Insurance and Cost of Care
When coming to Seattle Children’s for care, there are 3 main things to consider about your insurance plan:
Is Seattle Children’s covered by my insurance plan?
- See a list of plans that include Seattle Children’s for medical care.
- For mental health services, see our mental health insurance coverage page.
- Learn more in our Insurance Frequently Asked Questions section.
What is my cost?
The amount you owe depends on the insurance plan you have. Your cost is determined by your plan benefits like copay, coinsurance, individual and family deductible amounts, as well as the type of services your child receives.
We can provide an estimate based on what we know about your child’s treatment and other factors such as insurance. If you have Apple Health (Medicaid), there is no cost to you.
We have created a new tool to help you estimate the out-of-pocket cost of some of the services or procedures available at Seattle Children’s. The tool does not include all of the services or procedures available at Seattle Children’s. The estimate you will see in this tool is not a guarantee of the final amount you may be billed.
- MyChart is our expanded medical record and platform for patients and families. With a MyChart account, you can do things like contact your child’s medical team, read notes and After Visit Summaries, set up payment plans and much more. Learn more about how to sign up for a MyChart account.
Below is a list of our standard charges for all items and services provided by Seattle Children’s Hospital. However, your final cost will depend on your child’s treatment and your insurance coverage.
- Standard Charge List (CSV). This is a list of our services and charges before insurance discounts.
- You may have more than one of the charges on the list depending on your child’s care needs.
- Because there are so many different treatment options and charges, the service you find on this list may not be the actual treatment your child needs, so your cost may be different.
- The medication prices listed are unlikely to match the price for your child. Drug prices are calculated and can vary based on:
- The dose given.
- The patient’s age, weight or clinical condition.
- Our cost to purchase the drug, which changes often because of availability and price changes.
- Our cost to prepare the medicine, which depends on the type of medicine and clinical setting.
- For the most accurate cost estimate, call 206-987-3333.
- We are required by law to present the list in this format. To make it easier to read, expand the columns in the spreadsheet.
Visit our Insurance Frequently Asked Questions page.
Does my child’s visit require a pre-authorization from insurance?
Most insurance plans do not require pre-authorization for a specialty clinic consult. If the specialist orders additional tests, therapies or procedures, our insurance authorization team will request authorization from your insurance plan.
Kaiser Health Foundation Plan of Washington (formerly Group Health Cooperative), NPN, HMSO and TriCare insurance plans always require a pre-authorization before scheduling care at Seattle Children’s. If your child is covered by Kaiser Health Foundation Plan of Washington (formerly Group Health Cooperative), NPN, HMSO or TriCare, make sure you have your authorization number before you schedule an appointment.
If your insurance denies our authorization request, meaning they will not pay for services, we will contact you. Because of the high volume of requests we do each day, we will only notify you if our request is denied.
Pre-authorization does not guarantee your insurance will cover care. Some services do not require pre-authorization, but also are not covered. Because employer groups can customize plans for their employees, there is a wide range of plans and coverage. Contact your insurance to learn what your plan covers.