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 you are calling for a Behavioral Health appointment, please check with your insurance carrier for benefits and a listing of their participating network providers. Always check your coverage with your insurance carrier if you have questions.

It is always a good idea to call your insurance carrier about specific care you might seek or be referred to. That way you can learn in advance what your out-of-pocket costs might be. When you call your insurance, it is a good idea to:

- Ask about specific procedure (CPT) codes.
- Get a call reference number before hanging up, in case there is any dispute down the road.
- See the bottom of this page for more tips on getting the most out of your insurance.



2021 Plans Accepted

2020 Plans Accepted


2021 Plans Accepted

** The list of 2021 PacMed plans accepted is actively rolling out. If you see “TBD” below, please check back. This list will be updated as information is finalized. **

2021 Exchange Plans accepted:

  • TBD—please check back later

2021 Medicare Plans accepted:

  • Traditional Medicare (Part B)
  • Medicare Prescription Drug coverage (Part D) – at Maxor pharmacies located in PacMed clinics
    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.
  • 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.

2021 Medicare Advantage (Part C) Plans accepted:

Aetna

    • Aetna Medicare Choice Plan (PPO)
    • Aetna Medicare Eagle Plan (PPO)
    • Aetna Medicare Elite Plan (HMO)
    • Aetna Medicare Platinum Plus Plan (HMO)
    • Aetna Medicare Prime Plan (HMO)
    • Aetna Medicare Select Plan (PPO)
    • Aetna Medicare Value Plan (HMO)
    • Aetna Medicare Value Plus Plan (HMO)

Humana

Kaiser Foundation Health Plan of Washington (GHC)*

    • Kaiser Permanente Medicare Advantage Anchor (HMO)
    • Kaiser Permanente Medicare Advantage Basic (HMO)
    • Kaiser Permanente Medicare Advantage Centennial (HMO)
    • Kaiser Permanente Medicare Advantage Columbia (HMO)
    • Kaiser Permanente Medicare Advantage Essential (HMO)
    • Kaiser Permanente Medicare Advantage Harbor (HMO)
    • Kaiser Permanente Medicare Advantage Key (HMO)
    • Kaiser Permanente Medicare Advantage Optimal (HMO)
    • Kaiser Permanente Medicare Advantage Vital (HMO) Humana Honor

* Kaiser Medicare Advantage (MA) plans are contracted, but not preferred/designated as in-network. Kaiser MA members cannot choose PacMed providers as their PCP. Prior authorization is required.


Premera Blue Cross Medicare Advantage

    • Premera Blue Cross Medicare Advantage (HMO)
    • Premera Blue Cross Medicare Advantage Classic (HMO)
    • Premera Blue Cross Medicare Advantage Core (HMO)
    • Premera Blue Cross Medicare Advantage Core Plus (HMO)
    • Premera Blue Cross Medicare Advantage Classic Plus (HMO)
    • Premera Blue Cross Medicare Advantage Charter + Rx (HMO)
    • Premera Blue Cross Medicare Advantage Alpine (HMO)
    • Premera Blue Cross Medicare Advantage Sound + Rx (HMO)
    • Premera Blue Cross Medicare Advantage Peak + Rx (HMO)
    • Premera Blue Cross Medicare Advantage Total Health (HMO)

Providence Health Plan / Providence Health Assurance

    • Providence Medicare Focus Medical (HMO)
    • Providence Medicare Select Medical (HMO-POS)
    • Providence Medicare Timber + RX (HMO)
    • Providence Medicare Extra + RX (HMO)
    • Providence Medicare Choice + RX (HMO-POS)
    • Providence Medicare Bridge 2 + RX (HMO-POS)
    • Providence Medicare Summit + RX (HMO-POS)
    • Providence Medicare Harbor + RX (HMO)
    • Providence Medicare Cottonwood + RX (HMO-POS)
    • Providence Medicare Pine + RX (HMO)

Regence BlueShield

    • Regence Valiance (PPO)
    • Regence MedAdvantage + Rx Classic (PPO)
    • Regence MedAdvantage + Rx Primary (PPO)
    • Regence MedAdvantage + Rx Enhanced (PPO)
    • Regence BlueAdvantage HMO Plus (HMO)
    • Regence Valiance (HMO)
    • Regence BlueAdvantage HMO (HMO)
    • Regence Align (HMO)
    • Regence Align Plus (HMO)

United Health Care

    • AARP Medicare Advantage (HMO)
    • AARP Medicare Advantage Choice (PPO)
    • AARP Medicare Advantage Patriot (HMO-POS)
    • AARP Medicare Advantage Plan 1 (HMO)
    • AARP Medicare Advantage Plan 1 (HMO-POS)
    • AARP Medicare Advantage Plan 2 (HMO)
    • AARP Medicare Advantage Plan 2 (HMO-POS)
    • AARP Medicare Advantage Plan 3 (HMO)
    • AARP Medicare Advantage Walgreens (HMO)
    • AARP Medicare Advantage Walgreens (HMO-POS)

For dual-eligible Medicare/Medicaid members

    • UnitedHealthcare Assisted Living Plan (PPO I-SNP)
    • UnitedHealthcare Nursing Home Plan (PPO I-SNP)
    • UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP)
    • UnitedHealthcare Dual Complete (HMO D-SNP)

2021 All Other Accepted Insurance Plans

  • TBD—please check back later


2020 Plans Accepted

2020 Exchange Plans accepted:

  • Kaiser Foundation Health Plan of WA (specialty only with authorization)
  • Molina Marketplace - Exchange
  • Premera Lifewise Plans

2020 Medicare Plans accepted:

  • Traditional Medicare (Part B)
  • Medicare Prescription Drug coverage (Part D) – at Maxor pharmacies located in PacMed clinics

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.

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.


2020 Medicare Advantage Plans accepted (Part C):

  • Aetna Medicare Advantage PPO and HMO
  • AARP Medicare Advantage through UnitedHealthcare®
  • Humana HMO and PPO
  • Kaiser Foundation Health Plan of Washington (prior authorization is required)
  • Premera Blue Cross Medicare Advantage
  • Providence Health Plan / Providence Health Assurance
  • Regence BlueShield HMO and PPO

*Plans may vary by clinic. Please contact Connexion Insurance Solutions at 1-877-315-3279 to find a plan that meets your needs.

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.


2020 All Other Accepted Insurance Plans

Do you need 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.


Tips for saving time and getting the most from your medical insurance

We’ve put together some helpful tips to save you time and help you get the most out of your medical insurance. 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.

Prior to calling your insurance company, ask your provider:

  • Is this a routine exam (i.e. an annual exam or physical)?
  • What procedure (CPT) codes will apply to my visit/course of treatment?

When you call your insurance company, have a set of questions ready to ask. Some suggestions are:

  • Do I have benefit coverage for (insert 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 am I 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 with another agent)

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 and authorizations and co-payments.

Please bring your insurance card to every appointment.

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.