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

Medicare Advantage plans

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

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

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

Medicare Advantage plans

Cigna HealthSpring Preferred (HMO)
Cigna HealthSpring True Choice (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 Bronze^A
CHPW Cascade Select Gold^A
CHPW Cascade Select Silver^A

Medicare Advantage plans

Community Health Plan of WA Dual Plan (HMO D-SNP)^AA
Community Health Plan of WA Dual Select (HMO D-SNP)^AA
Community Health Plan of WA MA Freedom Plan HMO^AA
Community Health Plan of WA MA HMO Plan 1,2,3 & 4^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 Balanced Care 4
Ambetter Care-Balance Care Silver
Ambetter Care-Essential Care Bronze
Ambetter Coordinated Care Cascade Bronze
Ambetter Coordinated Care Cascade Gold
Ambetter Coordinated Care Cascade Silver
Ambetter Coordinated Care-Secure Care Gold
Coordinated Care Ambetter Cascade Select Gold^A
Coordinated Care Ambetter Cascade Select Plans Bronze^A
Coordinated Care Ambetter Cascade Select Silver^A

Medicaid

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

_{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 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 Choice (PPO)
Humana Dual Select H5619-165 (HMO D-SNP)^B,F,K
Humana Gold Plus (HMO) Plans^B,F,K
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)^B,F,K
Humana Gold Plus Giveback H1036-319 (HMO)
Humana Gold Plus SNP-DE (HMO D-SNP)^B,F,K
Humana Together in Health (PPO I-SNP)
Humana USAA Honor Giveback (PPO)

_{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 Access PPO
Kaiser Permanente Basic Plus^A,M
Kaiser Permanente Bronze HSA^A,M
Kaiser Permanente Bronze HSA X^A,M
Kaiser Permanente Cascade Bronze^A,M
Kaiser Permanente Cascade Gold^A,M
Kaiser Permanente Cascade Silver^A,M
Kaiser Permanente Options (First Choice Network)
Kaiser Permanente Summit PPO (First Choice Network)
Kaiser Permanente Virtual Plus Bronze^A,M
Kaiser Permanente Virtual Plus Silver^A,M
Kaiser Permanente Virtual Plus Silver X^A,M
Kaiser Permanente VisitsPlus (Gold, Silver, Bronze)^A,M
Kaiser Permanente WA Core HMO^A,M
Kaiser Permanente WA Core Select^A,M
Kaiser Permanente WA PPO Plus (First Choice Network)

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

Medicare Advantage plans

Kaiser Permanente Medicare Advantage Anchor^A,N
Kaiser Permanente Medicare Advantage Basic (HMO)^A,N
Kaiser Permanente Medicare Advantage Centennial^A,N
Kaiser Permanente Medicare Advantage Columbia^A,N
Kaiser Permanente Medicare Advantage Essential (HMO)^A,N
Kaiser Permanente Medicare Advantage Harbor^A,N
Kaiser Permanente Medicare Advantage Key (HMO)^A,N
Kaiser Permanente Medicare Advantage Optimal (HMO)^A,N
Kaiser Permanente Medicare Advantage Vital (HMO)^A,N
Kaiser Permanente Senior Advantage Enhanced (HMO-POS)^A,N
Kaiser Permanente Senior Advantage Standard (HMO-POS)^A,N
Kaiser Permanente Senior Advantage Value (HMO-POS)^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 Alpine Cascade Select^A
LifeWise Assurance Co.
LifeWise Cascade Care Bronze
LifeWise Cascade Care Gold
LifeWise Cascade Care Silver
LifeWise Cascade Select Bronze^A
LifeWise Cascade Select Gold^A
LifeWise Cascade Select Silver^A
LifeWise Essential Bronze
LifeWise Essential Bronze HSA
LifeWise Essential Gold
LifeWise Essential Low Deductible
LifeWise Health Plan of WA Preferred
LifeWise Primary

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

Medicare

AgeRight Advantage Health Plan (HMO-I-SNP)
AgeRight Advantage Plus Health Plan (HMO-I-SNP)

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

Note on other Medicare Parts:

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.
Medicare Part D covers prescription drugs, which we do not provide directly. Your pharmacy may accept Medicare Part D.

_{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 Bronze
Molina Cascade Complete (Gold, Silver)
Molina Cascade Gold
Molina Cascade Silver
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 Cascade Bronze
Premera Blue Cross Cascade Gold
Premera Blue Cross Cascade Silver
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 Individual Signature
Premera Blue Cross Preferred Bronze EPO
Premera Blue Cross Preferred Bronze HSA EPO
Premera Blue Cross Preferred Gold EPO

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

_{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 Extra + RX (HMO)
Providence Medicare Focus Medical (HMO)
Providence Medicare Pine + RX (HMO)
Providence Medicare Reverence (HMO-POS)
Providence Medicare Timber + RX (HMO)

Excluded plans (we do not accept)

Not accepted: Providence Connect Network

Group/Employer/Health Insurance Marketplace plans

Bronze 8000
Bronze Essential 8500
Bronze Essential 9000
Bronze HSA 7000
Bronze HSA 7750
Gold 2000
Regence Blue Shield
Regence Cascade Bronze
Regence Cascade Complete Gold
Regence Cascade Silver
Regence Cascade Vital Gold
Regence Select Network
Regence Selections
Regence Uniform Medical Plan
Silver 5000
Silver HSA 4500

Medicare

Regence BlueAdvantage HMO (HMO)
Regence MedAdvantage + Rx Enhanced (PPO)
Regence MedAdvantage + Rx Primary (PPO)

Excluded plans (we do not accept)

Not accepted: Regence HPN (High Performance Network)
Not accepted: Regence KingCare Select

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

_{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 Choice Plus^E,QT
United Healthcare Core^E,QT
United Healthcare Navigate^E,QT

Medicare

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

Medicaid

United Healthcare Apple Health (HMO)^B,K,QT

Excluded plans (we do not accept)

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

_{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.}

_{QT. Organ transplant services are not covered by this plan.}

All VA plans^J

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

Medicare

Wellcare Dual Access Open (PPO D-SNP)
Wellcare Dual Liberty (PPO D-SNP)
Wellcare Mutual of Omaha Premium Enhanced Open (PPO)
Wellcare Mutual of Omaha Simple Open (PPO)
Wellcare Patriot Giveback Open (PPO)

_{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 Dual Advantage (HMO D-SNP)^B,D
Wellpoint Full Dual Advantage (HMO D-SNP)^B,D

Medicaid

Wellpoint Apple Health^B,D

Health Insurance Marketplace plans

Cascade Complete Gold
Cascade Silver
Cascade Vital Gold