Insurance Plan Information

Considering Your Health Plan Options

Swedish is included in many health insurance plans. Since plan coverage can change, check with your health insurance company for specific information.

If you are selecting a plan through the Health Insurance Exchange, make sure Swedish is included in the plan's network:

2018 Medicare Advantage Plans

2018 Washington Health Benefit Exchange Plans


Please note that medical professionals providing services at Swedish may or may not be contracted with the same insurance plans as the hospital.

This insurance acceptance information applies to all Swedish campuses, Swedish Medical Group clinics, Minor and James Medical, and PET/CT Imaging, unless otherwise specified.


Aetna: Swedish is in-network with all Aetna networks, with the exception of certain Aetna Whole Health plans.

  • Aetna Whole Health, Providence Swedish Health Alliance – in-network for primary and specialty care
  • Aetna Whole Health, Polyclinic – in-network for specialty care only
  • Aetna Whole Health, Pacific Medical Center – in-network for specialty care only
  • Aetna Whole Health, Rainier Health Network – out-of-network for all services
  • Aetna Whole Health, Puget Sound Network – in-network for primary and specialty care 

Aetna’s Aexcel program is designated for high-performing doctors or groups of doctors in 12 specialty areas. Swedish doctors may or may not have Aexcel designation. Depending on your Aetna plan, seeing a non-Aexcel provider may result in a higher out-of-pocket cost. If you are interested in working with doctors with Aexcel status, have a plan that utilizes the Aexcel program and have questions, or are trying to locate Aexcel designated providers, please contact Aetna customer service for assistance.

Amerigroup: Healthy Options/Washington Apple Health and Medicare Advantage plans are accepted. Patients assigned to an Independent Practice Association (IPA) may require a special authorization from that group in order to come to Swedish.

Asuris:  

  • Swedish is in-network with the Asuris Preferred Network 
  • Swedish is out-of-network with the Asuris Individual and Family Network (RealValue)
Blue Cross Blue Shield (BCBS) Out-of-state

Swedish is in-network with most Blue Cross Blue Shield out-of-state plans.

Boeing Blue Cross Blue Shield (BCBS)

  • Swedish is in-network with the standard Boeing BCBS plan
  • Swedish is out-of-network with the UW Accountable Care Network plan

BridgeSpan: Swedish is out-of-network with all BridgeSpan plans.

Cigna:  Swedish is in-network with the Cigna PPO network (including Great West Health-GWH). Acceptance does not include discount card programs.

Community Health Plan of Washington: Swedish accepts CHPW Healthy Options/Washington Apple Health and CHPW Medicare Advantage for specialty care only, including OBGYN. Swedish is not contracted for primary care. 

Coordinated Care: Healthy Options/Washington Apple Health and Ambetter (Exchange plan) are accepted.

CorVel: Swedish is contracted with this disability management PPO.

Coventry/FirstHealth: Swedish is in-network with the First Health PPO Network. 

First Choice Health: Swedish is in-network with the First Choice Health PPO Network.

Greatwest Healthcare (now owned by Cigna): Swedish is in-network with the Cigna PPO network.

Healthsmart (formerly Interplan). Most plans are in-network.

Health Management Network (HMN): Swedish is contracted with this PPO.

Holland American Cruise Lines: Swedish is contracted with Holland America for services related to the Maritime Medical Act.

Humana: Swedish is in-network with the following Humana plans:

  • Humana Choice PPO (Medicare Advantage)
  • Humana Gold Plus HMO (Medicare Advantage)
  • Plans using the Humana commercial network (including the Choice Care Network)
  • Humana Medicare supplement plans

Patients assigned to an Independent Practice Association (IPA) may require special authorizations from that group in order to come to Swedish.

Interlink Transplant Services: Transplant related services only.

Kaiser Foundation Healthplan of Washington (formerly Group Health Cooperative):

  • Access PPO and Omni PPO: Swedish hospitals and clinics are in-network.
  • Options: Swedish hospitals are in-network. Swedish clinics are in-network with an authorization from Kaiser Permanente Washington, otherwise services will be applied to an out-of-network benefit.
  • Elect PPO: Swedish hospitals are in-network. Swedish clinics are out-of-network, unless an authorization has been obtained from Kaiser Permanente Washington.
  • Core and Medicare Advantage: Swedish hospitals are in-network. However, non-emergency services require an authorization from Kaiser Permanente Washington to come to Swedish.  Swedish clinics are out-of-network, unless an authorization has been obtained from Kaiser Permanente Washington.
  • Note, Swedish Medical Group Pine Lake accepts all Kaiser Permanente Washington plans.

Labor and Industry: L&I is accepted, including self-insured L&I carriers.

LifeWise Health Plan of Washington: All Swedish locations are considered in-network with LifeWise Preferred and LifeWise Connect networks. 

Medicaid Fee for-service/Washington Apple Health: Swedish accepts Washington State Medicaid fee-for-service, although zip codes residential restrictions may apply at some primary care locations.

Medicaid Managed Care/Healthy Options: Swedish accepts Molina, Coordinated Care, Amerigroup, United Healthcare, and, for specialty providers only, Community Health Plan of Washington as providers for the Medicaid Managed Care plans Healthy Options, Washington Apple Health, and Children’s Health Program (CHIP). Patients assigned to an Independent Practice Association (IPA) may require special authorizations from that group in order to come to Swedish.

Medicaid Out of State: Swedish will accept specialty care referrals for out-of-state patients with Medicaid. Patients referred with out-of-state Medicaid must have approval from their out-of-state Medicaid plan. If there is no approval, the services will not be paid. Please note: out-of-state Medicaid patients may not establish in primary care.

Medicare: Swedish accepts original Medicare.

Molina Healthcare: Medicaid/Healthy Options (Washington Apple Health), Medicare Advantage, and Molina “Marketplace” (Exchange plan) are in-network. Patients assigned to an Independent Practice Association (IPA) may require a special authorization from that group in order to come to Swedish.

Multiplan/PHCS: Swedish is in-network with Multiplan/PHCS PPO Network.  Acceptance does not include discount card programs.

OptumHealth: Transplant related services only.  For information on Optum Health Behavioral Solutions, please reference the Behavioral Health Networks section.

Premera Blue Cross: 

Swedish is considered in-network with the following Premera networks:
  • Premera Foundation and Foundation Plus 1
  • Premera Heritage and Heritage Plus 1
  • Premera Global
  • Premera Medicare Advantage
  • Premera Medicare Supplement
  • Premera Heritage Signature (effective Jan. 1, 2018)
Swedish is considered out-of-network with the following Premera networks.  
  • Premera Heritage Prime 
  • All Premera PersonalCare Partner networks (Swedish will be covered at the in-network benefit level by authorized referral only. Non-emergency services without an authorized referral will be considered out-of-network).

Private Healthcare Systems (PHCS)/Multiplan: Swedish is in-network with the Multiplan/PHCS PPO Network. Acceptance does not include discount card programs.

Regence Blue Shield: Swedish is in-network with all Regence networks, with the exception of:

  • UW Medicine
  • EvergreenHealth Partners-Virginia Mason
  • The Everett Clinic
  • Multicare
  • Peacehealth
  • UMP Plus – PSHVN
  • UMP Plus – UW Medicine ACN
  • Regence BlueAdvantage HMO (Medicare Advantage)
  • Regence Individual and Family (Real Value)

Soundpath Health: Swedish is in-network with Soundpath Health.  Patients assigned to an Independent Practice Association (IPA) may require a special authorization from that group in order to come to Swedish.

Three Rivers Provider Network: Swedish is out-of-network with TRPN, but will bill as a courtesy.

TRICARE: Swedish accepts TRICARE (Prime, Standard, and Extra). Zip code restrictions may apply for primary care locations. TRICARE for Life is billed secondary to Medicare and does not require a contract.

United Healthcare (UHC) and United Healthcare West (formerly PacfiCare): Swedish is in-network with most UHC products. Including most plans branded through Oxford Healthcare, AARP Medicare Complete, and Goldenrule. However, Swedish is out-of-network with UHC Charter. 

Swedish is in-network with United Healthcare Community Plan Healthy Options/Washington Apple Health. Patients assigned to an Independent Practice Association (IPA) may require special authorizations from that group in order to come to Swedish.

Uniform Medical Plan (administered by Regence Blue Shield): Swedish is in-network with UMP PPO. Swedish is out-of-network with UMP Plus – PSHVN and UMP Plus – UW Medicine AHN.

Veteran’s Affairs (VA): To have the US Department of Veterans Affairs pay for services, Veterans’ benefit recipients are required to receive care at a VA facility or have the VA authorize services at a non-VA facility (Swedish is a non-VA facility). The VA will also pay in the case of an emergency.

Veterans Affairs Patient-Centered Community Care (VAPC3) and Veterans Choice (administered by TriWest): VAPC3 and Veterans Choice program members require an authorization from TriWest to receive care at Swedish. 

Behavioral Health Networks

Some plans use other companies for Mental Health and Chemical Dependency claims. Swedish is contracted with these plans:
  • Aetna Health Management
  • Cigna Behavioral Health
  • Cenpatico (Coordinated Care)
  • Health Systems International (Intercontinental)
  • Humana (LifeSynch)
  • Optum Health Behavioral Solutions
  • Wellpoint Behavioral Health
  • Value Options

Swedish does not contract with, but will still bill:

  • Managed Health Network (MHNet) 

2018 Medicare Advantage Plans

Below is information for Swedish hospitals. For Swedish Medical Group primary care and specialty care clinics, click here

Medicare Resources

Aetna: Swedish is in-network with Aetna Medicare Advantage. 

Amerigroup: Swedish is in-network with Amerigroup Medicare Advantage. 

Community Health Plan of Washington: Swedish is in-network with Community Health Plan of Washington Medicare Advantage for specialty care only. 

Humana: Swedish is in-network with the following Humana plans:
  • Humana Choice PPO (Medicare Advantage)
  • Humana Gold Plus HMO (Medicare Advantage)
Patients assigned to an Independent Practice Association (IPA) may require a special authorization from that group in order to come to Swedish.

Kaiser Foundation Healthplan of Washington (formerly Group Health Cooperative): 

  • Hospitals: Swedish Hospitals are in-network for all Kaiser Permanente Washington Medicare Advantage plans, however, non-emergency services require an authorization from Kaiser Permanente Washington to be seen at Swedish. 
  • Clinics: Swedish Clinics are out-of-network with all Kaiser Permanente Washington Medicare Advantage plans, unless an authorization has been obtained from Kaiser Permanente Washington to come to Swedish. Swedish Medical Group Pine Lake accepts all Kaiser Permanente Washington plans.

Molina: Swedish is in-network with all Molina Medicare Advantage plans. Patients assigned to an Independent Practice Association (IPA) may require a special authorization from that group in order to come to Swedish.

Premera Blue Cross: Swedish is in-network with all Premera Medicare Advantage plans.

Providence Health Assurance: Swedish is in-network with Providence Health Assurance Medicare Advantage plans.

Regence Blue Shield: Swedish is in-network with Regence MedAdvantage PPO. Swedish is out-of-network with Regence BlueAdvantage HMO.

Soundpath Health: Swedish is in-network with Soundpath Health. Patients assigned to an Independent Practice Association (IPA) may require a special authorization from that group in order to come to Swedish.

United Healthcare: Swedish is in-network with all United Healthcare Medicare Advantage plans. Patients assigned to an Independent Practice Association (IPA) may require a special authorization from that group in order to come to Swedish.

This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.


2018 Health Benefit Exchange Plans

BridgeSpan Health: Swedish is out-of-network will all BridgeSpan plans.

Coordinated Care: Swedish is in-network with the Coordinated Ambetter Exchange plan.

Kaiser Foundation Healthplan of Washington (formerly Group Health Cooperative):

  • Hospitals: Swedish Hospitals are in-network for all Kaiser Permanente Washington Exchange plans, however, non-emergency services require an authorization from Kaiser Permanente Washington to be seen at Swedish. 
  • Clinics: Swedish Clinics are out-of-network with all Kaiser Permanente Washington Exchange plans, unless an authorization has been obtained from Kaiser Permanente Washington to come to Swedish. Swedish Medical Group Pine Lake accepts all Kaiser Permanente Washington plans.

LifeWise Health Plan of Washington: Swedish is in-network with the LifeWise Connect plan offered on the Exchange. 

Molina: Swedish is in-network with the Molina Marketplace Exchange plan.

Premera Blue Cross:

  • Premera is offering their PersonalCare Partners plans to residents of King, Snohomish and Pierce counties in 2018. For these plans Swedish will be covered at the in-network benefit level by authorized referral only. Non-emergency services without an authorized referral will be considered out-of-network.
  • For patients who reside outside of King, Snohomish and Pierce counties with a Heritage Signature EPO network plan, Swedish is considered in-network.