COVID-19 Info: 

Boosters are not yet approved by the Centers for Disease Control and Prevention (CDC); the third dose is only available to immunocompromised patients.

 

Kaiser Permanente

Patients who have health insurance through Kaiser Permanente may experience a change in coverage and financial responsibility for services provided by UW Medicine. Kaiser Permanente's contracts with UW Medicine expired on May 31, 2021. This means that the care received at UW Medicine sites by many Kaiser Permanente members will be considered "out-of-network" and Kaiser members 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

Kaiser members may wish to make arrangements to transfer care to an in-network provider or facility covered by their Kaiser Permanente health plan. If you choose to continue to receive your care at UW Medicine after the contract expiration date, you may be responsible for a greater out-of-pocket amount, possibly up to the full charge amount for healthcare services.

Please call the number on your Kaiser Permanente health insurance card with any questions regarding authorization for UW Medicine services that are scheduled on or after June 1, 2021, or in-network provider options. If your health insurance plan is sponsored by your employer and you wish to continue receiving services from UW Medicine, we encourage you to contact your employer’s Human Resources or Benefits department and request a plan that includes UW Medicine, if one is available to you. 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 expired on May 31, 2021. This impacts coverage of services provided to Kaiser members at UW Medicine entities and locations including:

  • 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 contract expiration affects many patients with Kaiser Permanente Commercial HMO coverage or Medicare Advantage coverage impacting members’ ability to receive care at UW Medicine entities including all the entities and locations referenced above.


Effective June 1, 2021, services at UW Medicine are out-of-network for Kaiser HMO members. This means that many Kaiser Permanente members receiving care at UW Medicine sites on or after June 1, 2021, may be required to pay a larger out-of-pocket amount, possibly up to the entire billed amount for healthcare services. Some Kaiser HMO members engaged in active treatment are covered for care for 90 days under continuity of care provisions, but these provisions are limited to specific types of cases (see below).


Kaiser commercial Access PPO, Elect PPO, and Summit PPO members will only be able to receive in-network services from UW Medicine through November 4, 2021 based on Kaiser’s participation in the First Choice Health Network which is contracted with UW Medicine. After such time, Kaiser Access PPO, Elect PPO, and Summit PPO members may be required to pay a larger out-of-pocket amount, possibly up to the entire billed amount. (Note: Kaiser members with coverage through Kaiser’s Added Choice, PPO Plus, or Dual Choice networks will have in-network access through December 31, 2021.)


Kaiser Point of Service POS members will only be able to receive in-network services from UW Medicine through September 1, 2021. After such time, Kaiser POS members may be required to pay a larger out-of-pocket amount, possibly up to the entire billed amount.


UW Medicine services will be considered “out-of-network” for Kaiser Medicare Advantage HMO members after May 31, 2021, and, therefore, Kaiser Medicare Advantage members may be required to pay a larger out-of-pocket amount, possibly up to the entire billed amount. Kaiser Medicare Advantage HMO members should contact their Kaiser health plan to discuss the full extent of any financial responsibility for services by UW Medicine.


Services covered for up to 90 days after May 31 contract expiration include:

  • Hospital services for Kaiser HMO members remaining inpatient after admitting on or prior to May 31 contract expiration; or
  • Services provided by UW Physicians and Valley Medical Group for Kaiser HMO members completing a course of care started prior to May 31 contract expiration (including obstetrics and cancer patients)
  • The 90-day limit does not to apply to maternity services, which may be covered longer. (This continuity of care provision does not include coverage for hospital services.)

Kaiser commercial HMO members electing to receive services from UW Medicine after May 31, 2021, will be asked to sign a “Notice of Non-Coverage” to indicate that the patient accepts financial responsibility for any services not covered by their Kaiser Permanente plan.


Yes, but you may be required to pay a higher out-of-pocket amount, possibly the entire billed amount for healthcare services. Kaiser members should contact their Kaiser health plan to discuss the full extent of any financial responsibility for services by UW Medicine.


Check with your insurance plan regarding your out-of-network benefits or other available coverage options. If your health insurance plan is sponsored by your employer and you wish to continue receiving your care at UW Medicine, we encourage you to contact your employer’s Human Resources or Benefits department and request a plan that includes UW Medicine, if one is available to you. 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 the Kaiser network you are a member of. Kaiser Access PPO, Elect PPO, and Summit PPO members will continue to access coverage for services through November 4, 2021 as part of Kaiser’s agreement with First Choice Health Network which is contracted with UW Medicine. For Kaiser HMO members who received an authorization prior to the May 31, 2021 contract expiration (including obstetrics patients), Kaiser has agreed to honor coverage. Kaiser Added Choice, PPO Plus, and Dual Choice members will have in-network access through December 31, 2021. If Kaiser does not cover your services, you may be required to pay increased out-of-pocket amounts, possibly up to the full billed amount.


Kaiser Access PPO, Elect PPO, and Summit PPO members will continue to have access to in-network UW Medicine transplant services through Kaiser’s participation in the First Choice Health Network through November 4, 2021. Kaiser Added Choice, PPO Plus, and Dual Choice members will continue to have access to in-network services through December 31, 2021. Kaiser will honor authorizations received prior to May 31, 2021, 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. UW Medicine transplant services will be considered out-of-network for any new transplant patients covered under a Kaiser Permanente HMO plan. If you are in the process of being evaluated for transplant, please contact Kaiser Permanente for clarification on your care options and financial responsibility.


Kaiser members seeking or receiving services related to Bone Marrow Transplant or Stem Cell Transplant at SCCA will not be impacted by the May 31, 2021, contract expiration. Kaiser members seeking or receiving physician services related to other treatments at SCCA may be required to pay a larger out-of-pocket amount, possibility up to the entire billed amount for physician services provided by UW Physicians at SCCA. Services provided by UW Physicians to HMO members to complete active treatments at the Seattle Cancer Care Alliance (SCCA) that began prior to the May 31, 2021, contract expiration, will be covered for 90 days after May 31, 2021. Kaiser members should contact their Kaiser health plan to discuss the full extent of any financial responsibility for services by UW Medicine.


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. Claims for services provided to Kaiser members after June 1, 2021, may be processed as out-of-network claims 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.

CSS Adjustments