Insurance Coverage

Insurance Coverage

Seattle Cancer Care Alliance (SCCA) is working to ensure all cancer patients have access to the care that will offer them the best possible outcome for their disease. We feel passionately that the first question you have when faced with a diagnosis isn’t what care is covered in your plan, but rather where can you receive the best care. SCCA is working with its partners in the public policy and advocacy sectors to ensure that all patients, regardless of means, have access to the quality of care and personalized service they deserve.

SCCA accepts most national private health insurance plans and Medicare, the federal health insurance program for people who are age 65 and older or who are disabled. We also accept Medicaid insurance for patients from Washington, Alaska, Montana, and Idaho.

Every advantage counts when you’re fighting cancer. Is SCCA covered on your health insurance plan?

For details see:

Your Insurance Coverage

Everyone’s insurance is different, so ask your insurer about your own plan. Is SCCA in your network? Are there deductibles or co-payments that you will have to pay yourself? The amounts will be lower if SCCA is in your health plan’s network.

Ask your insurance provider if your health plan contracts with the organizations that would provide your care here: SCCA, University of Washington Physicians (the practice group for the doctors who will take care of you), UW Medicine, and Seattle Children’s. If you need care that is only available at SCCA, an insurer may agree to cover your treatment here.

Plans on Washington Healthplanfinder

When it comes to accessing quality cancer care, many consumers seeking insurance through Washington Healthplanfinder will not have in-network coverage for cancer treatment at SCCA. Because this may affect you and your family’s out-of-pocket cost for care, we wanted to provide you with some information to help you navigate your care options during the open enrollment period from November 1, 2015 - January 31, 2016.

  • SCCA is an in-network provider for the following health care plans: Premera Blue Cross (Heritage Signature and Heritage Prime), Community Health Plan of Washington, United Healthcare Charter Plans HMO*, Group Health HMO*, and Kaiser HMO*. *Specialist services are covered, pending permission to see a specialist

For more information about access to SCCA on the Washington Healthplanfinder, view frequently asked questions.

Help Understanding Insurance

A Patient Financial Services (PFS) coordinator can assist you with understanding your insurance benefits. For questions, call (206) 288- 6226 or toll free at 1 (800) 304-1763, option 3. Or contact your SCCA clinic scheduler to arrange an appointment with a PFS coordinator.

If you are receiving a stem cell or bone marrow transplant, a meeting with Patient Financial Services can be scheduled as part of your pre-transplant consultation. Transplant patients sometimes conduct fundraising as part of their financial planning.

Estimating Costs

To find out the estimated charges of a recommended treatment plan, call (206) 288- 6226 or toll free at 1 (800) 304-1763, option 2.

 Many insurance companies limit payments to "usual, customary, and reasonable" (UCR) fee schedules. Our charges may differ from insurance companies' UCR allowances; you are responsible for payment regardless of your insurer’s UCR limits.

Pre-authorization for a Service

Health insurers often require pre-authorization for certain services, including CT, MRI and PET imaging, chemotherapy, radiation therapy, and bone marrow transplants. We will work with you to obtain pre-authorization from your insurance carrier for services we provide. However, this may not be possible if services are ordered and provided in less than a 48-hour window.

In those situations, we recommend that you contact your insurance carrier for pre-authorization. If your insurance company fails to pay due to lack of pre-authorization, you will be financially responsible for payment.

Contact your primary care doctor’s office for a referral to SCCA if your insurance plan requires a primary care provider referral before you can be treated here.

If You Are Uninsured

If you don’t have insurance, an SCCA financial counselor will work with you to determine if you qualify for financial assistance or Medicaid, a jointly funded, federal/state health-insurance program for low-income people.

SCCA directs patients without insurance to their state-specific Health Care Exchange. Washington residents can use Washington HealthPlanFinder to choose a plan based on cost, coverage, convenience, or any number of factors that are important to you. Under the federal Affordable Care Act insurance companies cannot deny coverage to people with existing conditions.

Clinical Trials

Coverage for treatment received as part of a clinical trial varies among health insurance companies. For Medicare beneficiaries, treatment received in clinical trials is covered, with some restrictions. If a clinical study is part of your treatment plan, you can use our worksheet to figure out your insurance coverage for clinical trials. If you have questions, call (206) 288- 6226 or toll free at 1 (800) 304-1763, option 0.

Help Paying for Care

Financial assistance is available to Washington residents based on family need and SCCA resources. An SCCA financial counselor can help you with the applications for financial assistance or public insurance programs such as Medicaid. These programs may help you with your current and future health care bills. Please ask your scheduler for an appointment with a financial counselor, or contact one directly at (206) 288- 6226 or toll free at 1 (800) 304-1763, option 3.