Plans That Include Seattle Children’s
Is Seattle Children’s covered by your health insurance plan?
Below you will find a list of insurance companies that have contracts in place with Seattle Children’s and Children’s University Medical Group (CUMG) in order to provide in network medical care. However, many of the plans offered by these insurance companies require referrals and approved authorizations before care can be provided, and in some cases, Seattle Children’s and CUMG may not be in the highest benefit tier of your benefit plan meaning you could have higher cost sharing (e.g., copay, deductible, and/or coinsurance).
Check the current status of your plan and plan benefits
This list is updated yearly and may not reflect the current status of your plan. Also, coverage and authorization requirements change often. Please review your insurance plan benefits, network status, specialty care copays, annual deductible (both in-network and out-of-network), and coinsurance to understand your cost. See also Consumer Rights Under the Balance Billing Protection Act (PDF).
If you have questions, please call 206-987-5770 or email [email protected]. If you have questions about your specific benefit plan, please connect with your insurance company.
For mental health services coverage, see mental health coverage.
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
A
Aetna
All plans are accepted, except Medicare. Some plans require an insurance referral for services that are out-of-network.
Alaska Medicaid
Alaska Medicaid is accepted.
Allegiance
Accepted for Seattle Children’s Pediatric Cardiology of Montana location. Services outside of Montana require insurance approval and referral.
Amerigroup
Washington Apple Health plans are accepted.
Apple Health (Medicaid)
Washington Apple Health plans are accepted.
Asuris
All plans are accepted, except Medicare. (Regence Blue Shield affiliate)
B
BDCT Transplant Services
Seattle Children’s is contracted for select transplant services.
Blue Cross Blue Shield of Montana
Accepted for Seattle Children’s Pediatric Cardiology of Montana location. Services outside of Montana require insurance approval and referral.
BridgeSpan Health
Plans sold on the Washington Health Benefit Exchange are accepted. (Regence Blue Shield Affiliate)
C
Careington Dental
All plans are accepted.
CareOregon
Accepted for services referred from Oregon.
Cigna
All plans are accepted, however some plans require an insurance referral for services that are out-of-network. Please note, some plans, such as Providence, have multiple benefit tiers with different out of pocket costs. While we are contracted with those plans, Seattle Children’s and Children’s University Medical Group may not be in the highest benefit tier (i.e., out of the primary network) and your out of pocket costs may be higher. Please refer to your benefit plan booklet and Cigna for more information.
Community Health Plan of Washington
Washington Apple Health plans and Cascade Select plans, offered on the Washington Health Benefit Exchange, are accepted.
Coordinated Care
Washington Apple Health and AmBetter plans are accepted, except Cascade Select plans offered on the Washington Health Benefit Exchange.
Coventry/First Health
All plans are accepted, except Medicare.
D
Delta Dental
All plans are accepted.
E
Envolve (formerly OptiCare)
Accepted for eye services.
EyeQuest
Accepted for eye services.
F
First Choice Health Network
All plans are accepted, except Medicare.
First Health
G
Great West Healthcare
See Cigna.
Group Health Cooperative
See Kaiser Health Foundation Plan of Washington.
H
Health Net Federal Services (TriCare)
All plans are accepted. Approved referral and authorization are required from the patient’s primary care provider. Call your plan for a pre-authorization number, then call us to schedule.
HMSO (Highline Medical Services Organization)
Washington Apple Health plans are accepted. HMSO requires a referral and authorization before scheduling services.
I
Idaho Medicaid
Idaho Medicaid is accepted.
Interlink Transplant Services
Seattle Children’s is contracted for select transplant services.
K
Kaiser Health Foundation Plan of Washington (formerly Group Health Cooperative)
Core and Options plans require referral and pre-authorization from Kaiser to access Seattle Children’s at the in-network benefit level. Seattle Children’s is in-network for Access PPO members. Contact Kaiser for more information. Please note: We are not contracted with Kaiser Foundation Health Plan of the Northwest, which offers plans on the Washington Health Benefit Exchange.
Koan Risk Solutions
Seattle Children’s is contracted for select transplant services.
L
LifeSource Transplant Services
Seattle Children’s is contracted for select transplant services.
LifeTrac Transplant Services
Seattle Children’s is contracted for select transplant services.
LifeWise Health Plan of Washington
All plans are accepted, except Medicare. Seattle Children’s accepts LifeWise plans sold on the Washington Health Benefit Exchange (Premera Blue Cross Affiliate).
M
MCNA Dental
Accepted for Idaho Medicaid members.
Medicare
Seattle Children’s is enrolled in the federal Medicare program and accepts assignment.
MetLife Dental
All plans are accepted.
Molina Healthcare
Except for Medicare, all Washington Apple Health and Molina Marketplace plans are accepted.
Mountain Health CO-OP
Accepted for Seattle Children’s Pediatric Cardiology of Montana location only.
Montana Medicaid
Montana Medicaid and Montana Healthy Kids are accepted. Services outside of Montana require insurance approval and referral.
Multiplan/PHCS
All products are accepted, except Medicare. Some plans require an insurance referral for services that are out-of-network.
N
NPN
Washington Apple Health plans are accepted. NPN requires authorization before scheduling services.
O
OptumHealth Transplant Services
Seattle Children’s is contracted for select transplant services.
Oregon Health Plan Transplant Services Program
Seattle Children’s is contracted for select transplant services.
Oregon Medicaid
Accepted for services referred from Oregon.
P
PacifiCare
See United Healthcare.
PacMed US Family Health Plan (USFHP)
All plans accepted. Approved referral and authorization are required from the patient’s primary care provider. Call USFHP for a pre-authorization number, then call us to schedule.
Premera Blue Cross
Except for Medicare, Tahoma plans and Amazon plans, all plans are accepted including plans sold on the Washington Health Benefit Exchange and Premera Blue Cross of Alaska. Please note, there are networks and benefit plans that have specific primary care provider (PCP) referral requirements, specialist referral requirements, and/or in-network waiver requirements that must be submitted to Premera before scheduling for services to be covered. In addition, some plans, such as Providence and Microsoft Health Connect, have multiple benefit tiers with different out of pocket costs. While we are contracted with those plans, Seattle Children’s and Children’s University Medical Group may not be in the highest benefit tier (i.e., out of the primary network) and your out of pocket costs may be higher. Please refer to your benefit plan booklet and Premera for more information.
Principal Dental
All plans are accepted.
R
Regence BlueShield
Except for the High Performance Network, the MultiCare Accountable Health Network and Medicare all plans are accepted. Please note, some plans require an insurance referral for services that are out-of-network.
S
6 Degrees Health
McKinstry, Selland Construction, Floyd Peterson, Gig Harbor Firefighters and Northwest Framing plans are accepted. All other plans under 6 Degrees Health are out-of-network.
T
TriCare
All plans are accepted. Approved referrals and authorization are required from the patient’s primary care physician. Call TriCare for a pre-authorization number, then call us to schedule.
U
Uniform Medical Plan
All plans are accepted.
UnitedHealthcare
All plans are accepted. Approved referrals and authorization are required from the patient’s primary care physician for Charter Cascade Plan.
UnitedHealthcare Community & State
Washington Apple Health plans are accepted.
UW Medicine Accountable Care Network (Boeing Employees)
Seattle Children’s participates in the UW Medicine Accountable Care Network offered to Boeing employees and their covered dependents.
W
Washington Medicaid (Apple Health)
Washington Apple Health plans are accepted.