COVID-19 Update: 

Please continue to wear a mask in UW Medicine facilities even if fully vaccinated. All patients and visitors will be screened for COVID-19 symptoms upon entry. Learn how to get vaccinated.

 

Kaiser Permanente

Patients who have health insurance through Kaiser Permanente may experience a change in coverage for services provided by UW Medicine. Kaiser Permanente's contracts with UW Medicine expired on May 31, 2021. Services at UW Medicine may no longer be included in your benefits unless you are a Kaiser commercial PPO plan member or are a commercial HMO member allowed continuing coverage by Kaiser for active treatment (as described in FAQs below). This means that many Kaiser Permanente patients receiving care at UW Medicine sites after June 1, 2021, will be considered "out-of-network" and may be required to pay a larger out-of-pocket amount, possibly up to the entire billed amount.

UW Medicine entities and locations include:

  • Harborview Medical Center
  • UW Medical Center
  • Valley Medical Center and clinics
  • Valley Medical Group
  • UW Physicians
  • UW Neighborhood Clinics
  • Services provided by UW Physicians at Seattle Cancer Care Alliance

Patients will need to make arrangements to transfer care to another provider or facility covered by Kaiser Permanente, effective June 1, 2021. If you choose to receive your care at UW Medicine after the contract expiration date, Kaiser Permanente may not cover the charges and you may be responsible for a greater out-of-pocket amount, possibly up to the full charge amount.

Please call the number on your Kaiser Permanente health insurance card with any questions regarding authorization for services that are scheduled on or after June 1, 2021. If your health insurance plan is sponsored by your employer, we encourage you to contact your employer’s Human Resources or Benefits department and request a plan that includes UW Medicine. If you want to continue care with UW Medicine at your own expense, you can also inquire about self-pay options by calling our Contact Center at 855.520.2282.

We value our relationship with you and hope to continue to provide the highest quality medical services to you and your family. For more information, please review the Frequently Asked Questions (FAQs) below. If you have questions, please contact our Contact Center at 855.520.2282.

Frequently Asked Questions – Kaiser Permanente Contract Expiration


UW Medicine’s contract with Kaiser Permanente is set to expire on May 31, 2021 unless it is renewed. UW Medicine entities and locations include:

  • Harborview Medical Center
  • UW Medical Center
  • Valley Medical Center and clinics
  • Valley Medical Group
  • UW Neighborhood Clinics
  • UW Physicians
  • Services provided by UW Physicians at Seattle Cancer Care Alliance.


This potential expiration will affect all patients with Kaiser Permanente Commercial or Medicare Advantage coverage that allows members to receive care at UW Medicine entities including UW Medical Center, Harborview Medical Center, Valley Medical Center and clinics, Valley Medical Group, UW Neighborhood Clinics, and services provided by UW Physicians at Seattle Cancer Care Alliance.


Should the contracts expire, effective June 1, 2021, services at UW Medicine may no longer be included in your benefits unless you are a Kaiser commercial PPO plan member or are a commercial HMO member allowed continuing coverage by Kaiser for active treatment (as described below). This means that many Kaiser Permanente patients receiving care at UW Medicine sites on or after June 1, 2021, will be considered "out-of-network" and may be required to pay a larger out-of-pocket amount, possibly up to the entire billed amount.


Kaiser commercial PPO members will be able to receive covered services from UW Medicine for the foreseeable future (post-expiration) based on Kaiser’s participation in the First Choice Health Network which is contracted with UW Medicine. Kaiser HMO members that seek care will not have this access.


HMO patients that are inpatient the day the contract expires will be covered for those inpatient services for 90 days after expiration under Kaiser’s continuity of care policy. Likewise, services provided by UW Physicians and Valley Medical Group to HMO members to complete active treatments that began prior to expiration, will be covered for 90 days (the 90-day limit does not apply to maternity services, which may be covered longer).

For HMO patients that received an authorization prior to the contract expiration, Kaiser has agreed to honor the authorization of services (including obstetrics and cancer patients).


Yes, but you may be required to pay out of pocket unless you are a Kaiser commercial PPO patient or Kaiser Permanente has entered into an individual case arrangement with UW Medicine for your case.


Check with your insurance plan regarding your out-of-network benefits. If your health insurance plan is sponsored by your employer, we encourage you to contact your employer’s Human Resources or Benefits department and request a plan that includes UW Medicine. If you want to continue care with UW Medicine at your own expense, you can also inquire about self-pay options by calling our Contact Center at 855.520.2282.


Coverage for pregnancy and birth depends on whether you are a Kaiser commercial PPO or HMO member. PPO patients will continue to access coverage for services beyond May 31, 2021 through Kaiser’s agreement with First Choice Health Network which is contracted with UW Medicine. For HMO patients that that received an authorization prior to the contract expiration (including obstetrics patients), Kaiser has agreed to honor coverage.


Kaiser PPO members will continue to have access to UW Medicine transplant services through Kaiser’s participation in the First Choice Health Network. Kaiser will honor authorizations for transplant services to HMO members for services beyond May 31, 2021. Patients should contact Kaiser Permanente to determine what their out-of-pocket expenses will be.

New transplant patients covered under a Kaiser Permanente HMO plan will not be considered "contracted" or "in-network" for transplant services. Patients covered under a Kaiser Permanente PPO plan will be considered “contracted” under Kaiser’s participation in the First Choice Health Network which is contracted with UW Medicine. If you are in the process of being evaluated for transplant please contact Kaiser Permanente for clarification on "contracted" or "in-network" care options.


Coverage for oncology services depends on whether you are a Kaiser commercial PPO or HMO member, and when you received prior authorization for care. PPO patients will continue to access coverage for services beyond May 31, 2021 through Kaiser’s agreement with First Choice Health Network which is contracted with UW Medicine. HMO members who received prior authorization for services before contract expiration, will be covered for 90 days for in-progress cancer-related services provided by UW Physicians and Valley Medical Group services.

Services provided by UW Physicians to HMO members to complete active treatments at the Seattle Cancer Care Alliance (SCCA) that began prior to expiration, will be covered for 90 days. For all other patients, services provided by UW Physicians at Seattle Cancer Care Alliance (SCCA) will no longer be considered "contracted" or "in-network" after May 31, 2021. This means that patients may need to pay a larger out-of-pocket amount for bills for UW Physicians services at SCCA.


Please call Kaiser Permanente at the phone number on your insurance card and ask for a list of in-network doctors and facilities.


Please contact our Release of Information department at 206.744.9000, Monday through Friday, 7:30 a.m. – 4:30 p.m. Valley Medical Center patients should call 425.690.3406 between 8 a.m. and 4:30 p.m. or visit valleymed.org/records.


This change does not affect referrals or transfers of Kaiser members to one of our UW Medicine hospitals for emergency medical care. You can always access any of our emergency rooms or standalone emergency care centers, regardless of insurance. Emergency services are covered under your benefits, but if you are subsequently admitted to a UW Medicine hospital you may incur higher out-of-pocket costs.


Charges for services provided before May 31, 2021 will still be processed as normal. Beginning June 1, 2021, claims may be processed as an out-of-network benefit depending on your insurance plan.


Charges for services provided before June 1, 2021 will still be processed as normal.


Yes. Patients will continue to have access to MyChart accounts.

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