Some people prefer to buy health insurance directly from an insurance company or through a broker. Thanks to strict regulation, you will pay the same price for a plan regardless of where you buy it or whether you sign up via phone, online or by filling out paper forms.
Residents can file complaints online using this form, or contact the office. You’ll find health plans in as many as four coverage levels, commonly called metal tiers: platinum, gold, silver and bronze.
Platinum plans charge high premiums but offer the best cost-sharing benefits, covering an average of 90 percent of health expenses incurred. You are eligible to buy coverage if you are a U.S. citizen, a U.S. national or an immigrant lawfully living in the U.S.
Those who are incarcerated or who are living in the U.S. illegally are not eligible to purchase coverage. Your expected income and household size determine whether you can receive subsidies.
If you qualify for the premium tax credit, you can use it to reduce the cost of your monthly premium upfront, receive the amount when you file your taxes or opt for a mix of the two. Those who are eligible for cost-sharing subsidies must pick a Marketplace silver plan to use them.
Catastrophic plans, which have cheaper premiums but high deductibles, are only available to adults younger than 30 and those who qualify for a hardship or affordability exemption. Minimum Essential Coverage (MEC) is a set of essential health benefits and qualifications offered by all Marketplace plans, and the minimum requirement to be considered healthcare coverage by the Affordable Care Act (ACA).
Due to the end of the individual mandate fee in 2019, you may buy a health plan outside the Marketplace that does not provide Minimum Essential Coverage without incurring a fee. Short-term plans are not offered in the Marketplace because they do not meet the Affordable Care Act’s standard of coverage and benefits.
However, due to a 2017 Executive Order and changes in Department of Health and Human Services regulations, short-term health insurance policies have changed and are being offered in some states by private insurers. Under the Affordable Care Act, insurers are not allowed to deny coverage based on pre-existing medical conditions.
If you are unemployed, you might qualify for Medicaid or a subsidy to help cover the expense of a private health insurance plan. Which programs or subsidies you are eligible for depend on your household size and income, not your employment status.
If you are receiving unemployment compensation, you will need to report the expected amount when applying for coverage. However, if you are looking to qualify for tax credits to help you pay for your insurance, your total household income will be considered.
If you live in Washington and aren’t happy with your health insurance or need to sign up, you’ve got a big decision to make. Health insurance plans, provided by private or government health insurers, cover everything from doctor and hospital visits to behavioral health care, physical therapy, and medical supplies.
If you are 65 and older or under 65 and disabled according to the Social Security Administration and are eligible for Medicare, your rates are regulated by the Centers for Medicare and Medicaid Services (CMS), a government agency that oversees these plans. Also, you’ll need to choose a primary care doctor for all regular visits.
PPO's plans are comprised of a large network of hospitals, specialists and doctors you can choose for care. Referrals aren’t required with PPO plans, and you can switch doctors anytime.
Part B: Covers outpatient care, doctor and specialist visits, and medical equipment and supplies. Offered by private insurers, you can choose either an HMO or PPO Medicare Advantage plan.
That figure could vary depending on factors such as your age, health and income. If you receive your coverage through your employer you’ll probably pay a much lower monthly cost if your company contributes a large portion.
Most insurance plans cover costs such as doctor visits, inpatient and outpatient stays, specialist visits, skilled nursing care, physical therapy and some medical supplies. When you sign up for a health plan, you’ll receive an Evidence of Coverage document that spells out what is covered.
Medical costs you incur while doing something illegal Care you receive if you file a false claim or used another person’s health card Care you receive while traveling abroad unless your policy includes it Most nursing home care Certain vaccinations Extremely expensive treatments or experimental drugs or treatments Every year, the National Committee for Quality Assurance (NCAA), an independent, non-profit agency focused on improving health care, rates private insurance plans in the areas of prevention, treatment and customer satisfaction.
Power in the 2019 Commercial Member Health Plan Satisfaction Study for communication, provider choice, billing, customer service, coverage and benefits, and cost. Regency Bluesier of Washington’s PPO plan was rated 3.5 out of 5 for customer satisfaction in NCAA’s survey and ranked 4th overall.
Power’s study, recognized for outstanding provider choice, billing, customer service, coverage and benefits. Its website features links to help you find dental providers, behavioral health facilities and useful plan information.
Aetna’s PPO plan, ranked 5th in NCAA’s survey, received high marks for treatment and prevention. Power’s study, recognized for overall satisfaction, provider choice and customer service.
You can earn rewards such as gift cards from popular retailers if you reach your goals. Open enrollment runs from November 1 to December 15 each year for non-Medicare enrolled.
You can sign up for a Medicare Advantage plan during your Initial Enrollment Period. By taking extra time to consider your options, you’ll choose the besthealthinsurance plan for you and your family.
States Kaiser Foundation Health Plan of the Northwest, Inc. WA PPO/EPO Yes Kaiser Foundation Health Plan of Washington Options, Inc.
AK, AZ, CA, CO, HI, ID, IA, KS, MN, MO, MT, NE, NV, NM, ND, OR, SD, TX, UT, WA, WYPOSYesIIINo Data Reported Compass Rose Health Plan AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WYPPONoNo Data Reported Government Employees Health Association, Inc.
AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, GU, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, Weapon People in the Evergreen State are spoiled for choice when it comes to healthcare options.
Marketplace plans come in metal tiers: bronze, silver, gold, and platinum. These are average monthly premiums for each plan type for a 40-year-old non-smoker from Washington in 2020, the most recent year this data is available.
Even with a higher premium, a bronze or silver plan will likely save you money if you actually need to use your health insurance. A high body mass makes you statistically more likely to suffer from numerous health problems.
Out of the thousands of Washingtonians who used QuoteWizard to compare health insurance plans, only 26 percent of shoppers have a BMI in the obese range. Smokers pay more for health insurance due to the substantial risks from smoking.
If your neighbors file claims at an abnormally high rate, you might face a premium hike. That means living in a health -conscious state can lead to lower premiums.
Thanks to the Affordable Care Act, insurance companies can't use certain factors when pricing your policy. Before the ACA, people with pre-existing conditions paid considerably more for health insurance.
Washington state law requires that insurance companies provide some coverage for these services: Medicare and Medicaid are both government-funded health care programs, with each option catering to different types of people.