HomeNewsHow To Buy Health Insurance In Washington State

How To Buy Health Insurance In Washington State

Any Policy Plan Or Contract Secured To Fulfill The Above Requirements Must At Minimum Be:

How to pick a health plan in Washington state
  • Underwritten by an insurance corporation having:A. an A.M. Best rating of A- or above B. a McGraw Hill Financial/Standard & Poors Claims- paying Ability rating of A- or above C. a Weiss Research, Inc. rating of B+ or above D. a Fitch Ratings, Inc. rating of A- or above E. a Moodys Investor Services rating of A3 or above or
  • Be backed by the full faith and credit of the government of the exchange visitors home country or
  • Part of a health benefits program offered on a group basis to employees or enrolled students by a designated sponsor
  • Offered through or underwritten by a federally qualified Health Maintenance Organization or eligible Competitive Medical Plan as determined by Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services.

Be aware that you and any accompanying J-2 spouse and dependent also may be subject to the requirements of the Affordable Care Act.

If you are eligible and plan to waive the UW ISHIP coverage, you must ensure that your alternate health insurance plan meets all minimum requirements above.

How Do I File A Complaint

The Washington state Office of the Insurance Commissioner protects insurance consumers and oversees the insurance industry.

If you have a problem with your insurance company, the OIC can require it to explain its actions and make sure it followed Washington state laws and your policy.

Complaints can be filed over the phone, or via the OIC website.

If you need to submit documents please fax them to 360-586-2018 or upload electronic copies to the contact form. The OIC notes that its office is currently closed and it has a limited ability to accept postal mail.

The OIC will investigate your complaint and will take action — including fines or suspending or revoking a license — if appropriate. In most cases, the OIC has no authority to order reimbursement payments.

Best Replacement Cost Policy: Safeco

Washington residents looking to maximize coverage for their home and personal property against the stateâs volatile weather should consider Safecoâs excellent replacement cost coverage options. Safeco has four comprehensive tiers of coverage, and all include the option to add extended replacement cost, a policy add-on that increases your homeâs coverage limits an additional 25% or 50% if rebuild costs exceed your dwelling coverage amount. Safecoâs âPremier Planâ, its highest level of coverage, includes guaranteed replacement cost, which pays for a rebuild of your home regardless of the price.

Read our full review of Safeco here

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Can Employees Opt Out Of The Program

Yes, an employee may opt out of the Program and its taxes and benefits if:

  • The employee is 18 years old or older on the date he or she applies for the exemption, and
  • The employee attests that he or she has other long-term care insurance.

To opt out, the employee must provide identification to verify his or her age and must apply for exemption with ESD between October 1, 2021, and December 31, 2022. If approved, an employees exemption will be effective for the quarter immediately following approval. Once an employee opts out, the employee cannot opt back into the Program. The opt-out is permanent.

Washington Home Insurance Discounts

Washington State Forces Nearly Everyone to Buy Long

There are several ways to reduce your Washington home insurance costs. Many insurers will lower your bill if you purchase more than one type of insurance policy from them. This process known as “bundling” can cut your costs by up to 19%, on average, according to Insurance.coms discount data analysis.

You can also cut your costs by making your home more disaster-resistant. Installing hurricane glass or accordion shutters might net you a discount.

Other possible home insurance discounts include:

  • Installing smoke detectors, a burglar alarm or dead-bolt locks — 5% each
  • Installing a sprinkler system, and a fire and burglar alarm — 15% to 20% percent
  • Loyalty discounts about 4% on average, after three to five years, and 6% for six years or more

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Washington State Divorce & Health Insurance Coverage

If you are filing for divorce in Washington State and have health insurance coverage through your spouse, you need to have a plan in place for health coverage after the divorce is finalized. While your children may still be covered under your husband or wife’s plan, you will no longer be considered a dependent and cannot continue to receive coverage.

Find Cheap Health Insurance Quotes In Washington

The average cost of health insurance in Washington state for a Silver plan is $443 per month for a 40-year-old.

In Washington, individual health insurance is available for purchase through the Washington Healthplanfinder marketplace. Health coverage is also available through Medicaid if your household income is equal to or below 138% of the federal poverty level.

After reviewing policies from every county in Washington, we found that the Ambetter Balanced Care 1 is the cheapest Silver plan available in 15 of the counties.

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The Marketplace In Your State

No matter what state you live in, you can enroll in affordable, quality health coverage.

New Jersey: For 2021 coverage, use Get Covered NJ to enroll

Starting November 1, 2020, New Jersey residents will no longer enroll in coverage through HealthCare.gov. Instead, theyll use GetCovered.NJ.gov. Enroll for 2021 as soon as November 1, 2020.

Continue using HealthCare.gov for 2020 coverage information.

Pennsylvania: For 2021 coverage, use Pennie to enroll

Starting November 1, 2020, Pennsylvania residents will no longer enroll in coverage through HealthCare.gov. Instead, theyll use Pennie.com. Enroll for 2021 as soon as November 1, 2020.

Continue using HealthCare.gov for 2020 coverage information.

Best Company For Discounts: State Auto

A New Way to Find Quality Health Insurance | WA Healthplanfinder

Washington residents looking for home insurance savings should look no further than State Auto, a company that offers an astonishing nine available discounts for everything from bundling your home and auto insurance to fitting your house with smart home devices to fortified home discounts.

Read our full review of State Auto here

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Enrollment Is Now Open Through August 15 2021

Starting , consumers enrolling in Marketplace coverage will be able to take advantage of lower premiums and access to financial assistance during the American Rescue Plan Act of 2021 announced by the Biden administration. If you’re looking for health insurance marketplace plans, UnitedHealthcare Exchange plans offer affordable, reliable coverage options from UnitedHealthcare of Oregon, Inc. in Washington.

Call / TTY 711 to talk to a representative.

There Is No Cap On The Amount Of Taxed Wages

Unlike other state insurance programs, there is no cap on wages. All wages and other compensation, including stock-based compensation, bonuses, paid time off, and severance pay, are subject to the tax. For example, an employee with wages of $75,000 will pay $435 toward the Program each year while an employee with wages of $300,000 will pay $1,740 yearly toward the Program.

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Buying Coverage Directly From An Insurer

As an alternative to the Exchange, you can buy insurance directly from insurance companies that operate plans outside the Exchange. See When Should You Enroll in a Plan regarding differences in the open enrollment dates.

You may wish to buy health insurance directly from an insurance company if your doctor or provider is not available through any of the QHPs in the Exchange but is available through a plan sold directly by an insurer. If you are considering doing this, ask your provider which plans they participate in before enrolling. You can get assistance with enrollment from an insurance broker. More information on brokers is available here.

The biggest disadvantage of buying health insurance directly from an insurance company is that you cannot receive Premium Tax Credits or Cost-Sharing Reductions unless you purchase a QHP through the Exchange. This means that if your income is below 400% of the Federal Poverty Level, a QHP will likely be more affordable than buying insurance directly.

Also note that if you bought individual insurance directly from an insurance company before the ACA was passed on March 23, 2010 and its benefits and costs have not changed much, you may be able to keep it if it is considered a grandfathered plan. Currently, only LifeWise has individual market grandfathered plans in Washington State. For more information, click here.

See footnote 2 above.

Where To Apply For Health Coverage

Washington State Health Care Authority  Logos Download

People in most states use HealthCare.gov to apply for and enroll in health coverage.

If your state appears on the list below, you wont use HealthCare.gov. Youll use your states website to enroll in individual/family or small business health coverage, or both.

Covered California is your state’s Marketplace. Visit Californias website.

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Finding The Best Health Insurance Coverage In Washington

The best health insurance coverage for you will depend on your level of income and medical needs. Besides individual health insurance, Washington offers Medicaid coverage through its Apple Health program. Furthermore, the state has passed legislation that expands Medicaid coverage under the Affordable Care Act.

Households with incomes that are below 138% of the federal poverty level can enroll in federally funded health care.

Before choosing a plan, you should analyze the premiums and deductibles for each metal tier and decide on affordability based on your income and savings. Below, we have provided an in-depth look at each metal tier and broken down situations in which they make the most sense.

Start with Silver plans

We recommend starting your search with Silver plans, as these policies have moderate premiums and deductibles.

This policy would work best in most situations unless you are very healthy or expect a number of expensive medical costs. In that case, Bronze or Gold coverage may work better for you.

Silver policies are the only health insurance plans that offer cost-sharing reductions if your income is below 250% of the federal poverty level.

A cost-sharing reduction is an added benefit that decreases the amount you pay for copays, coinsurance and deductibles. For this reason, Silver tier policies can sometimes be the most cost-effective plan offered on the health insurance exchange.

Bronze: Best for young, healthy individuals

Individual Health Insurance For Washington State Residents

Under the Patient Protection and Affordable Care Act , most people are currently required to enroll in health insurance or pay a penalty. However, as of January 1, 2019, Congress removed the penalties to being uninsured, with some exceptions, though the requirement to have insurance remains.

Washington State residents are fortunate to have several options for obtaining coverage. If you do not have health insurance through your employer or government programs like Medicare and Medicaid, you can buy insurance for yourself and your family as individuals. This article provides information about applying for and comparing individual insurance products in Washington, including products sold through the Washington Health Benefit Exchange and products offered in the outside market. It is current as of October 2020.

General information on the ACA and government health programs can be found here.

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When Should You Enroll In A Plan

Usually, you will need to enroll in health insurance and renew your coverage during an open enrollment period. The period for state residents to enroll in 2021 coverage through the Washington State Health Benefit Exchange is .

Apply by December 15 for coverage starting January 1, and apply by January 15 for coverage starting February 1. While Open Enrollment dates are the same on and off the Exchange, some health plans accept enrollment later in the month for coverage starting the next month if you purchase off-Exchange.

You can only enroll in insurance outside of the open enrollment period if your household has a qualifying event or special circumstance that makes you eligible for a special enrollment period.

Washington Dental And Vision Plans

Senator Murray on WA Health Insurance Marketplace

Dental and vision insurance plans, underwritten by Golden Rule Insurance Company, have no age limit restrictions.1 They offer coverage for the dental and vision services many medical insurance plans dont include.

From Seattle to Spokane, Tacoma to Vancouver, explore these Washington health insurance options and more that may be available now.

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Preferred Provider Organization Plans

PPO plans are comprised of a large network of hospitals, specialists and doctors you can choose for care. You dont have to choose a primary care doctor but youre encouraged to do so. Youll pay less if you choose providers within your PPO network because those providers and hospitals have agreed to charge established amounts for care.

Referrals arent required with PPO plans and you can switch doctors anytime. Youll pay less for prescription drugs if you choose drugs on their preferred drug list and use a pharmacy on their preferred pharmacy provider list. PPO plans give you more freedom and theyre typically priced higher.

How Much Will You Pay For Insurance

Seeing a doctor or filling a prescription at a pharmacy can be very expensive. It is also difficult to know when you will need to get medical care. When you buy health insurance, you agree to pay a monthly premium, and in return, the insurance company agrees to pay part of the cost of your medical bills.

Not every health insurance plan helps you pay your bills in exactly the same way. There are differences between plans that affect how much you will need to pay for your health care, and it is important to keep track of each of them when comparing plans. These include monthly premiums, cost-sharing when you get services, and out-of-network charges .

Where you buy your insurance can also affect your healthcare costs. Shopping through the Washington Health Benefit Exchange the state-operated insurance marketplace, can help many people save money.

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What You Need To Know

The Affordable Care Act is a program that allows many Washington residents to access health insurance coverage at an affordable rate and, in some instances, at no cost. The ACA was created to ensure most can get the healthcare they need. You cannot be denied health insurance coverage due to an illness or prior health issue.

The Exchange plans offer more options for insurance coverage through the Washington Healthplanfinder. Beyond the nonstandard plan selection, the Exchange has Cascade Care Plans. Cascade Care launches Washington State on the path to achievable universal care. Like the nonstandard Exchange plans, the Cascade Plans may allow you to receive federal subsidies for premiums, with the subsidy level declining as income rises. All plans offer the ten essential health benefits.

There are three types of Qualified Health Plans plans to choose on the Washington Exchange:

  • Nonstandard Plans offer the ten essential health benefits.
  • Cascade Standard Plans offer more benefits with just a copay instead of having to meet your deductible first. These plans typically offer a lower deductible with more transparent, predictable cost-sharing.
  • Cascade Public Option Plans takes the Cascade Care Standard Plans a step further. These Public Option plans may cost less because they will cap aggregate statewide provider reimbursement rates at 160% of Medicare rates. The Health Care Authority is partnering with the Exchange to establish public option plans.
  • Nasro Provides Clarity Amongst The Chaos

    How to Find Health Insurance as a Freelancer in Washington ...

    NASRO is a non-profit association, founded by health care consultant and activist Robert Gaw, that is both your health care advocate and a humanitarian organization for the common good. NASRO is a trusted independent organization that provides accurate information on the strengths and weaknesses of health insurance carriers and their plans, and we support Washington citizen efforts to make affordable health care available to all state residents and move toward universal health coverage.

    NASRO can assist any state resident with their Washington state health insurance problems in part because we are a non-profit, but also because we work with Washington state health insurance staff that is very dedicated and experienced.

    Our local health insurance and health care professionals are not just working for a living, but are also offering their leadership and have the skill sets to really assist any state resident or employer group with direct straight answers to questions about benefits choices, costs and which health plan provider network is best for you and your family. There are no complicated telephone matrixes, waits or impersonal service from out of state telemarketing centers when you call NASRO .

    The Impact of Health Insurance Reform


    Types of Coverage

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    What Is Covered And How Much Will It Cost

    Coverage and cost depend on where you live, the type of plan you choose, your estimated household income, and the age and disability status of you and your family. If you qualify for Washington Apple Health, youll be able to get free or low-cost coverage and may not need to worry about premiums or copays, depending on your level of income. All Washington Healthplanfinder plans cover 10 essential benefits, including:

    • Emergency services and hospitalization
    • Pediatric care
    • Preventive services, including counseling, screenings and vaccinations

    Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family. Deductibles and out-of-pocket costs vary between plans.Washington law requires children to have dental coverage. Dental is included for children and adults in Washington Apple Health plans, but dental policies need to be purchased separately if you enroll in a Washington Healthplanfinder plan. You can select a dental coverage plan while shopping for your health plan.

    Standardized Plans And A Public Option Available Starting In 2021 But Public Option Only Available In 20 Of The States 39 Counties And Premiums Are Higher Than Officials Had Hoped Cascade Care 20 Enacted In 2021 Makes Improvements And Funds State

    In May 2019, Washington enacted legislation calling for the creation of standardized health plans and a public option health plan that would be available as of 2021 , plus additional premium subsidies that are expected to be available by 2022. The legislation is known as Cascade Care and implementation work began as soon as the bill was enacted.

    HealthCare.gov briefly offered standardized plans in many areas of the country, and several states already had standardized plans. Washington joined them for 2021, with standardized plans and a public option in about half of the states counties available through Washington Healthplanfinder.

    Washingtons insurance commissioner announced in May 2020 that the proposed rate filings for the Cascade Care plans had been submitted by insurers. In early July, the state confirmed that five insurers would offer Cascade Care public option plans in 2021, but noted that the public option plans would only be available in 20 of the states 39 counties in 2021.

    The standardized plan designs include a wide variety of services, all of which would be covered with the same cost-sharing regardless of which insurer offers the plan . The idea is to make it easier for a consumer to compare plans based on things like provider networks and customer service, since the dollar-level benefits wouldnt vary. The exchange on the proposed plan designs, and announced in early December that the plan designs had been approved.

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