Health Insurance Companies in Washington State: A Comprehensive Guide

Washington state has a diverse range of health insurance companies to choose from, each with its own unique features and benefits.

Premera Blue Cross is one of the largest health insurance companies in Washington state, offering a wide range of plans to individuals and families.

For those who are self-employed or have a small business, Kaiser Permanente is a popular option, offering affordable group plans and a network of quality healthcare providers.

Aetna is another well-established health insurance company in Washington state, providing a variety of plans that cater to different needs and budgets.

If you're looking for health insurance companies in Washington state, you have several options. Twelve insurers offer Marketplace plans in Washington as of 2024, but this number may change in the future.

Some of the top health insurance companies in Washington state include BridgeSpan, Community Health Network, and Kaiser. These companies offer individual and family plans in Washington.

PacificSource is one of the insurers that offers Marketplace plans in Washington, but it's exiting the market at the end of 2024. If you're enrolled in a PacificSource plan, you'll need to select a new plan during open enrollment, which begins November 1, 2024.

Here are some of the top health insurance companies in Washington state:

Eleven of the insurers that offered Marketplace plans in Washington as of 2024 will continue to offer coverage in 2025, providing stability for those who have plans with them.

In Washington state, you can enroll in an ACA-compliant plan during the open enrollment period, which begins on November 1 and continues through January 15. If you enroll by December 15, your coverage will be effective on January 1, while enrollments completed between December 16 and January 15 will have coverage effective on February 1.

You can enroll in an ACA Marketplace/exchange plan through Washington Healthplanfinder, the state's health insurance exchange, which allows you to compare plans, determine your eligibility for financial assistance, and enroll in coverage during open enrollment or a special enrollment period. You can reach Washington Healthplanfinder's customer service team at 855-923-4633 (TTY/TDD: 855-627-9604) for assistance.

To be eligible to enroll in private health coverage through Washington Healthplanfinder, you must live in Washington, not be incarcerated, and not be enrolled in Medicare. Additionally, you must be lawfully present in the U.S. to use the exchange/Marketplace, although Washington has obtained federal permission to allow undocumented immigrants to enroll in health plans starting with the 2024 plan year.

Here are the state's Medicaid financial requirements:

To be eligible to enroll in private health coverage through Washington Healthplanfinder, you must live in Washington, not be incarcerated, and not be enrolled in Medicare. You must also be lawfully present in the U.S. to use the exchange/Marketplace in any state, although Washington obtained federal permission to allow undocumented immigrants to enroll in health plans through Washington Healthplanfinder starting with the 2024 plan year.

You can buy Marketplace health insurance in Washington through HealthCare.gov or directly from a health insurance company. To enroll in a plan, you can visit Washington Healthplanfinder, which is the state's health insurance exchange.

To qualify for financial assistance, you must not have access to an affordable plan offered by an employer, not be eligible for Apple Health (Medicaid/CHIP), and not be eligible for premium-free Medicare Part A. You must also file a joint tax return with your spouse, if you're married, and not be able to be claimed by someone else as a tax dependent.

Here are the state's Medicaid financial requirements, which are also known as Apple Health:

Some qualified health plans for individuals and families in Washington include BridgeSpan, Community Health Plan of Washington, and Kaiser Permanente Washington. You can also enroll in a plan directly from a health insurance company.

The Exchange received initial operational and implementation funding through federal grant dollars totaling $302,333,310.

This substantial amount of grant funding was used to develop the IT system critical to determining eligibility for and enrolling residents in health plans, which is essential for a smooth enrollment process.

The grant funding also supported activities such as the development of the navigator program and a marketing campaign, which helped raise awareness about the Exchange.

Beginning in 2015, the Exchange was required to be self-sustaining and has been appropriated funds by the state legislature.

The Exchange sustainability is tied to three funding sources established in statute: the existing 2 percent tax on health insurance premiums sold through Washington Healthplanfinder.

Reimbursement for activities performed on behalf of Washington Apple Health, the state's Medicaid program, is also a funding source for the Exchange.

An agreed upon carrier assessment is the third funding source for the Exchange.

The Exchange was provided with $110 million for operation in the recently passed 2015-17 biennial budget.

There are 12 insurers offering Marketplace plans in Washington as of 2024, and 11 of them will continue to offer coverage in 2025. PacificSource is exiting the Washington market at the end of 2024.

You can choose from various plan types, including bronze, silver, gold, and platinum, with different levels of coverage and costs. Bronze plans have the lowest premiums, but also the lowest level of coverage, with a $305 average monthly premium for a 40-year-old non-smoker.

Here's a breakdown of the average monthly premiums for each plan type in 2020:

Keep in mind that premiums for gold plans cost nearly 43 percent more than bronze plans, and gold plans cover 80 percent of healthcare costs, while bronze plans cover 60 percent.

Choosing a health insurance plan in Washington means selecting a provider network that works for you. Some plans have networks of doctors and hospitals that you must use in order to receive full coverage.

You'll pay much more to purchase health services from a provider who is not included in the network, and some health plans don’t cover out-of-network services at all. Out-of-network charges can be very large, and you might receive a "surprise bill" or "balance bill" after receiving services.

It's essential to make sure your regular doctors or other providers are included in the network. You can use WA Healthplanfinder to start shopping for plans, and their "Smart Planfinder" tool can help you choose a plan by searching for your providers, facilities, and prescriptions.

In Washington, consumers are now protected from some kinds of out-of-network "surprise bills" under the state Balance Billing Protection Act and federal No Surprises Act. If these laws apply to your plan, you cannot be billed more than the in-network cost-sharing amount for care you receive in certain situations.

Under the Affordable Care Act (ACA), most plans no longer have annual benefit limits, and none have lifetime benefit limits.

The ACA set new minimum standards for all health plans, eliminating pre-existing condition limitations and questionnaires about your health status.

Insurers must provide a summary of their plans' coverage, including all services listed in the Washington state benchmark plan, and offer additional services if they choose to.

You'll receive a summary of benefits and coverage (SBC) and a glossary of commonly used terms before enrolling and each year when you renew your plan.

State law requires your insurer to give you certain information if you request it.

For Apple Health, income eligibility maximums are updated annually in April, using the current year's Federal Poverty Level (FPL) standards.

For Washington Health Benefit Exchange Qualified Health Plans, income eligibility maximums are updated annually in January with a one-year lag, using the previous year's FPL standards.

If you're looking to improve your smile, dental insurance can be a smart addition to your health coverage. Dental coverage in Washington can vary depending on the type of plan you choose.

Many dental insurance plans in Washington offer coverage for routine cleanings, fillings, and extractions. Some plans may also cover more extensive procedures like crowns and root canals.

Some dental insurance plans in Washington may have a waiting period before you can use your coverage for certain procedures. For example, some plans may require you to wait six months before getting a crown.

Hoping to improve your smile? Dental insurance may be a smart addition to your health coverage.

The cost of health insurance in Washington state can be a bit of a puzzle to figure out. The average monthly cost per individual per month is $517, according to the Washington Office of the Insurance Commissioner. This figure can vary depending on factors such as your age, health, and income.

If you're 40 years old, you can expect to pay around $482 for a Gold plan, $443 for a Silver plan, or $332 for a Bronze plan. These prices have been steadily increasing over the years, with a 10.7% average rate increase approved for 2025.

To give you a better idea of how costs have changed, here's a breakdown of the average cost of health insurance for a 40-year-old in Washington state over the past few years:

Keep in mind that these prices are for full-price premiums, and most enrollees receive premium subsidies to lower their costs.

You have two types of health care plans to choose from. These plans are designed to provide varying levels of coverage and cost.

There are four metal tiers to consider: bronze, silver, gold, and platinum. Bronze plans cover 60% of healthcare costs, while gold plans cover 80%.

If you're a 40-year-old non-smoker from Washington, here's what you can expect to pay in average monthly premiums for each plan type:

Some people may qualify for catastrophic plans, which come with a $8,150 yearly deductible.

If you're looking to enroll in a Marketplace plan in Washington, you can visit Washington Healthplanfinder to compare plans and determine eligibility for financial assistance.

You can enroll in coverage through Washington Healthplanfinder with the help of an insurance agent or broker, or an exchange-certified Navigator.

Twelve insurers offer Marketplace plans in Washington as of 2024, although PacificSource is exiting the market at the end of 2024.

You can reach Washington Healthplanfinder's customer service team at 855-923-4633 (TTY/TDD: 855-627-9604) for assistance.

There are several qualified health plans available for individuals and families, including BridgeSpan, Community Health Plan of Washington, and Kaiser Permanente Washington.

Here are some of the qualified health plans available for individuals and families:

For small businesses, there are also qualified health plans available, including Kaiser Foundation Health Plan of the Northwest and UnitedHealthcare.

Medicare coverage is a vital aspect of healthcare in Washington state. If you're 65 or older, you qualify for Medicare, which offers various coverage options.

There are four main parts to Medicare: A, B, C, and D. Medicare Part A covers hospital stays, while Part B covers doctor visits and outpatient care. Part C is a Medicare Advantage plan, and Part D covers prescription medications.

To qualify for a Medicare Savings Program, you must meet certain income limits. For individuals, the monthly income limit is $1,456. For married couples, it's $1,960.

Here's a summary of the income limits for Medicare Savings Programs:

Short-term coverage is an option for those who need temporary health insurance.

Short-term health plans provide temporary health insurance for consumers who may find themselves without comprehensive coverage.

These plans are designed to fill gaps in coverage, such as between jobs or during a waiting period for a new plan to kick in.

In Washington, short-term health plans are available to provide temporary health insurance coverage.

HMO plans are a type of health insurance that focus on health and wellness, encouraging optimal health through programs like fitness and weight loss programs, smoking cessation programs, and blood pressure medication.

You'll need to choose a primary care doctor for all regular visits with an HMO plan, and if you need to see a specialist, your doctor will need to give you a referral.

HMO plans are more limiting than other types of plans, requiring you to use a network of doctors and hospitals in order to receive full coverage.

If you choose a provider outside of the network, you'll pay full price for care with an HMO plan.

HMO plans typically cost less than PPO plans, making them a more affordable option for some people.

You have different types of health care plans to choose from, including bronze, silver, gold, and platinum plans. These plans vary in terms of coverage and cost.

Bronze plans offer the lowest level of coverage, with 60 percent of healthcare costs covered. This means you'll pay more out-of-pocket for medical expenses.

Silver plans offer moderate coverage, with 70 percent of healthcare costs covered. This is a good option for those who want a balance between coverage and cost.

Gold plans offer the highest level of coverage, with 80 percent of healthcare costs covered. This means you'll pay less out-of-pocket for medical expenses, but premiums are higher.

Here's a breakdown of the average monthly premiums for each plan type in Washington State in 2020:

Some people may qualify for catastrophic plans, which offer the lowest level of coverage. However, these plans come with a $8,150 yearly deductible, making them a less attractive option for those who need regular medical care.

Here's what you need to know about health insurance companies in Washington state:

You can purchase health insurance from the Washington Health Benefit Exchange, also known as Washington Healthplanfinder.

There are several health insurance companies in Washington state, including Premera Blue Cross, Kaiser Permanente, and UnitedHealthcare.

Premera Blue Cross offers a wide range of health insurance plans, including individual and family plans, as well as Medicare Supplement plans.

Kaiser Permanente has a strong network of providers and offers a variety of health insurance plans, including HMO and PPO plans.

UnitedHealthcare offers a range of health insurance plans, including individual and family plans, as well as Medicare Advantage plans.

The Washington Health Benefit Exchange offers a tax credit to eligible individuals and families who purchase health insurance through the exchange.

You can enroll in a health insurance plan through the Washington Health Benefit Exchange during the annual open enrollment period, which typically runs from November to January.

Kaiser Permanente has a strong focus on preventive care and offers a range of wellness programs and services to its members.

Premera Blue Cross offers a 24/7 nurse hotline and online chat service to help members with questions and concerns.

UnitedHealthcare offers a mobile app that allows members to access their health insurance information and communicate with their providers on the go.

Washington State has a state-run health plan marketplace called Washington Healthplanfinder, which makes it easy to compare and apply for individual insurance plans.

You can also find other health care coverage options in Washington helpful, including information on government programs.

Washington Healthplanfinder is a great resource for residents to find and compare individual insurance plans in a single place.

If you're looking for the best health insurance options in Washington state, you have several top-notch providers to choose from. Kaiser Permanente is a great choice for budget-friendly care, while Regence BlueShield of Washington offers nationwide coverage.

The National Committee for Quality Assurance (NCQA) has rated private insurance plans in Washington, and their top picks for health insurance plans include those from Providence Health Plan, Kaiser Permanente, and Regence BlueCross BlueShield.

To find the best health insurance provider for your needs, you can use the "Smart Planfinder" tool on the WA Healthplanfinder website, which allows you to search for plans by provider, facility, and prescription.

Here are some of the best Washington health insurance companies to consider:

These companies offer individual and family plans in Washington, and some of them have received top ratings from the NCQA for their quality of care and customer satisfaction.

In Washington, the open enrollment period for health insurance begins on November 1 and continues through January 15.

You can enroll in an ACA-compliant plan during this time, but keep in mind that enrollments completed by December 15 will have coverage effective January 1, while enrollments completed between December 16 and January 15 will have coverage effective February 1.

If you experience a qualifying life event, such as giving birth or losing other health coverage, you may still be able to enroll or make a plan change after the open enrollment period ends.

Enrollment in Washington’s Apple Health (Medicaid) is available year-round for eligible applicants, so if you're eligible, you don't have to wait for open enrollment to sign up.

The open enrollment period for health insurance in Washington typically runs from November 1st to December 15th each year, although special enrollment periods may be available for certain qualifying life events.

It's a good idea to take extra time to consider your options before signing up for a plan, as the health insurance plan you choose has a big impact on your health and finances.