Insurance Accepted
Pacific Medical Centers is committed to making it simple for our valued patients to receive the care they need by offering a full range of primary and specialty services and accepting most major insurance plans.
We accept the following health insurance plans. If your plan name is not listed, we may be out of network with your plan, which will result in a higher cost share and rejected/denied referrals and/or prescriptions.
Please check with your insurance carrier for benefits and a listing of their participating network providers. This includes if you are calling for a Behavioral Health appointment.
Always check your coverage with your insurance carrier about specific care or procedures you might seek or be referred to. That way you can learn in advance what your out-of-pocket costs might be. Read more tips on getting the most out of your insurance.
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- 2025 Medicare Options Accepted
- 2025 Group, Exchange and Other Plans Accepted
- HMO/Managed Care doctor selection
- Vision Care Coverage
- Getting the Most Out of Your Health Insurance
2025 Medicare Options Accepted
- Traditional Medicare (Part B)*
- Medicare Prescription Drug coverage (Part D) – at Maxor pharmacies located in PacMed clinics
- Medicare Advantage (Part C) – PacMed accepts a variety of these plans. Please see each insurer below for their specific Medicare Advantage plans where we are in network.
- Medicare Supplemental (“Medigap”) plans can also be used to pay for care at PacMed; these plans pay secondary to Medicare and may cover an additional percentage of Medicare Part B-eligible services. PacMed accepts all Medigap plans for those who also have Medicare as primary insurance.
* Note: Medicare Part A coverage is hospital insurance; PacMed does not have a hospital so this coverage does not apply. Please check with our affiliated hospital in your area about their Medicare Part A policy in case of hospital admissions.
2025 Group, Exchange and Other Plans Accepted
Start by looking for your insurance carrier’s name, then search for your plan under the category it falls within:
- Group / Employer Plan – available to you through an employer, union, trade association or other group you belong to
- Medicare Advantage Plans* – commercial plans that replace Original Medicare, also known as Medicare Part C
- Exchange and Individual Plans – available to purchase individually on the Washington State Health Insurance Exchange
- Medicaid Plans – for those who qualify for low-income health insurance through Washington State
*Medicare Advantage Plans may vary by clinic. You can contact Connexion Insurance Solutions at 1.877.315.3279 to find a plan that meets your needs. The plans listed below are not a complete listing of Medicare 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.
Click the “+” next to an insurer to view their plans we accept.
Some insurance plans may only be accepted for specialty care appointments. Please refer to the notes section under your insurer to confirm primary care visits are covered under your plan.
Group / Employer 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 Aetna 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
Medicare Advantage Plans
• Aetna Medicare PPO Choice
• Aetna Medicare PPO Eagle
• Aetna Medicare PPO Preferred
• Aetna Medicare PPO Smartfit
• Aetna Medicare HMO-POS Elite (A, B)
• Aetna Medicare HMO-POS Extra Value (A, B)
• Aetna Medicare HMO-POS Sound Advantage (A, B)
• Aetna Medicare HMO-POS Classic (A, B)
Out of Network: N/A
Not Accepted: Exchange and Individual Plans
Not Applicable: Medicaid Plans
NOTES
A Patients must update their assigned PCP to the PacMed provider they will see.
B Specialty referrals from outside Providence Swedish or PacMed PCPs require a pre-authorization or referral from your assigned PCP.
Exchange and Individual Plans
- BridgeSpan-RealValue Network (Regence)
- BridgeSpan Cascade Bronze
- BridgeSpan Cascade Silver
- BridgeSpan Cascade Gold
- BridgeSpan Cascade Essential
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Group/Employer Plans, Medicare Plans, Medicaid Plans
Group / Employer Plans
- Community Care Alliance with Providence (HPN)
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Medicare Advantage Plans, Exchange and Individual Plans
Group / Employer 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 Point of Service
- Cigna HMO
- Cigna HMO POS
- Cigna HMO Open Access
- Cigna HMO Open Access POS
- Cigna SureFit
Medicare Advantage Plans
No Medicare Advantage plans are accepted.
Out of Network: Cigna Preferred Medicare HMO, Cigna True Choice Medicare PPO, Cigna True Choice Courage Medicare PPO, Cigna Local Plus, Cigna Local Plus In-Network
Not Accepted: N/A
Not Applicable: Exchange and Individual Plans, Medicaid Plans
Exchange and Individual Plans (A, B)
- Cascade Select Gold
- Cascade Select Silver
- Cascade Select Bronze
Medicare Advantage Plans (B, C)
- Community Health Plan of WA MA Freedom Plan HMO
- Community Health Plan of WA MA Plan 2 HMO
- Community Health Plan of WA MA Plan 4 HMO
- Community Health Plan of WA Dual Plan HMO D-SNP
- Community Health Plan of WA Dual Select HMO D-SNP
Medicaid Plans (A, B)
- Apple Health CHPW
Out of Network: N/A
Not Accepted: see notes
Not Applicable: Group/Employer Plans
NOTES
A Specialty Care only; Primary Care not accepted with this plan.
B Specialty referrals limited to Providence & Swedish as referring provider.
C Patients must update their assigned PCP to the PacMed provider they will see.
Exchange and Individual Plans
- Ambetter Coordinated Care Cascade Plans Gold (B)
- Ambetter Coordinated Care Cascade Plans Silver (B)
- Ambetter Coordinated Care Cascade Plans Bronze (B)
- Ambetter Balanced Care 4 (B)
- Ambetter Care-Essential Care Bronze (B)
- Ambetter Care-Balance Care Silver (B)
- Ambetter Coordinated Care-Secure Care Gold (B)
- Coordinated Care Ambetter Cascade Select Plans Gold (A)
- Coordinated Care Ambetter Cascade Select Plans Silver (A)
- Coordinated Care Ambetter Cascade Select Plans Bronze (A)
Medicaid Plans
- Apple Health Coordinated Care ‘Core Connections” Foster Care
- Apple Health Coordinated Care – Non-Foster (A, B)
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Group/Employer Plans; Medicare Advantage
NOTES
A Specialty Care only; Primary Care not accepted with this plan.
B Specialty referrals limited to Providence & Swedish as referring provider.
Group / Employer Plans
- All Coventry/First Health plans utilizing the Aetna network
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Medicare Advantage Plans, Exchange and Individual Plans
Group / Employer Plans
- Employee Health Network – Wholefoods
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Medicare Advantage Plans, Exchange and Individual Plans
Group / Employer Plans
- EverMed Direct Primary Care
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Medicare Advantage Plans, Exchange and Individual Plans
Group / Employer Plans
- First Choice Health Network
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Medicare Advantage Plans, Exchange and Individual Plans, Medicaid Plans
Group / Employer Plans
- Health Smart (Formerly Interplan)
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Medicare Advantage Plans, Exchange and Individual Plans, Medicaid Plans
Group / Employer Plans
- All plans using the Humana commercial network (including the Choice Care Network)
Medicare Advantage Plans
- Humana USAA Honor PPO
- Humana Honor PPO
- Humana Choice PPO
- Humana Value Plus HMO (A, B)
- Humana Gold Plus HMO (A, B)
- Humana Gold Plus SNP-DE (HMO D-SNP) (A, B)
Out of Network: Any plans not listed
Not Accepted: N/A
Not Applicable: Exchange and Individual Plans
NOTES
A Patients must update their assigned PCP to the PacMed provider they will see.
B Specialty referrals from outside Providence Swedish or PacMed PCPs require a pre-authorization or referral from your assigned PCP.
Medicare Advantage Plans:
- PACE Program (A, B)
NOTES
A Specialty Care only; Primary Care not accepted with this plan.
B Specialty referrals limited to Providence & Swedish as referring provider.
Group / Employer Plans
- 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
Medicare Advantage Plans (A, B, C)
- Kaiser Permanente Senior Advantage HMO-POS Enhanced
- Kaiser Permanente Senior Advantage HMO-POS Standard
- Kaiser Permanente Senior Advantage HMO-POS Value
- Kaiser Permanente Medicare Advantage Basic HMO
- Kaiser Permanente Medicare Advantage Optimal HMO
- Kaiser Permanente Medicare Advantage Essential HMO
- Kaiser Permanente Medicare Advantage Vital HMO
- Kaiser Permanente Medicare Advantage Harbor HMO
- Kaiser Permanente Medicare Advantage Key HMO
- Kaiser Permanente Medicare Advantage Anchor HMO
- Kaiser Permanente Medicare Advantage Columbia HMO
- Kaiser Permanente Medicare Advantage Centennial HMO
Exchange and Individual Plans (A, B)
- Kaiser Permanente Washington Bronze 9100
- Kaiser Permanente Washington HSA 7100
- Kaiser Permanente Washington Silver 750
- Kaiser Permanente Washington Gold 0
- Kaiser Permanente Washington Gold 1750
- Kaiser Permanente Basics Plus Catastrophic
- Kaiser Permanente Bronze HSA
- Kaiser Permanente VisitsPlus Gold
- Kaiser Permanente VisitsPlus Silver
- Kaiser Permanente VisitsPlus Bronze
Out of Network: See notes.
Not Accepted: See notes.
Not Applicable: Medicaid Plans
NOTES
A Specialty Care only; Primary Care not accepted with this plan.
B Prior Authorization is required.
C Kaiser Medicare Advantage (MA) and exchange/individual plans are contracted, but we are not preferred/designated as in-network. However, some specialists may be designated as in-network; please inquire with Kaiser before receiving care.
Group / Employer Plans
- Lifewise Health Plan of WA Preferred
- LifeWise Assurance Co.
- LifeWise Primary
Exchange and Individual Plans
- LifeWise Cascade Plans Gold
- LifeWise Cascade Plans Silver
- LifeWise Cascade Plans Bronze
- LifeWise Essential Plans Low Deductible
- LifeWise Essential Plans Bronze
- LifeWise Essential Plans Bronze HSA
- LifeWise Essential Plans Gold
Out of Network: LifeWise Alpine Cascade Select, LifeWise Cascade Select Public Option Plans (Gold, Silver, Bronze)
Not Accepted: N/A
Not Applicable: Medicare Advantage Plans, Medicaid Plans
Medicaid Plans (A)
- Medicaid of WA (WA Apple Health) – not accepting new patients
NOTES
A Specialty referrals limited to Providence & Swedish as referring provider.
Medicare Plans
- Medicare Part B
- Medicare Part A & B
Out of Network: N/A
Not Accepted: Medicare Part A Only (hospital services only)
Not Applicable: N/A
Exchange and Individual Plans
- Molina Constant Care Silver 1
- Molina Cascade Gold
- Molina Cascade Silver
- Molina Cascade Bronze
Medicare Advantage Plans (B)
- Molina Medicare Complete Care HMO D-SNP
- Molina Medicare Complete Care Select HMO D-SNP
Medicaid Plans (A, B)
- Molina Apple Health WA (HMO)
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Group / Employer Plans
NOTES
A Patients should be encouraged to update their assigned PCP to the PacMed provider they will see.
B Specialty referrals limited to Providence & Swedish as referring provider.
If you have Molina or other Medicaid eligibility-related questions, please call 206.621.4049.
Group / Employer Plans
- All PPO products
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Medicare Advantage Plans, Exchange and Individual Plans, Medicaid Plans
Group / Employer 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 Individual Signature
Medicare Advantage Plans
Medicare Advantage plans are no longer offered in WA state.
Exchange and Individual Plans
- Premera Blue Cross Cascade Bronze
- Premera Blue Cross Cascade Gold
- Premera Blue Cross Cascade Silver
- Premera Blue Cross Preferred Bronze EPO
- Premera Blue Cross Preferred Bronze HSA EPO
- Premera Blue Cross Preferred Gold EPO
- Premera Blue Cross Preferred Silver EPO
Out of Network: Premera Blue Cross Heritage Prime, Premera Blue Cross Heritage Prime HPN, Premera Blue Cross Peak Care (Multicare EPO/Tahoma Network)
Not Accepted: Medicare Advantage plans
Not Applicable: Medicaid plans
Group / Employer Plans
- Providence Health Plan
Medicare Advantage Plans
- Providence Medicare Reverence (HMO-POS)
- Providence Medicare Cottonwood + Rx (HMO-POS)
- Providence Medicare Pine + Rx (HMO)
- Providence Medicare Focus Medical (HMO)
- Providence Medicare Timber + Rx (HMO)
- Providence Medicare Bridge + Rx (HMO-POS)
- Providence Medicare Extra + Rx (HMO)
- Providence Medicare Choice + Rx (HMO-POS)
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Exchange and Individual Plans, Medicaid Plans
Exchange and Individual Plans
- Regence Individual and Family Network Plans Gold
- Regence Individual and Family Network Plans Silver
- Regence Individual and Family Network Plans Bronze
- Regence Individual and Family Network HSA Plans Gold
- Regence Individual and Family Network HSA Plans Silver
- Regence Individual and Family Network HSA Plans Bronze
- Regence Individual and Family Network Essential Plans Gold
- Regence Individual and Family Network Essential Plans Silver
- Regence Individual and Family Network Essential Plans Bronze
Group / Employer Plans
- Regence Blue Shield
- Regence Uniform Medical Plan
- Regence Select Network
- Regence Selections
Medicare Advantage Plans
- Regence BlueAdvantage HMO (A, B)
- Regence MedAdvantage + Rx PPO Plans Enhanced
- Regence MedAdvantage + Rx PPO Plans Primary
Out of Network: Regence KingCare Select, BCBS Embright PPO
Not Accepted: N/A
Not Applicable: Medicaid Plans
NOTES
A Patients must update their assigned PCP to the PacMed provider they will see.
B Specialty referrals from outside Providence Swedish or PacMed PCPs require a pre-authorization or referral from your assigned PCP.
Group / Employer Plans
- USFHP (Uniformed Services Family Health Plan) – All Plans (A, B)
Out of Network: TRICARE Prime, TRICARE Select
Not Accepted: N/A
Not Applicable: Medicare Advantage Plans, Exchange and Individual Plans, Medicaid Plans
NOTES
A Patients must update their assigned PCP to the PacMed provider they will see.
B Specialty referrals from outside Providence Swedish or PacMed PCPs require a pre-authorization or referral from your assigned PCP.
Group / Employer Plans
- United Healthcare Choice
- United Healthcare Choice Plus
- United Healthcare Choice Advanced
- United Healthcare Choice Plus Advanced
- United Healthcare Core
- United Healthcare Core Essential
- United Healthcare Doctors Plans
- United Healthcare EDGE
- United Healthcare Options PPO Plans
- United Healthcare Surest
- GEHA (UHC Network)
- United Healthcare Navigate (B, C)
- United Healthcare NexusACO (B, C)
- United Healthcare Signature Value Plans (B, C)
- United Healthcare Tiered Benefit Plans (B, C)
Medicare Advantage Plans
- AARP Medicare Advantage from UHC WA HMO-POS Essentials Plan (A, B)
- AARP Medicare Advantage from UHC WA HMO-POS Extras Plan (A, B)
- AARP Medicare Advantage from UHC WA HMO-POS Patriot No Rx WA Plan (A, B)
- UHC Dual Complete WA HMO-POS D-SNP Plans (A, B)
- UHC Dual Complete WA HMO-POS C-SNP Plans (A, B)
- AARP Medicare Advantage Access from UHC WA (PPO)
- AARP Medicare Advantage from UHC WA PPO Plans (Patriot No Rx)
- UHC Dual Complete PPO D-SNP
- UHC Care Advantage WA PPO I-SNP
- UHC Nursing Home Plan WA PPO I-SNP
Medicaid Plans
- United Healthcare Apple Health (HMO) (B)
Out of Network: UHC Individual/Exchange Gold, Silver, Bronze Plans (Standard, Copay Focused, Value, Advantage), UHC Cascade & Cascade EPO Gold, Silver, Bronze Plans, UHC Charter PPO, Oxford United Healthcare PPO
Not Accepted: N/A
Not Applicable: Exchange and Individual Plans
NOTES
A Specialty referrals limited to Providence & Swedish as referring provider.
B Patients must update their assigned PCP to the PacMed provider they will see.
C Specialty referrals from outside Providence Swedish or PacMed PCPs require a pre-authorization or referral from your assigned PCP.
All plans (A, B, C)
NOTES
A Specialty Care only; Primary Care not accepted with this plan.
B VA authorization needed for specialty referrals.
C Not accepting specialty referrals at this time.
Medicare Advantage Plans
- Wellcare Mutual of Omaha Premium Enhanced Open (PPO)
- Wellcare Mutual of Omaha Simple Open (PPO)
- Wellcare Patriot Giveback Open (PPO)
- Wellcare Dual Access Open (PPO D-SNP)
- Wellcare Dual Liberty Open (PPO D-SNP)
- Wellcare Dual Access (HMO-POS D-SNP) (A, B)
- Wellcare Dual Liberty (HMO-POS D-SNP) (A, B)
- Wellcare Giveback (HMO-POS) (A, B)
- Wellcare Simple (HMO-POS) (A, B)
- Wellcare Dual Reserve (HMO-POS D-SNP) (A, B)
Out of Network: N/A
Not Accepted: N/A
Not Applicable: Exchange and Commercial plans
NOTES
A Patients must update their assigned PCP to the PacMed provider they will see.
B Specialty referrals limited to Providence & Swedish as referring provider.
Medicare Advantage Plans (A, B)
- WellPoint Kidney Care (HMO C-SNP)
- WellPoint Dual Advantage (HMO D-SNP)
- WellPoint Full Dual Advantage (HMO D-SNP)
Medicaid Plans (A, B)
- WellPoint Apple Health
Out of Network: N/A
Not Accepted: N/A
Not Applicable: N/A
NOTES
A Specialty Care only; Primary Care not accepted with this plan.
B Specialty referrals limited to Providence & Swedish as referring provider.
HMO/Managed Care doctor selection
Some plans are considered HMO or Managed Care, which means they operate with a limited network of providers.
Assigning a PCP: Managed Medicare and Medicaid HMO plans require patients to receive primary care services from their assigned primary care physician (PCP), who is on file or “assigned” with your insurance plan. This assigned PCP acts as a care coordinator. Seeing specialists or other providers typically requires a referral from this assigned PCP, and those referrals are usually restricted to others within the same assigned HMO network.
Checking your assigned PCP: If you have one of these plans and would like to see a primary care physician with us, we recommend that you check with your insurance prior to your appointment to ensure the PCP you have assigned with your plan is the same one you are scheduled with. If your insurance has you assigned to a different PCP, they may not pay for your visits and any prescription or referral requests for specialized care may be denied.
Vision Care Coverage
- PacMed does not accept separate vision insurance products (such as VSP, Davis Vision, EyeMed, Humana Vision, etc.) for routine/preventative eye care from any outside insurance provider, with the exception of VSP plans for Providence Clinical Network caregivers. Vision care with PacMed is only typically covered if it is included in your medical plan’s “Summary of Benefits,” and/or associated with a medical issue (such as diabetes eye care). Even if a medical condition is present, some of your exam may not be covered if you have a separate vision plan.Before seeking vision treatment, we highly recommend that you CALL YOUR INSURANCE CARRIER and ask whether the services you are seeking are covered at PacMed. (If they confirm, ask for a call reference number for your records.)
Getting the Most Out of Your Health Insurance
We’ve put together some helpful tips to save you time and help you get the most out of your medical insurance. To maximize your health insurance benefits, please contact your insurance company’s Customer Service department for policy and benefit verification. The Customer Service phone number should be located on the back of your health insurance ID card.
- Please check with your insurance carrier for information on required referrals, authorizations and co-payments.
- Ask your insurance company about any upcoming procedures or visits to confirm coverage (see below)
- Please bring your insurance card to every appointment.
As with everything, good communication is the key to working well with insurance companies. Because policies vary, it’s important to contact your insurance company directly to confirm how your plan will pay charges for services and to keep records of the conversations.
1) Prior to your visit, ask your provider or care team:
- Is this a routine exam (i.e. an annual exam or physical)?
- Please note, if your visit is a routine annual exam or physical, your doctor will not be able to address questions about specific symptoms or health concerns, per insurance company contracts and rules. If you discuss medical issues outside the scope of a routine annual exam or physical, we are required to include that in our notes which will result in the visit being upgraded to a regular office exam, and may no longer be covered 100% by your insurance.
- What procedure (CPT) codes will likely apply to my visit/course of treatment?
2) Then, call your insurance company with your questions about their coverage of your upcoming visit. Some things you might ask:
- Do I have benefit coverage for (service name/CPT code)?
- Is a referral or preauthorization necessary to have this service? (If yes, your primary care provider must initiate the referral or preauthorization.)
- Do I have a deductible?
- Following my deductible, how much will I owe?
- How much will I be responsible for paying following the insurance coverage?
- What is the call reference number for this conversation? (use this in case you need to refer back to the call later if there are any disputes).
Do you need health insurance coverage?
If you need help finding insurance coverage for yourself or loved ones, please visit Washington Healthplanfinder.
Questions? Please call 206.621.4049.
Are you an external provider group of facility looking to refer your patient to PacMed?
Please fax in your request and all applicable chart notes to our centralized referral team at 206.505.1445.
Questions about the Affordable Healthcare Act? You can find more information here.
If you are unable to pay your full statement balance, please contact the Pacific Medical Centers Patient Accounts department at 206.621.4392 to discuss payment options.