Insurance and assistance

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 your plan covers, but rather where you can receive the best care. SCCA is working with its partners in the public policy and advocacy sectors to ensure that all patients, regardless of their financial situation, have access to the quality of care and personalized service they deserve.

SCCA participates in 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 participate in 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 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.

Washington state’s Surprise Billing law (HB 1065) requires health care facilities and providers to post a list of the commercial health insurer provider networks in which they participate. Click here to see the networks list for Seattle Cancer Care Alliance. Click here to learn more about your rights under the Balance Billing Protection Act. If you have questions regarding your statement and Balance Billing, please contact Seattle Cancer Care Alliance at (206) 606-6226.

Click here for insurance provider contact information and tips on how to ask about SCCA coverage in your network.

Plans on Washington Healthplanfinder

In response to the potential growth of COVID-19 cases. The Washington Health Benefit Exchange announced a limited-time special enrollment period for qualified individuals who are currently without insurance that will allow uninsured individuals an opportunity to enroll in health insurance coverage through Washington Healthplanfinder.

  • Anyone enrolling through April 8, 2020 will have coverage effective April 1, 2020
  • Anyone enrolling from April 9, 2020 to May 8, 2020 will have coverage effective May 1, 2020

In addition, current Washington Exchange enrollees with income changes due to:

  • Reduction in work hours during the COVID-19 state of emergency
  • Loss of employment

You can report income changes at any time during the plan year. Based on the income change you may be eligible for increased subsidy assistance to pay for Washington Health Benefit Exchange premiums.  Also, based on income and citizenship status, you may qualify for Washington Apple Health Medicaid which provides healthcare at no cost. More information is available here.

Individuals seeking special enrollment or to request a change can:

  • Contact Washington Healthplanfinder Customer Support Center 7:30 am to 5:30 pm Monday through Friday at (855) 923-4633; TTY: (855) 627-9604. Language assistance and disability accommodations are provided at no cost
  • Contact a local certified broker
  • Contact SCCA Patient Financial Services at (206) 606-6226 or toll free at (800) 304-1763
  • Read more information available here

Many people 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 want to give you information to help you understand your care options during the open enrollment period from November 1, 2020 - December 15, 2020.

  • SCCA is an in-network provider for the following health care plans: Premera Blue Cross, Kaiser Foundation Health Plan of WA* and BridgeSpan (UW Medicine). *Specialist services are covered, pending permission to see a specialist
     

Learn more about access to SCCA on the Washington Healthplanfinder. If you are shopping for a plan on the Washington Benefit Exchange, click here for steps to find a plan that covers SCCA

Help understanding insurance

A Financial Coordinator can assist you with understanding your insurance benefits. Call (206) 606-6226 or toll-free at (800) 304-1763 and ask to be transferred to a Financial Coordinator. Or, contact your SCCA clinic scheduler to arrange an appointment with a Financial Coordinator.

If you are receiving a stem cell or bone marrow transplant, you can schedule a meeting with Patient Financial Services as part of your pre-transplant consultation. 

Estimating costs

To find out the estimated charges of a recommended treatment plan, call (206) 606-6226.

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 get 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 find out 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 other 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 you have questions, call (206) 606-6226 or toll-free at (800) 304-1763.

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) 606-6226 or toll free at (800) 304-1763.