Group Health Medicare Advantage Plans

Group Health offers individual Medicare Advantage plans to eligible Medicare members. Members can choose between plans with or without prescription drug benefits (known as Medicare Part D).

Group Health Cooperative offers HMO plans in the following counties:

  • Grays Harbor (only in ZIP codes 98541, 98557, 98559, 98568)
  • Island
  • King
  • Kitsap
  • Lewis
  • Mason (only in ZIP codes 98524, 98528, 98546, 98548, 98555, 98584, 98588, 98592)
  • Pierce
  • San Juan
  • Skagit
  • Snohomish
  • Spokane
  • Thurston
  • Whatcom

Group Health Options, Inc. offers one PPO plan (with Medicare Part D) in the following counties:

  • Clallam (only in ZIP codes 98362, 98363, 98382)
  • Jefferson (only in ZIP codes 98325, 98339, 98358, 98368)

Group Health processes and pays for all covered Medicare managed-care benefits for services rendered to eligible members. There is no need to bill Medicare directly.

Employer Group Plans and Medicare

Some members receive benefits from an employer group plan in addition to their Medicare benefits. In this case, Group Health coordinates with Medicare for all authorized care per the employer coverage plan and Medicare benefits. For more information, refer to the "Payment for Services" section of your provider agreement.

Revised 11/6/2014

The Provider Manual is not intended for any use by any party other than as a resource for Group Health Cooperative's contracted providers in fulfilling their obligations under provider contracts. Group Health intends for the manual to be accurate for its intended purpose but doesn’t guarantee accuracy. Providers should comply with the terms of their provider contracts and any legal requirements in the event of an inconsistency between the manual and a requirement in their provider contracts or the law.