INSURANCE INFORMATION

We are in-network and a preferred provider with the following insurers

PLEASE confirm we are in network with YOUR plan!

  1. HOVER OVER YOUR INSURANCE LOGO ABOVE

  2. CLICK THE LINK TO BE REDIRECTED TO YOUR INSURANCE PLAN

  3. LOGIN AND UTILIZE THE “FIND A DOCTOR” TOOL TO CONFIRM WE ARE “IN NETWORK”

  4. YOUR INSURANCE MIGHT WANT TO KNOW:

Insurance is a complicated industry to navigate and since each plan is unique, we cannot guarantee coverage for patients.

  • Ultimately, it is your responsibility to confirm coverage with your plan.

Unable to confirm based on using the website link above?

  • Then, we suggest using the # on the back of your insurance card to confirm we’re in network.

Aetna

for women’s health services and mental health services, WE ARE “IN-NETWORK” WITH THE FOLLOWING aetna PARTICIPATING NETWORKS:

  • Open Choice Network | Managed Choice Network | Elect Choice Network | Aetna Premier Care Network

physical therapy is not in network with aetna.

First Choice Health Network

We are “in-network” with all First Choice Health network plans.

Kaiser Permanente

WE ARE not “IN-NETWORK” WITH the general kaiser plan.

We are “in-network” with Kaiser Options PPO plan through First Choice Health network.

Premera

WE ARE “IN-NETWORK” WITH THE FOLLOWING PREMERA PARTICIPATING NETWORKS:

  • Global | Heritage & Heritage Plus 1 | Heritage Prime | Heritage Signature | LifeWise Assurance Company | LifeWise Connect | LifeWise Health Plan of WA Preferred

Regence

WE ARE “IN-NETWORK” WITH THE FOLLOWING regence PARTICIPATING NETWORKS:

  • Unfortunately, at this time we are not “in-network” with the UW Medicine ACN network.

For Those Whom SWMC is “Out of Network” Or Uninsured

OH NO, YOUR PLAN IS NOT LISTED ABOVE… DON’T WORRY.

  • When you have insurance, but not a plan we accept, you can receive care at the cash rate (due at time of service).

    • Then, you submit a “Superbill” to your insurance plan for reimbursement of some or all of the costs.

  • You’ll want to know through your insurance plan what your “out of network” reimbursement rate is.

    • If your “out of network” reimbursement rate is 90% for example and your clinic fees are $200, you’ll pay the clinic $200 at time of service, receive the “superbill” receipt, submit it to your insurance and they will reimburse you for 90% of $200, so $180, therefore YOUR out-of-pocket fees in the end are $20.

  • Email us if this is you and you have questions. No need to email us if you’re familiar with this and have no questions :)

YOU DON’T HAVE INSURANCE?

  • We offer cash rates, which are due at time of service. Email us to inquire about this option.

WHY DOES SWMC NOT TAKE YOUR INSURANCE?

  • Insurance companies compensate healthcare providers/facilities differently and SWMC has chosen to contract with payors (insurers) that reimburse the clinic fairly and appropriately for the services we provide.  A great quote in a helpful article on this subject (Which Doctors or Healthcare Facilities Accept Insurance Varies) explained it well in non-medical terms:

    • "Here's another way to think about it. Suppose you went to work and did your job well. When it came time to get your paycheck, your employer told you he had decided your services weren't really worth what you expected to be paid, so he was going to begin paying you less. Take it or leave it. That's the position doctors are put in by payers each year."

Understanding Insurance