Find a Provider Near You

US Family Health Plan offers a network of providers in Western Washington, most of Central and Eastern Washington, Northern Idaho, Western Oregon, and most of California.

View the Provider Directory

We make every effort to provide you with the most current information about our provider network. This provider information is subject to change as new providers join and others leave. Please check availability and wait times prior to selecting a primary care provider.

Need Help?

Contact Member Services at 800-585-5883, option 2 or our marketing team at 866-418-7346.

Covered Doctors, Specialists and Services

Learn about provider networks, provider groups and referral networks, and understand coverage information and procedures for pharmacy and various types of care.

Covered primary care provider groups

USFHP provides a network of some of the area’s leading primary care providers (PCP). Plan members choose a primary care provider (PCP) from one of our network provider groups.

Western Washington
  • Pacific Medical Centers (PMC)
  • Providence Medical Group (PMG)
  • Family Care Network (FCN)
  • Franciscan Medical Group (FMG)
  • FMG - The Doctors Clinic
  • Harrison HealthPartners - A part of FMG
  • Island Hospital Group & Clinics
  • Mason Health
  • MultiCare Health Services (MHS)
  • PeaceHealth Clinics
  • Peninsula Community Health Services (PCHS)
  • Snoqualmie Valley Hospital & Clinics
  • WhidbeyHealth Hospital & Clinics
  • Pediatric Associates of Whidbey Island
  • Yelm Family Medicine
  • North Island Family Medicine
  • Sea Mar Lakewood Pediatrics
  • Woodcreek Pediatrics by Mary Bridge Children’s
  • Swedish Medical Group
Eastern / Central Washington
  • Providence Medical Group
  • Kadlec
Southwest Washington
  • Providence Medical Group
  • PeaceHealth Clinics
Northern Idaho
  • Coeur d'Alene Pediatrics
  • Heritage Health
  • Kaniksu Health Services
  • Kootenai Health
  • Shoshone Medical Center
Western Oregon
  • Providence Medical Group
  • PeaceHealth Clinics
  • Salem Health
  • North Bend Medical Center
  • Evergreen Family Medicine
  • Waterfall Community Health Center
  • Coquille Valley Hospital
  • Columbia Health Services
California
  • Facey Medical Group
  • Providence Medical Foundation
  • Providence Medical Institute
  • St. John’s Physicians Partners

 

Your PCP will get to know you, your medical history and your individual needs. In addition to routine health care and medical record maintenance, your PCP also monitors your medications and orders tests or services. If you have a complex problem, you may be referred to a USFHP Network qualified specialist. Your PCP and your specialist will work together, as a team, to meet your health care needs.

Each enrollee in your family selects a PCP. Family members do not need to select the same PCP. You may change your selection upon request. Choose a provider with whom you are comfortable!

Types of primary care providers
  • Pediatrician
  • Family medicine physician
  • Internal medicine physician
  • Doctor of osteopathy (DO)
  • Advanced registered nurse practitioner (ARNP)
  • Physician assistant (PA)

Specialty providers receive extensive additional medical training in a specific field such as in cardiology, dermatology, gynecology, etc.

How does your PCP work with your medical specialty providers?

Your PCP will refer you to specialists and other medical professionals who are also connected with the Plan. We call this group the “referral network.” This system ensures better communication. It also ensures good coordination of care between your providers.

If the specialty care you need is not available within the referral network, your PCP will refer you elsewhere. When both your PCP and the Plan authorize you to get care outside of the referral network, it is covered by the Plan.

US Family Health Plan offers a full range of hospital benefits.

If you must be hospitalized, your PCP or specialty provider will make the arrangements for you.

Members must use hospitals that are affiliated with their PCP. The only exception is in an emergency. In the event of an emergency, go to the nearest hospital.

Services overview

All services that are deemed medically necessary are covered. Hospital services may include:

  • Semi-private room accommodations (a private room may be covered if a Plan provider determines it is medically necessary)
  • Physician services related to medical treatment or surgery
  • Specialized care units, such as intensive care or cardiac care units
  • General nursing services
  • Operating room, anesthesia and supplies
  • Prescribed inpatient drugs
  • Inpatient physical therapy and rehabilitation at the appropriate level of care
  • Other medically necessary supplies and services

If you are experiencing a life-threatening emergency, dial 911.

Urgent care is for injuries or illnesses that are not life-threatening. Examples of urgent care situations include a sprained ankle, respiratory illnesses, sore throat, ear aches or a minor cut that needs stitches.

Members are covered anywhere in the world for emergency care and urgent care.

These are the steps to follow:

  • During clinic hours: If you need urgent care, call your PCP’s office. All urgent care must be preauthorized in order to be covered by the Plan.
  • After clinic hours: Even after hours, you must get authorization. Call your PCP's clinic for authorization before getting care. Your clinic’s phone system will direct you to an after-hours phone service.
  • If you are traveling: If you become ill and need urgent care (non-life threatening), call your primary care physician to have your care authorized and coordinated. If it is after hours, call your clinic’s main number to reach the after-hours service. Be sure to notify the Plan within 24 hours or within the next business day of when you receive care.
  • Payment: If you are asked to pay at the time of service, make sure to get an itemized statement from the provider. When you return to your coverage area, request from the Plan to have these expenses reimbursed.

Getting your prescriptions filled is convenient and easy. We offer an excellent pharmacy network.

The prescription drug benefit is comprehensive. You’ll find it’s one of US Family Health Plan’s most valuable benefits!

You can get your prescriptions filled at:

  • Network retail pharmacies
  • Mail-order pharmacy
  • Designated clinic pharmacies within our network

TRICARE maintains an approved list of drugs, called a formulary. All drugs on this list are covered, subject to TRICARE coverage rules. See the TRICARE formulary.

Durable medical equipment (DME) includes items like wheelchairs, hospital beds and oxygen. It is covered by the Plan when medically necessary. Your PCP will work with our case management team to provide seamless care coordination.

DME is covered with prior approval by the Plan.

Skilled nursing facilities (SNFs) are places of residence for people who must have constant skilled nursing care. They are unable to do a significant amount of the activities of daily living. Adults who are 18 years or older and have had an accident or illness may stay in a SNF to get special therapy. They may get physical, occupational and other rehabilitative therapy.

SNF visits are covered when provided by an authorized provider. SNF services must be for the diagnosis or treatment of a specific illness, condition or set of symptoms. SNF admissions are covered with prior approval by the Plan.

Please follow the following steps:

  • For SNF inquiries call Member Services at 800-585-5883, option 2.
  • For SNF referrals, contact your PCP to request a referral.

The Plan provides home care when it is necessary for medical reasons and the patient is homebound, i.e. unable to leave the home. The care may include durable medical equipment. Home care also includes intermittent visits for physical, speech, nursing, or occupational therapy at home. These are provided only for short, defined periods.

Home care visits are covered with prior authorization by the Plan.

For home health inquiries call Member Services at 800-585-5883, option 2.

For home health referrals contact your PCP to request a referral.

Find an in-network ambulatory surgery center near you by calling the Member Service team at 800-585-5883, option 2 or search our directory.