Abortion Coverage for Providence Health Plan Members in Washington State
The Increasing Access to Reproductive Choice service was established to ensure people with state-regulated health insurance have equitable access to all state-required benefits.
Washington State recognizes that all people have the right to choose or refuse to have an abortion and requires state-regulated health plans that provide maternity benefits to provide coverage for abortions. The State also requires Health Benefit Exchange plans to provide maternity benefits (which means they must also provide abortion benefits).
Beginning January 2020, Providence Health Plan entered the state health insurance market. They offer plans in several counties and large group plans throughout the state.
Providence Health Plans invoked a religious objection and do not cover most abortion-related services.
To ensure equitable access to essential services, the Department of Health will pay for abortion services for people with Providence Health Plans that originate in Washington state.
For people enrolled in Providence Health Plans
We will pay for your abortion services if you have Providence Health Plan coverage that originates in Washington State and receive services from a provider who agrees to accept reimbursement from us.
You will have financial responsibility for your abortion care unless and until your provider submits the department-approved claim form to us for that care. Some organizations guarantee that they will submit claims to the department. They are listed in the next section.
You can choose to receive abortion services from any provider. The department will pay for those services through the method and at the rates described in the For Providers section below. Your provider is not required to submit a claim or accept department payment unless they have a contract with us, but any provider can choose to submit a claim.
- If you receive abortion services from a provider in the list below, there will be no cost to you. These providers have contracts with the Department of Health.
- If you receive abortion services from any other provider, you have full financial responsibility for all services received, unless and until your provider submits a claim using the department's claim form. Once your provider submits the appropriate claim form, your financial responsibility is removed and there will be no cost to you.
Contact us at (360) 972-6852 if you have questions.
Organizations that guarantee abortion services at no cost to eligible clients
The following organizations will provide abortion services to all eligible clients at no cost to the client.
- Cedar River Clinics, 800-572-4223 (Renton, Seattle and Tacoma)
- Equinox Primary Care PLLC, 206-388-3515, (Seattle and telemedicine statewide)
- Planned Parenthood of the Columbia Willamette, 888-875-7820 (Vancouver, Washington & Beaverton, Bend, Milwaukie-Oak Grove, Portland and Salem, Oregon)
- Planned Parenthood of Greater Washington and North Idaho, 800-230-7526 (Ellensburg, Kennewick, Moses Lake, Pasco, Pullman, Spokane, Sunnyside, Walla Walla, Wenatchee, and Yakima)
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, 800-769-0045 (Bellevue, Bremerton, Centralia, Everett, Federal Way, Lynnwood, Marysville, Olympia, Port Angeles, Puyallup, Tacoma, and Seattle)
We will add to this list as we finalize contracts with other organizations.
For healthcare providers
You can receive reimbursement for providing services to eligible clients—people covered through Providence Health Plans that originate in Washington state—even if you do not have a contract with the Sexual and Reproductive Health Program. However, please contact us at (360) 972-6852 prior to submitting a claim so that we create an active Purchase Order for your agency.
Providers may submit claims by:
- Downloading the Abortion Coverage Claim Form (Excel)
- Reviewing the terms of reimbursement described in red text at the bottom of the form. By submitting this form to the department you are agreeing to these terms
- Filling in the yellow-shaded sections of the form
- Submitting the form to us by fax or email as described at the top left of the form
- We will typically pay within 30 days if you have an active Purchase Order with the Department of Health
Contact us at (360) 972-6852if you have questions.