Haris Ashley
UW Medicine participates in plans offered by health insurance companies, Medicare, Medicaid, Apple Health, and plans available through the Washington Health Benefit Exchange. UW Medicine is in-network for several health insurance plans offered through the exchange, the Washington Healthplanfinder. UW Medicine does not participate in all Exchange plans, and it is important to note that insurance coverage varies among individual insurers and policies. UW Medicine is in-network with some Medicaid plans, with some exceptions. For those who are uninsured or underinsured, UW Medicine offers payment plans, discounts, and financial assistance.
| Characteristics | Values |
|---|---|
| Insurance plans | Medicare, Medicaid, Apple Health, Washington Health Benefit Exchange, Kaiser Foundation Health Plan of Washington, Community Health Plan of Washington |
| Availability | UW Medicine is "in-network" for several health insurance plans offered through the exchange, the Washington Healthplanfinder |
| Cost | Generally, you pay less out of pocket when visiting in-network providers. Out-of-network visits may require higher out-of-pocket costs or copays, or may not be covered at all. |
| Enrollment | Open enrollment ended on January 15, 2025. A special enrollment period (SEP) allows enrollment if an individual has a qualifying life event. |
| Eligibility | All US citizens, legal permanent residents, and student visa holders are eligible to apply for insurance through the exchange, regardless of income and other criteria. |
| Financial assistance | UW Medicine offers payment plans, discounts, and financial assistance for those who are uninsured or underinsured and need help paying medical bills. |
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What You'll Learn
- UW Medicine is in-network for several health insurance plans offered through the exchange
- UW Medicine does not participate in all Exchange plans
- UW Medicine is in-network with some Medicaid plans
- UW does not offer health insurance to domestic students
- UW Medicine is in-network with the Community Health Plan of Washington (CHPW) Apple Health plan
UW Medicine is in-network for several health insurance plans offered through the exchange
UW Medicine is "in-network" for several health insurance plans offered through the Washington Health Benefit Exchange, also known as the Washington Healthplanfinder. This means that patients with these insurance plans will generally pay less out of pocket when they visit UW Medicine healthcare providers. Going out-of-network may result in higher out-of-pocket costs, such as deductibles or copays, or services may not be covered at all.
The specific insurance plans that UW Medicine participates in include Kaiser Foundation Health Plan of Washington, Community Health Plan of Washington (Apple Health), and UnitedHealthcare of Oregon, Inc. (Cascade Bronze, Silver, and Gold). UW Medicine is also in-network with some Medicaid plans, although there may be exceptions.
It is important to note that insurance coverage can vary among individual insurers and policies. Patients are responsible for providing UW Medicine with their insurance coverage information and notifying them of any changes. To understand their coverage, patients should contact their insurance company before their visit to confirm which providers and hospitals are in-network and what out-of-pocket costs they may incur.
For those who are uninsured or underinsured, UW Medicine offers payment plans, discounts, and financial assistance. Additionally, Washington state has implemented the Balance Billing Protection Act to protect residents from surprise medical bills, which occur when an out-of-network provider bills the patient for the difference between the provider's charge and the insurance company's allowed amount.
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UW Medicine does not participate in all Exchange plans
UW Medicine participates in plans offered by health insurance companies, Medicare, Medicaid, Apple Health, and plans available through the Washington Health Benefit Exchange. However, it is important to note that UW Medicine does not participate in all Exchange plans.
The Washington Health Benefit Exchange offers a range of health insurance plans, including Apple Health (Medicaid) and the Washington Health Exchange. Apple Health is available for individuals and households with a countable income of under 138% of the Federal Poverty Table (FPT), while the Washington Health Exchange is designed for those without employer-sponsored health insurance or those eligible for Apple Health.
UW Medicine is "in-network" for several health insurance plans offered through the Washington Healthplanfinder, which is the state's health insurance marketplace. Being in-network means patients generally pay less out of pocket when visiting UW Medicine healthcare providers. Going out-of-network may result in higher out-of-pocket costs, such as deductibles or copays, or services may not be covered at all.
While UW Medicine participates in many Exchange plans, it is important for patients to verify their specific plan's coverage for services through UW Medicine. Some plans, such as Community Health Plan of Washington (CHPW) Apple Health, offer authorized specialty care at Harborview, UW Medical Center, and for UW Physicians, but primary care is only covered at the Lopez Island clinic.
Additionally, UW Medicine does not participate in all insurance plans. For example, as of June 1, 2025, Aetna may no longer be contracted with UW Medicine, and UW Medicine does not participate in Aetna Whole Health plans. Patients should always check with their insurance company before their visit to understand their coverage and which providers are in-network.
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UW Medicine is in-network with some Medicaid plans
UW Medicine participates in plans offered by health insurance companies, Medicare, Medicaid, Apple Health, and plans available through the Washington Health Benefit Exchange. UW Medicine is "in-network" for several health insurance plans offered through the exchange, the Washington Healthplanfinder. Generally, patients pay less out of pocket when they visit healthcare providers that are in-network. Going out-of-network may require patients to pay more toward their deductible or in a copay, or the service may not be covered at all.
There are five managed care organizations (MCOs) that are contracted with Washington State to manage the care of people with Medicaid. The benefits are standard across the plans, but the network of providers differs. UW Medicine is in-network with some Medicaid plans, with some exceptions. Members can receive primary care at UW Medicine Lopez Island Clinic only with the Cascade Select and Essential Plans.
If you are uninsured or underinsured and need assistance paying your medical bills, UW Medicine may be able to help. They offer payment plans, discounts, and financial assistance. If you need help paying your bill, whether or not you have insurance, you may qualify for financial assistance. Under age 65, The Washington Healthplanfinder can help you search for health plans available to individuals and families. You may also qualify for subsidies or coverage through Washington’s Medicaid program or Apple Health Expansion for immigrants.
It is important to note that insurance coverage varies among individual insurers and policies. Patients should call their insurance company before their visit to understand what they will pay, which providers and hospitals are in-network, and what they will need to pay out-of-pocket. It is the patient's responsibility to provide UW Medicine staff with their insurance coverage information and to notify them if their coverage changes.
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UW does not offer health insurance to domestic students
UW Medicine accepts a variety of insurance plans, including Medicare, Medicaid, Apple Health, and plans available through the Washington Health Benefit Exchange. UW Medicine also accepts out-of-state private insurance plans, though these may only provide emergency coverage in Washington State.
Regarding health insurance for students, UW does not offer health insurance to domestic students, including US citizens, legal permanent residents, DACA, and undocumented students. However, UW does offer health insurance to two specific student groups: graduate students whose UW employment positions qualify them for the Graduate Appointee Insurance Program (GAIP) and international students on J1 and F1 student visas via the International Student Health Insurance Program (ISHIP).
Most UW students have in-state or out-of-state private insurance, while about 25% of Seattle students have Washington State Medicaid (Apple Health). Students with private health insurance should be prepared for out-of-pocket costs such as premiums, deductibles, and coinsurance. On the other hand, Medicaid (Apple Health) has no associated costs as long as contracted providers are used for covered services.
For domestic students who need health insurance, they can apply through the Washington Health Plan Finder, Washington state's health insurance marketplace. There is one application for health insurance through this marketplace, and applicants will be sorted into either private insurance (with or without a government subsidy) or Medicaid (Apple Health) based on their eligibility. All US citizens, legal permanent residents, and student visa holders can apply for insurance through the exchange, and they may be eligible for government subsidies to assist with monthly premiums and other out-of-pocket costs.
Additionally, UW provides medical and mental health services to all enrolled students through the University Health Services (UHS). However, UHS is not a substitute for comprehensive health insurance and does not provide emergency care, hospitalization, or specialty care for complex problems.
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UW Medicine is in-network with the Community Health Plan of Washington (CHPW) Apple Health plan
UW Medicine is "in-network" with several health insurance plans offered through the Washington Health Benefit Exchange, also known as the Washington Healthplanfinder. UW Medicine is in-network with the Community Health Plan of Washington (CHPW) Apple Health plan, with some exceptions. Those with the CHPW Apple Health plan can receive specialty care at Harborview, UW Medical Center, and UW Physicians, but primary care is only covered at the Lopez Island clinic.
The Washington Healthplanfinder can help individuals and families search for health plans available to them. This includes information on subsidies or coverage through Washington's Medicaid program or Apple Health Expansion for immigrants. For those aged 65 or older, trained volunteers can help learn about Medicare plans in Washington through the Statewide Health Insurance Benefits Advisers program.
It is important to note that insurance coverage varies among individual insurers and policies. Patients are responsible for providing UW Medicine with their insurance coverage information and notifying them of any changes. Patients are advised to call their insurance company before their visit to understand their coverage, including which providers and hospitals are in-network and what they will need to pay out-of-pocket.
UW Medicine also provides patient resources for billing and insurance, including information on the Balance Billing Protection Act, which was implemented in Washington state to offer protection from surprise medical bills.
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Frequently asked questions
UW Medicine is "in-network" for several health insurance plans offered through the Washington Health Benefit Exchange, also known as the Washington Healthplanfinder. These include:
- Kaiser Foundation Health Plan of Washington (HMO plans require permission from Kaiser FHP before services can be provided)
- Community Health Plan of Washington (specialty care only, except primary care covered at Lopez Island clinic)
- UnitedHealthcare of Oregon, Inc. (Cascade Bronze, Cascade Silver, Cascade Gold)
- UW Medicine is also in-network with some Medicaid plans.
The Washington Health Benefit Exchange is a health insurance marketplace for Washington state. It is designed for individuals who do not have employer-sponsored health insurance or are eligible for Apple Health (Medicaid).
UW Medicine does not participate in all Exchange plans, so it is best to ask the health plan about your coverage for services through UW Medicine. You can also contact UW Medicine directly for more information.
