Doctors, Specialists, and Services

Primary Care Providers (PCP)

Your PCP is your partner in managing your health. 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 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!

USFHP provides a network of the area’s leading Primary Care providers

Provider groups:  

  • FMG - Franciscan Medical Group
  • FMG - Harrison Health Partners
  • FMG - The Doctor's Clinic
  • Island Hospital & Clinics
  • FCN - Family Care Network


  • MHS - MultiCare Health System
  • Pacific Medical Centers
  • PCHS - Peninsula Community Health Services
  • PMG - Providence Medical Group
  • Yelm Family Medicine 

Pediatric groups: 

  • ABC Pediatrics - Mary Bridge Children's
  • Lakewood Pediatric Associates
  • Franciscan Medical Group Pediatrics
  • MHS - MultiCare Health Services - Pediatrics


  • Pacific Medical Centers - Pediatrics
  • PCHS - Pensinsula Community Health Services - Pediatrics
  • Pediatric Associates of Whidbey Island
  • South Sound Pediatric Associates
  • Woodcreek Pediatrics - Mary Bridge Children's

Types of PCPs to choose from:

  • Pediatrician
    • Care for children. These doctors combine compassionate care with advanced training.
    • Children grow and change rapidly. Pediatricians care for them in a thoughtful way to meet their ever-changing needs. From infancy or any stage of childhood, our pediatricians will follow the development of your child. They will work with you to ensure optimal health and well-being.
  • Family Medicine Physician
    • Care for all ages. These doctors are also called family practitioners. At the heart of this specialty is the relationship between the patient and the doctor.
    • Family medicine practitioners cover all areas of a family’s health and wellness. They care for children, women and men. They also cover gynecology and aging issues. Some deliver babies.
    • These specialists provide a medical home to their patients, looking out for overall health of the entire family by knowing them as a whole. They are also responsible for the coordination of any specialty care the patient may need.
  • Internal Medicine Physician
    • Care for adults, from late teenage years and on. Internal Medicine doctors are also called internists. They are trained to deal with any issue, from preventive care and common disorders to chronic disease.
    • They do not treat children or deliver babies, and they do not perform surgeries.
    • Some internists are additionally trained and board-certified in specialties. So, an internal medicine doctor may be trained in cardiology or geriatrics. They are also good at treating patients who have several chronic illnesses at one time. Other doctors often ask them to help solve complex or puzzling health issues.
  • Doctor of Osteopathy (DO)
    • Care for adults. A DO degree is very similar to an MD degree (Doctor of Medicine). The training is comparable, and these doctors may practice the full scope of medicine and surgery anywhere in the U.S.
    •  The DO student completes 300–500 hours of hands-on study of the muscular and skeletal systems. Many DO physicians complete specialty program
  • Advanced Registered Nurse Practitioner (ARNP)
    •  Care for children or adults, depending on the scope of practice. An ARNP has a graduate level degree. It is either a Master of Nursing or a Doctor of Nursing Practice.
    • ARNPs can examine, diagnose and treat patients with acute illness or chronic diseases.
    • These nurses also can order and interpret tests and prescribe medications. And they often focus on prevention, wellness and education.
  • Physician Assistant (PA)
    • Care for adults, from late teenage years and on. Internal Medicine doctors are also called internists. They are trained to deal with any issue, from preventive care and common disorders to chronic disease.
    • Care for children or adults, depending on the scope of practice. A PA is a medical professional, and he or she works as a team with a supervising physician.
    • A physician’s assistant can examine, diagnose and treat patients, and prescribe medications. And they often focus on prevention, wellness and education.
    • PAs hold a master’s degree. They have their own medical license, which is regulated by state medical boards.


Specialty providers received extensive medical training pertaining to a specific medical field. Your PCP will refer you to specialists and other medical professionals who are associated with the USFHP network.

How your PCP works with your medical specialty providers

If you have a complex health problem, your PCP may refer you to an USFHP affiliated specialist. The USFHP referral network is extensive and offers many qualified specialty providers.

Your PCP and Specialty provider will work together as a team to meet your health care needs. This system ensures better communication and good coordination of care among your providers.

USFHP Referral Network

The referral network includes specialists at these medical groups:

  • ATI Physical Therapy
  • Children's University Med Gp
  • Eye Associates NW, PC
  • FMG-Franciscan Medical Group
  • FMG-HarrisonHealth Partners
  • FMG-The Doctors Clinic
  • Inland Imaging
  • Integra Imaging Associates
  • Island Hospital & Clinics
  • Kitsap Physical Therapy
  • MHS-MultiCare Health Svc
  • NW Asthma & Allergy
  • Olympia OB/Gyn
  • Paceline Anesthesia
  • Pacific Medical Centers
  • PeaceHealth
  • Peninsula Community Health Svc
  • PMG-Providence Medical Group
  • Ryther Counseling, Mental Health
  • Seattle Hand Surgery Group
  • Skin Surgery Center Group
  • Snoqualmie Valley Hospital
  • Swedish Medical Group
  • Western Washington Medical Gp
  • WhidbeyHealth Medical Ctr/Clinics

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 your care outside of our 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

Urgent Care

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 and Supplies (DME)

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)

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 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 or 206-621-4090.
  • For SNF referrals, contact your PCP to request a referral.

Home Health

The Plan provides home care when it is necessary for medical reasons and the patient is homebound. The care may include durable medical equipment. Home care 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 or 206-621-4090

For Home Health Referrals contact your PCP to request a referral.

Ambulatory Surgery Center (ASC)

Find an in-network Ambulatory Surgery Center near you.