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Washington Health Insurance
According to the Center for Disease Control, an average of 14.3% of Washington residents went uninsured for Washington health insurance each year from 2001 to 2003.
Washington Health Insurance Regulations
Any Washington resident who has health insurance through a group or employer cannot be denied or limited coverage under that group Washington health insurance plan. Individuals looking for individual Washington medical coverage can be denied and limited under certain circumstances. Washington health insurance companies require individuals to complete a health questionnaire before approving the application for health insurance coverage. If the score on the questionnaire is high and above 288 then the Washington health insurance company can turn away the applicant but must give written notice that the applicant is eligible for the state’s high risk pool (Washington State Health Insurance Pool). If the score is less than 288 then the company must offer the individual options for health insurance plans.
Washington health insurance plans can have pre-existing condition policies that limit coverage for conditions for which the individual was diagnosed, treated, or should have been diagnosed, treated, or advised during the six months prior to the beginning of coverage under the new policy. A pre-existing condition period can last no more than nine months. Sometimes prior continuous coverage can be credited towards pre-existing condition exclusion periods.
Pregnancy can be considered a pre-existing condition. If the parent’s policy covers dependents, than the individual Washington medical insurance plan automatically covers newborns and adopted children for the first 60 days after birth or adoption. Disabled children may remain under a parent’s policy coverage beyond the age at which dependent coverage usually stops.
Washington health insurance rates cannot vary due to health. An individual cannot be charged more for a health condition. Washington medical insurance rates can, however, vary due to age, family size, demographics, and type of plan.
Some Washington health insurance companies sell temporary individual health insurance. Individuals who are between policies or employers can consider getting temporary health coverage for a limited time through these plans. Rates vary.
Alternative Washington Health Insurance Options
For individuals who have difficulty obtaining or affording Washington health insurance there are state programs that may help:
- Basic Health & Basic Health Plus for Kids are insurance options for uninsured individuals who meet the income eligibility requirements.
- Washington Medicaid is available to any eligible individual who meets the qualifying criteria.
- Washington State Health Insurance Pool (WSHIP) is the state’s high risk pool that allows individuals who may be considered “uninsurable” to purchase individual Washington health insurance. Pre-existing condition period may apply.
- Healthy Kids Now! Is the state’s children’s health insurance program that is designed to provide health insurance for children under 19 whose families do not qualify for Medicaid and who may not be able to afford Washington health insurance.
Washington Office of the Insurance Commissioner
P.O. Box 40255
Olympia, Wash. 98504-0255
Consumer Advocacy — for questions or complaints about your insurance coverage:
(360) 725 - 7080 or 1-800-562-6900
TDD (360) 586-0241
Fax: (360) 586-2018
Statewide Health Insurance Benefits Advisors (SHIBA) HelpLine — health insurance education, assistance and advocacy for consumers of all ages:
TDD (360) 586-0241
Fax (360) 389 - 2745
For other Washington Insurance Resources, See:
Connect With Washington Health Insurance Agents Now By Filling Out The Quick Form At The Top Of The Page.
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