For medically necessary services, a prior authorization acts as a guideline for what the insurance will and will not cover. There may be an alternative treatment, such as a similar prescription drug or service, that is covered by the plan. In that case, your doctor will switch you to this service. However, if you need a specific treatment that is not currently covered, you can ask us to make an exception to our coverage rules. We will take your health needs into account when we make our decision. Learn more about coverage exceptions.
I have received a specific treatment in the past, but now it is not covered by my plan. What can I do?
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Nurse Advice Line
What kind of care do you need? Not every medical issue needs emergency care. If you have a medical issue that doesn’t seem to be life-threatening, but you’re not sure what to do, you can call our Nurse Advice Line for help. They can help you decide if you should see a primary or urgent care doctor. The Nurse Advice Line is free and available 24/7 for members at 1-866-418-2920 (TTY Relay: 7-1-1).
- TALK TO AN EXPERT
- Click here to schedule a plan review.
- NURSE ADVICE LINE
- 1-866-418-2920
- (TTY Relay: Dial 711)
- ADDRESS
- 1111 Third Ave
- Suite 400
- Seattle, WA 98101
- HOURS
- 8:00 a.m. to 8:00 p.m.
- Seven Days a Week
QUICK LINKS
- PROVIDERS
- Prior Auth
- Provider Manual
- Forms & Tools
Community Health Plan of Washington is an HMO plan with a Medicare contract. Enrollment in Community Health Plan of Washington Medicare Advantage Plan depends on contract renewal. To enroll in a Community Health Plan of Washington Medicare Advantage plan, you must be eligible to receive Medicare Part A and Part B and live in our service area (Adams, Benton, Chelan, Clark, Cowlitz, Douglas, Franklin, Grant, King, Kitsap, Lewis, Pierce, Okanogan, Skagit, Snohomish, Spokane, Thurston, Walla Walla,Whatcom, and Yakima counties in Washington state). This is not a complete description of benefits, please contact us for more information.
Benefit Disclaimer: Limitations, copayments, and restrictions may apply.
Premiums Disclaimer: You must continue to pay your Medicare Part B premium.
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