascade Bronze
Ambetter Balanced Care 4
Ambetter Care-Essential Care Bronze
Ambetter Care-Balance Care Silver
Ambetter Coordinated Care-Secure Care Gold
Coordinated Care Ambetter Cascade Select Gold^A
Coordinated Care Ambetter Cascade Select Silver^A
Coordinated Care Ambetter Cascade Select Plans Bronze^A

Medicaid

Coordinated Care Core Connections (Foster Care) Apple Health
Coordinated Care Apple Health (Non-Foster)^C

_{A. Specialty care only. Primary care is not covered by this plan.}

_{C. For primary care coverage on this plan, please update the PCP listed with your insurance plan to a Swedish clinician.}

CorVel Disability Management PPO

All Coventry/First Health plans utilizing the Aetna network

EHN (Employee Health Network)

All First Choice Health network plans

First Health-Coventry PPO

Health Net-TRICARE

Health Smart PPO (formerly Interplan)

Group/Employer/Health Insurance Marketplace plans

All plans using the Humana commercial network (including the Choice Care Network)

Medicare Advantage plans

Humana Honor (PPO)
Humana Choice (PPO)
Humana USAA Honor (PPO)
Humana Value Plus (HMO)^B,F,K
Humana Gold Plus (HMO) Plans^B,F,K
Humana Gold Plus SNP-DE (HMO D-SNP)^B,F,K

_{B. For primary care coverage on this plan, you must update your insurance plan to list a Swedish primary care clinician as your PCP.}

_{F. For specialty care to be covered, your PCP needs to a submit a referral with a request for authorization. This needs to be complete prior to scheduling you for these services.}

_{K. Specialty care requires approval from your Independent Physician Organization group before scheduling.}

Medicare Advantage plan

Pace Program^A,L

_{A. Specialty care only. Primary care is not covered by this plan.}

_{L. Specialty care requires referral/authorization from ICHS.}

Group/Employer/Health Insurance Marketplace plans

Elect PPO^*
Kaiser Permanente Flex Gold^A,M
Kaiser Permanente Flex Silver HD^A,M
Kaiser Permanente Flex Bronze^A,M
Kaiser Permanente Virtual Plus Silver X^A,M
Kaiser Permanente Virtual Plus Silver^A,M
Kaiser Permanente Virtual Plus Bronze^A,M
Kaiser Permanente Bronze HSA^A,M
Kaiser Permanente Bronze HSA X^A,M
Kaiser Permanente Cascade Gold^A,M
Kaiser Permanente Cascade Silver^A,M
Kaiser Permanente Cascade Bronze^A,M
Kaiser Permanente Basic Plus^A,M
Kaiser Permanente Access PPO
Kaiser Permanente WA PPO Plus (First Choice Network)
Kaiser Permanente Options (First Choice Network)
Kaiser Permanente Summit PPO (First Choice Network)

* Swedish Medical Centers are in network, but all other organizations are not

Medicare Advantage plans

Kaiser Permanente Medicare Advantage Basic (HMO)^A,N
Kaiser Permanente Medicare Advantage Optimal (HMO)^A,N
Kaiser Permanente Medicare Advantage Essential (HMO)^A,N
Kaiser Permanente Medicare Advantage Vital (HMO)^A,N
Kaiser Permanente Medicare Advantage Key (HMO)^A,N

_{A. Specialty care only. Primary care is not covered by this plan.}

_{M. Prior authorization from Kaiser is required before receiving care with us on this plan.}

_{N. Prior authorization from Kaiser is required before receiving care with us on this plan. Providence Swedish is a non-preferred provider for Kaiser Medicare plans, meaning you may pay more for care with us than you would with another provider, except for some specialties. Please inquire with Kaiser before coming for your visit.}

All L&I (including self-insured L&I carriers)

Group/Employer/Health Insurance Marketplace plans

LifeWise Cascade Care Gold
LifeWise Cascade Care Silver
LifeWise Cascade Care Bronze
LifeWise Cascade Select Gold
LifeWise Cascade Select Silver
LifeWise Cascade Select Bronze
LifeWise Essential Low Deductible
LifeWise Essential Bronze
LifeWise Essential Bronze HSA
LifeWise Essential Gold
LifeWise Health Plan of WA Preferred
LifeWise Assurance Co.
LifeWise Primary

Excluded plans (we do not accept)

Not accepted: LifeWise Alpine Cascade Select

Medicaid of WA (WA Apple Health)^S
Out-of-State Medicaid^A,O

_{A. Specialty care only. Primary care is not covered by this plan.}

_{O. Specialty care requires pre-approval from your out-of-state Medicaid plan.}

_{S. Zip code residential restrictions may apply at some primary care locations. Please check with your insurance to verify coverage before visiting a new clinic location.}

Medicare Parts A&B
Medicare Part A only^R
Medicare Part B only^RB

Note on other Medicare Parts:

Medicare Part D covers prescription drugs, which we do not provide directly. Your pharmacy may accept Medicare Part D.
Medicare Part C is also known as Medicare Advantage. You can find Medicare Advantage plans listed under the various carriers on this page. You can also find a complete list of Medicare Advantage plans we accept.

_{R. If you carry Medicare Part A only, you can be seen at hospitals, but you are not covered for outpatient primary care, specialty care or other clinic-based services.}

_{RB. If you carry only Medicare Part B, that means you can be seen for routine outpatient appointments (both Primary Care and Specialty Care) - but you do NOT have coverage for hospital admissions or stays. Please see your Medicare literature for complete rules.}

Group/Employer/Health Insurance Marketplace plans

Molina Cascade Gold
Molina Cascade Silver
Molina Cascade Bronze
Molina Constant Care Silver 1
Molina Marketplace

Medicare

Molina Medicare Choice Care (HMO)^C
Molina Medicare Complete Care (HMO D-SNP)^C
Molina Medicare Complete Care Select (HMO D-SNP)^C

Medicaid

Molina Apple Health WA (HMO)^C

_{C. For primary care coverage on this plan, please update the PCP listed with your insurance plan to a Swedish clinician.}

Group/Employer/Health Insurance Marketplace plans

Premera Blue Cross Foundation
Premera Blue Cross Foundation Plus 1
Premera Blue Cross Global
Premera Blue Cross Heritage
Premera Blue Cross Heritage Signature
Premera Blue Cross Cascade Gold
Premera Blue Cross Cascade Silver
Premera Blue Cross Cascade Bronze
Premera Blue Cross Preferred Gold EPO
Premera Blue Cross Preferred Silver EPO
Premera Blue Cross Preferred Bronze EPO
Premera Blue Cross Preferred Bronze HSA EPO
Premera Blue Cross Individual Signature

Excluded plans (we do not accept)

Not accepted: Premera Blue Cross Heritage Prime
Not accepted: Premera Blue Cross Heritage Prime HPN
Not accepted: Premera Blue Cross Peak Care (Multicare EPO/Tahoma Network)
Not accepted: Premera Blue Cross SEBB
Not accepted: Premera Blue Cross Sherwood HMO
Not accepted: Premera Blue Cross Medicare Advantage (HMO)^B,F,K
Not accepted: Premera Blue Cross Medicare Advantage Classic (HMO)^B,F,K

_{B. For primary care coverage on this plan, you must update your insurance plan to list a Swedish primary care clinician as your PCP.}

_{F. For specialty care to be covered, your PCP needs to a submit a referral with a request for authorization. This needs to be complete prior to scheduling you for these services.}

_{K. Specialty care requires approval from your Independent Physician Organization group before scheduling.}

Group/Employer/Health Insurance Marketplace plans

Providence Health Plan

Medicare

Providence Medicare Focus Medical (HMO)
Providence Medicare Select Medical (HMO-POS)
Providence Medicare Timber + RX (HMO)
Providence Medicare Extra + RX (HMO)
Providence Medicare Choice + RX (HMO-POS)
Providence Medicare Bridge 2 + RX (HMO-POS)
Providence Medicare Summit + RX (HMO-POS)
Providence Medicare Harbor + RX (HMO)
Providence Medicare Cottonwood + RX (HMO-POS)
Providence Medicare Pine + RX (HMO)

Excluded plans (we do not accept)

Not accepted: Providence Connect Network

Group/Employer/Health Insurance Marketplace plans

Regence Blue Shield
Regence Uniform Medical Plan
Regence Select Network
Regence Selections

Medicare

Regence BlueAdvantage HMO
Regence BlueAdvantage HMO Plus
Regence Valiance HMO
Regence Valiance PPO
Regence MedAdvantage + Rx Enhanced PPO
Regence MedAdvantage + Rx Classic PPO
Regence MedAdvantage + Rx Core PPO
Regence MedAdvantage + Rx Primary PPO

Excluded plans (we do not accept)

Not accepted: Regence Cascade Select
Not accepted: Regence KingCare Select
Not accepted: Regence Individual and Family Network Plans (Bronze Essential Direct, Bronze HSA, Silver, Silver HSA, Gold Direct)
Not accepted: Regence UMP Plus Plans (PSHVN, UW Medicine ACN)
Not accepted: Regence HPN (High Performance Network)

U.S. Family Health Plan (USFHP)^G
TRICARE Prime^T,H,A
TRICARE Select^T,A

_{G. Specialty care services require a referral and prior authorization. Contact your plan for full requirements.}

_{H. To receive full specialty care coverage, a referral and authorization from your PCP is required before visiting specialists.}

_{T. Zip code residential restrictions may apply. Please check with your insurance to verify coverage before visiting a new clinic location.}

Group/Employer/Health Insurance Marketplace plans

United Healthcare Core^E
United Healthcare Choice Plus^E
United Healthcare Navigate^E

Medicare

AARP Medicare Advantage (PPO)^K
AARP Medicare Advantage Patriot No Rx (PPO)^K
UHC Dual Complete (PPO D-SNP)^K
UHC Care Advantage WA (PPO I-SNP)^K
UHC Nursing Home Plan WA (PPO I-SNP)^K
AARP Medicare Advantage (HMO POS)^B,F,K
UHC Dual Complete WA (HMO-POS D-SNP)^B,F,K

Medicaid

United Healthcare Apple Health (HMO)^B,K

Excluded plans (we do not accept)

Not accepted: United Healthcare Cascade Select
Not accepted: United Healthcare Standard/Essentials
Not accepted: United Healthcare Copay Focus
Not accepted: United Healthcare Value
Not accepted: United Healthcare Advantage

_{B. For primary care coverage on this plan, you must update your insurance plan to list a Swedish primary care clinician as your PCP.}

_{E. Specialty care services may require a referral or prior authorization. Contact your plan to verify requirements.}

_{F. For specialty care to be covered, your PCP needs to a submit a referral with a request for authorization. This needs to be complete prior to scheduling you for these services.}

_{K. Specialty care requires approval from your Independent Physician Organization group before scheduling.}

All VA plans^J

_{J. VA authorization is required before receiving care.}

Medicare

Wellcare Mutual of Omaha No Premium Open (PPO)
Wellcare Patriot Giveback Open (PPO)
Wellcare Dual Access Open (PPO D-SNP)
Wellcare Mutual of Omaha Low Premium Open (PPO)
Wellcare Dual Access (HMO D-SNP)^B,F,K
Wellcare Dual Liberty (HMO D-SNP)^B,F,K
Wellcare No Premium (HMO)^B,F,K
Wellcare Giveback (HMO)^B,F,K
Wellcare Assist (HMO)^B,F,K

_{B. For primary care coverage on this plan, you must update your insurance plan to list a Swedish primary care clinician as your PCP.}

_{F. For specialty care to be covered, your PCP needs to a submit a referral with a request for authorization. This needs to be complete prior to scheduling you for these services.}

_{K. Specialty care requires approval from your Independent Physician Organization group before scheduling.}

Medicare

Wellpoint Kidney Care (HMO C-SNP)^B,D
Wellpoint Dual Advantage (HMO D-SNP)^B,D

Medicaid

Wellpoint Apple Health^B,D