Insurance & Coverage
Learn how insurance plans, benefits and healthcare provider networks affect what you pay.
Verify your health insurance coverage
Health insurance helps pay for healthcare services to keep you well or make you better if you’re sick or hurt. But health insurance can be challenging to understand. We’re here to help with information about health plans, the insurance process, billing and options if you are uninsured or underinsured.
Health insurance carriers with plans accepted by UW Medicine
UW Medicine participates in plans offered by health insurance companies, Medicare, Medicaid, Apple Health and plans available through the Washington Health Benefit Exchange.
Important message for our Medicare Advantage patients
Starting January 1, 2025, these insurers are making changes to their Medicare Advantage coverage:
- Premera Blue Cross will no longer offer Medicare Advantage products
- Premera Medicare Supplement plans will continue to be offered.
- Regence Medicare Advantage HMO plans in King County will no longer be offered
- Regence Medicare Advantage PPO plans in King County will continue to be offered.
If these changes impact your coverage, Medicare open enrollment period is October 15 to December 7 for coverage effective January 1, 2025. For any questions, contact your insurer.
As you schedule and/or arrive for your 2025 UW Medicine appointments, present your new insurance card to ensure your coverage is captured for billing purposes.
Commercial carriers
- Aetna (Note: UW Medicine does not participate in Aetna Whole Health plans)
- Boeing BlueCross BlueShield of Illinois
- Centivo Embright
- Cigna
- Embright Network
- First Choice Health Network
- Kaiser Foundation Health Plan of Washington (HMO plans require permission from Kaiser FHP before services can be provided)
- MultiPlan
- Premera Blue Cross
- Regence Blue Shield
- UnitedHealthcare
- Uniform Medical Plan administered by Regence BlueShield
Government programs
- Washington Apple Health (Managed Medicaid plans):
- Coordinated Care
- Community Health Plan of Washington (Harborview, UW Medical Center, and UW Physicians: authorized specialty care only, except primary care covered at Lopez Island clinic. Valley Medical: authorized facility services only)
- Molina Healthcare of Washington
- United Healthcare Community Plan
- Wellpoint (formerly Amerigroup)
- Washington Apple Health Expansion
- Indian Health Services
- Washington Health Benefit Exchange (Note: UW Medicine does not participate in all Exchange plans, click here for more information)
- Bridgespan Health Company
- Community Health Plan of Washington (Harborview, UW Medical Center, and UW Physicians: authorized specialty care only, except primary care covered at Lopez Island clinic. Valley Medical: authorized facility services only)
- Molina Healthcare of Washington
- Premera Blue Cross
- Regence BlueShield of Washington
- United Healthcare of Oregon, Inc.
- Washington State Medicaid
- Medicare – Original Part A and Part B
Medicare advantage
- Aetna (Note: UW Medicine does not participate in Aetna Whole Health plans)
- Community Health Plan of Washington (specialty care only)
- Humana
- Kaiser Foundation Health Plan of Washington (specialty care only)
- Molina Healthcare
- PacificSource Health Plans
- Premera Blue Cross
- Regence Blue Shield
- UnitedHealthcare
- WellCare Health Plans
- Wellpoint (formerly Amerigroup)
Balance Billing Protection Act
Effective 1/1/2020 Washington state implemented the Balance Billing Protection Act (BBPA) to offer protection from surprise medical bills. Balance Billing (also referred to as surprise billing) occurs when an out-of-network provider bills the patient for the difference between the provider's charge and the insurance company's allowed amount.
- For disclosure, healthcare facilities and providers are required to provide a list of the commercial health insurer networks in which they participate. Click here to see the networks' list for Harborview Medical Center, UW Medical Center and UW Physicians. Click here to learn more about your rights and protections. To learn more about your rights and protections in አማርኛ (Amharic), العربية (Arabic), ភាសាខ្មែរ (Khmer/Cambodian), 한국어 (Korean), ਪੰਜਾਬੀ (Punjabi), Pусский (Russian), 简体 (Simplified Chinese), Af-Soomaali (Somali), Español (Spanish), Tagalog (Tagalog), ትግርኛ (Tigrinya), 繁体 (Traditional Chinese), Tiếng Việt (Vietnamese), Українська (Ukrainian).
- These protections apply to fully insured commercial, Federal Employees Health Benefits (FEHB), Public Employees Benefits Board (PEBB), School Employees Benefits Board (SEBB), and self-funded employer sponsored.
- If you have any questions regarding your statement and balance billing, contact Patient Accounts and Support Services at 206.520.0400 or 1.855.520.0400.
Will insurance pay for my care?
The steps below can help you find out if and how much your health plan will pay.
NOTE: Insurance coverage varies among individual insurers and policies. Please call your insurance company before your visit to understand what they will pay, which providers and hospitals are in-network, and what you will need to pay out-of-pocket. It is your responsibility to provide UW Medicine staff with your insurance coverage information and to notify them if your coverage changes. Bring your insurance and photo ID cards with you to your appointment.
Check if UW Medicine is in your health plan’s network.
Your health plan documents may describe what is covered when you get care “in-network” and “out-of-network.” The differences can be substantial.
- In-network: When UW Medicine is “in-network,” it has negotiated a contract with rates for services it provides to you and other members of your health plan. Some insurance plans only pay for your services at in-network healthcare providers and facilities.
- Out-of-network: We don’t have a contract if UW Medicine is “out-of-network” for your health plan. Some plans won’t pay any of the costs if UW Medicine is not in their network or will pay lower percentages of billed charges.
While many major health insurance carriers and transplant networks have contracts with UW Medicine, it’s important to note that not every plan offered by a contracted insurer covers services at UW Medicine, so it’s a good idea to confirm.
If you need help, you can call your health plan or use its online directory of providers (often called “Find a doctor”). Please refer to the list of insurers at the top of this page for more detailed information.
Find out if your treatment needs prior approval.
Health plans often require approval for major services and treatments in advance. The health plan will not cover costs if certain treatments aren’t approved.
Your UW Medicine doctor’s office will submit a request to approve treatment to your health plan. But it’s always wise to ask your doctor, “Will my health plan need to approve this first?” The health plan notifies you and your doctor of their decision.
Learn what your portion of costs may be.
Getting a cost estimate before a major service will help you prepare for and understand your bills. You can contact us for an estimate, use the cost estimator available on MyChart or use a cost estimator on your health plan’s website.
What if I’m uninsured or underinsured?
If you are uninsured or underinsured and need assistance paying your medical bills, may be able to help. We have payment plans, discounts and financial assistance available. If you need help paying your bill, whether or not you have insurance, you may qualify for financial assistance.
Help finding a health plan
Under age 65 — The Washington Healthplanfinder can help you search for health plans available to individuals and families. You may also qualify for subsidies or coverage through Washington’s Medicaid program or Apple Health Expansion for immigrants.
Learn about the Washington Health Benefit Exchange and Apple Health »
65 or older — Trained volunteers can also help you learn about Medicare plans in Washington through the Statewide Health Insurance Benefits Advisers program. Or you can shop for plans at medicare.gov.