Accepted insurance plans in Seattle and Tacoma

Accepted Networks:

• Aetna Aexel Network*
• Aetna Premier Care Network*
• Aetna Premier Care Network with Aetna Managed Pharmacy
• Aetna Whole Health-Puget Sound Network
• Aetna Whole Health-Puget Sound Network with Aetna Managed Pharmacy Network
• Elect Choice Network
• Elect Choice Network with Aetna Managed Pharmacy
• Managed Choice Network
• Managed Choice Network with Aetna Managed Pharmacy
• Open Choice Network
• Open Choice Network with Aetna Managed Pharmacy Network

*Aetna Aexel Network is designated for, Gastroenterology, General Surgery, Plastic surgery, and Urology. You may have higher copays and co-insurance if you see a non-designated provider.

Accepted Networks:

In network through Regence Blue Shield

• Regence Participating Provider Network
• Regence Preferred Provider Network

Accepted Networks:

• Washington OAP Direct Network
• Washington OAP with National Pharmacy Network
• Washington PPO-PPA Direct Network
• Washington PPO-PPA Direct with National Pharmacy

Accepted plans utilizing the following network: 

• First Choice Health Preferred Network

Accepted plans utilizing the following network: 

• First Health*

*In-network though Aetna rental agreement

Accepted networks:

• Access PPO
• Options Federal (formerly Omni PPO)
• Options*
• KP Plus**

*Members must have prior authorization for in-network benefits; Out-of-network benefits apply without prior health plan authorization. 

**Members must have prior authorization for In-network benefits; Out-of-network benefits apply without prior authorization (Limited benefit. See KPWA benefit summary for limitations). 

Out-of-network networks:

• Core* (Exchange)
• Virtual Plus/Connect*
• Elect PPO*

*Although out-of-network, with approved prior authorization the claim will process with your in-network benefits.

Optum Care Washington will accept new L&I claims, including self-insured L&I carriers.

Optum Care Washington works with a number of fishing vessel companies to provide health care coverage to crew members covered under The Jones Act.

Optum Care Washington will establish care with new patients after a motor vehicle accident, only if we are contracted with your medical insurance carrier. Your MVA insurance will be billed as a courtesy but if there is no PIP coverages or if no payment is received after 60 days, then your medical insurance will be billed.

Please contact your MVA insurance company with any coverage questions.

Multiplan rebranded to Claritev in 2025.

Accepts plans with Primary Networks:

• PHCS

Accepts plans with Complementary Networks:

• Multiplan

  Claims that utilize complementary networks may pay for Covered Services at an in or out of network benefit level. Contact your payer directly for any questions.

Accepted plans with OptumHealth Vision (formerly known as Spectera).

Accepted Networks:

• Global
• Heritage
• Heritage and Dental Choice
• LifeWise Assurance Co. 
• LifeWise Health Plan of Washington Preferred
• Sherwood HMO*
• Sherwood HMO and Dental Choice*
• Heritage Prime (Exchange)
• Heritage Signature (Exchange)
• Heritage Signature and Dental Choice (Exchange)
• Individual Signature (Exchange)

*OB and Transplant Services are excluded from our contract and are considered Out of Network Services.

Accepted Networks:

• Participating Provider Network
• Preferred Provider Network
• UMP Puget Sound High Value Network

Not contracted. This may result in higher out-of-pocket expenses. Contact Tricare for cost share information.

Accepted Networks:

• Charter and Charter with Standard SelectRx (Exchange)
• Choice and Choice with Standard SelectRx
• Core and Core with Standard SelectRx
• Navigate and Navigate with Standard SelectRx
• Options and Options with Standard SelectRx
• SignatureValue and SignatureValue with Standard SelectRx
• Select and Select with Standard SelectRx
• NexusACO and Nexus ACO with StandardRX
• Doctors Plan and Doctors Plan with Standard SelectRx

Optum Care Washington uses US Anesthesia Partners (USAP) to provide anesthesia services for some surgeries in our plastic surgery department and at First Hill Surgery Center. USAP is out-of-network with UnitedHealthcare as of September 1, 2019. 

Please ask your insurer to see how this might affect your coverage.

Accepted Networks:

In network through Regence BlueShield 

• Regence Participating Provider Network
• Regence Preferred Provider Network
• Regence UMP Plus Puget Sound High Value Network*

*Optum Care Washington is not contracted with UMP Plus UW network.

Accepted Medicare Advantage plans:

Learn more about Aetna Boeing Retiree Medicare Advantage plan.

Accepted Medicare Advantage plans:

• Humana Medicare Advantage (HMO)
• Humana Medicare Advantage (PPO)
• Humana Medicare Advantage (SNP-DE)

Learn more about Humana Medicare Advantage plans.

Accepted plans: 

We accept Original Medicare Part B for established patients only. For the most updated information, please call the provider’s office directly.

Accepted plans:

• UnitedHealthcare Medicare Advantage (HMO)
• UnitedHealthcare Medicare Advantage (PPO)
• UnitedHealthcare Medicare Advantage (D-SNP)
• UnitedHealthcare Medicare Advantage (I-SNP)

Learn more about Medicare Advantage plans from UnitedHealthcare.

View plan seminar schedules from UnitedHealthcare Medicare Advantage.

Community Health Plan of Washington is not contracted with Shoreline and Puyallup locations. Learn more about Community Health Plan of Washington.

Learn more about Coordinated Care.

Molina Healthcare is not contracted with Shoreline and Puyallup locations. Learn more about Molina Healthcare of Washington.

Wellpoint is not contracted with Shoreline and Puyallup locations. Learn more about Wellpoint Washington.