Washington State Health Insurance Quotes – Compare The Cheapest Plans

Find the most affordable medical insurance rates in the state of Washington. Easily compare multiple companies that offer the lowest  prices for  individuals, families and small business owners. The Washington Healthplanfinder was created by the State Health Benefit Exchange and the Affordable Care Act legislation to make it easier to review low cost options and quickly enroll online for coverage.

2019 Open Enrollment began November 1st. However, Washington Apple Health (Medicaid) and Medicare for persons age 65 and over, have different qualifying periods. Senior Medigap coverage is offered through Supplement and Advantage plans that can often pay for many expenses not covered by original Medicare. Also, it is possible for one spouse to be covered under a Marketplace plan, while the other spouse has a combination of Medicare and Medigap benefits.

Special Enrollment Periods (SEP) are available throughout the year with an approved exception. For example, if you lose qualified benefits from an employer, move to a different service area, reach age 26 while covered on a parent’s plan, get divorced, or become pregnant, a qualifying life event has been created.  However, non-compliant short-term plans may be purchased throughout the entire year. Note: December 16th-January 15th was designated as an extended OE period.

Typically, the Northwest features some of the most favorable prices for healthcare. Premiums offered by the major companies are usually very budget-friendly even though “Basic Health” is no longer available for households whose income (before taxes) is below 200% of the Federal Income Guidelines. Instead, a combination of subsidized Marketplace plans and Medicaid eligibility policies provide many low-cost choices.

Prices will not be the same in all parts of the state. For example, individual premiums in Seattle or Spokane will not be identical to rates in Yakima or Tacoma. The proximity of hospitals and physicians, and the effectiveness of their treatment, will affect what you pay. Naturally, we find the most competitive offers from all of the “big players.” And since prices change so often, we update the best options daily.

 

What Is The Washington Health Marketplace?

The Exchange (Marketplace) offers coverage to individuals and families (you can still view rates and apply on our website). Comprehensive, catastrophic, HSA, and high-deductible  policies are offered on a single or family basis. You can view the best prices later in this article or by utilizing our quote box. Small businesses are also eligible to apply for a policy through a special “SHOP” Exchange.

You can purchase plans with the help of a federal subsidy (if you qualify), or choose to enroll in an “off-Marketplace” plan, that does not use federal funding to pay any of the premium. Both types of policies are not medically-underwritten, so you can not be turned down because of past, present, or potential future conditions.

 

Participating Insurers

The eight Marketplace companies in Washington are  BridgeSpan, Coordinated Care,  Kaiser Foundation Health Plan Of Washington, Kaiser Foundation Health Plan Of The Northwest, LifeWise, Molina, and Premera Blue Cross.  Each carrier offers individual and family plans that are available through the Marketplace. A brief synopsis each company is provided below.

Thanks to the Affordable Care Act, you don’t have to medically qualify for any of the plans, and federal subsidies can reduce the premium (if you meet income eligibility requirements). However, as your income changes, it’s important to recalculate your financial subsidy. Significant differences in income from one year to another could result in large rate increases or decreases.

Washington Health Plans And Rates By Region For 2019

Find Best Healthcare Plans In State Of Washington

Washington’s Five Healthcare Regions

 

The state is divided into five regions, which determine the specific carriers that offer “on-Exchange” policies and the participating counties where they are available. We have outlined each of the five counties below:

Region 1 – King County. Available companies include Coordinated Care, Kaiser Foundation Healthcare Of Washington, Molina, and Premera Blue Cross.

Region 2 – Counties of Clallam, Jefferson, Mason, Whatcom, Skagit, Pierce, Lewis, Grays Harbor, Kitsap, Thurston,  Pacific, Cowlitz, San Juan,  Island, Wahkiakum, and Snohomish. Available companies include  Coordinated Care,  Kaiser Foundation Health Plan Of Washington, Kaiser Foundation Health Plan Of The Northwest, Molina, Premera Blue Cross, and LifeWise.

Region 3 – Counties of Clark, Skamania and Klickitat. Available companies include BridegeSpan,  Kaiser Foundation Health Plan Of The Northwest, LifeWise, Molina, and Premera Blue Cross.

Region 4 – Counties of Ferry, Stevens, Lincoln, Spokane, and Pend Oreille. Available companies include  Kaiser Foundation Health Plan Of Washington, Coordinated Care, LifeWise, Molina, and Premera Blue Cross.

Region 5 – Counties of Yakima, Benton, Douglas, Grant, Franklin, Adams, Columbia, Okanogan, Chelan, Kittitas, Walla Walla, Asotin, Garfield, and Whitman. Available companies include Asuris, BridgeSpan, Coordinated Care, Lifewise, Health Alliance Northwest, Kaiser Foundation Health Plan Of Washington,  Molina, and Premera Blue Cross.

 

Individual Companies Offering Policies

Premera Blue Cross is the Pacific Northwest’s biggest healthcare provider, insuring individuals, families, and businesses. More than two million persons are covered under medical, dental, vision, disability, life or other ancillary products. Most customers live in Washington, Oregon, or Alaska. Medicare Supplement coverage is available to Seniors, and all policyholders can choose from a provider network of more than 35,000 doctors, hospitals, and other facilities. Popular plan options include Preferred Bronze HSA EPO 5250, Preferred Bronze EPO 6350, Preferred Silver HSA EPO 3000, and Preferred Silver EPO 4500.

Lifewise prides itself on great customer service and a vast network of more than 15,000 doctors and facilities. The Essential Bronze EPO 6350, and Essential Silver HSA EPO 3000 are two of their most competitive plan options. Additional Silver-tier and Gold-tier plans are also offered.

Find affordable healthcare plans in State Of Washington

Affordable Washington Health Insurance Plans

 

Coordinated Care  covers about 200,000 persons in the state. The parent company is Centenne Corporation, who offers plans under the brand name “Ambetter” in many states. Often, their prices are very competitively-priced. Washington Apple Health plan (low-income adults) and Apple Health Core Connections (children and young adults) are also offered. Many popular and low-cost plans are available, including Ambetter Essential Care1, Ambetter Balanced Care 4, Ambetter Balanced Care 2, and Ambetter Balanced Care 1.

Molina offers integrated Medicare and Medicaid coverage, along with Marketplace plans in many states. Rates are generally attractive, and several plan choices are offered. Bronze-tier plans are not available.

Bridgespan is affiliated with Cambia Health Solutions and offers coverage in Washington, Utah, Idaho, and Oregon. Member satisfaction is typically high, and several ancillary dental and vision products are offered. Popular plans include Bronze HDP 6000 EPO Providence/Swedish Health, and Bronze HDHP 6000 EPO MultiCare Connected Care.

Kaiser Foundation Health Plan is the biggest nonprofit healthcare organization in the US. Although many of their customers are located in the West, they still cover more than 8 million persons. States that they service include Washington, Virginia, Oregon, California, Colorado, Maryland, Hawaii, Georgia, Ohio, and the District of Columbia. Based in Oakland, Kaiser was founded more than 70 years ago, and also consists of many hospitals, and the for-profit Permanente Medical Groups.  Their most affordable Washington plans are  KP WA Bronze 5700/30% HSA, KP WA Bronze 6500/50, KP WA Bronze 5000/50, and KP WA Silver 3000/30. The two companies offering coverage are Kaiser Foundation Health Plan of the Northwest and Kaiser Foundation Health Plan of Washington.

 

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Healthcare Reform Is Here

 

NOTE: Approximately 250,000 persons do not have group benefits provided by an employer, or government-provided coverage, such as Medicaid or CHIP. More than 200,000 persons typically enroll in the Exchange, and more than half of these applicants qualify for a federal subsidy.  If household income changes, the amount of the provided subsidy is also likely to increase or decrease. All Marketplace tiers are eligible for financial aid except “catastrophic” plans, which are offered to applicants under age 30.

Also, the federal mandate requiring the purchase of “qualified” healthcare ended at the beginning of 2019. Previously, the tax penalty could be as high as 2.5% of the household income. Any lapse in coverage resulted in a pro-rated penalty, based on the number of months that members were uninsured. The penalty was applied the following year when federal taxes were filed.

 

The Exchange

The Washington Health Insurance Exchange (Marketplace) started accepting applications five years ago. (When you request quotes on our website, you will be able to view your options). Close to a half of a million persons applied for coverage. Senate Bill 5445 created the establishment of the program, which is designed to offer affordable medical plans to all residents, regardless of income.  The program is also referred to as the “Healthplanfinder.”

There is no required medical underwriting  since it is community-rating based. Your age, zip code and smoking status are the principal criteria to determine pricing. A federal tax is levied for residents that do not purchase coverage (since it is now a law). For 2018, the maximum penalty is 2.5% of  qualified household income. Also, subsidies (in the form of instant tax credits) can potentially  reduce your premium by as much as 100%!

2019 prices are higher than 2018. A 13.8% increase is the average of all carriers, which is less than the average increase over the last decade. The largest rate hikes are  by the biggest insurers such as Premara Blue Cross, who has more than a 45% market share. In fairness, Premara also assumes the most risk because of its large customer-base.

 

Most Affordable Washington State Health Insurance Plans

 

Catastrophic Tier

Kaiser Core Basics Plus – $7,900 deductible with $7,900 maximum out-of-pocket expenses and 0% coinsurance. First three pcp office visits are covered at 100%.

 

Bronze Tier

Kaiser Flex Bronze – $5,500 deductible with $7,150 maximum out-of-pocket expenses and 20% coinsurance. First three pcp office visits are covered with a $40 copay. Preferred generic drug copay is $25 ($20 for mail order).

Kaiser Core Bronze HSA – HSA-eligible plan with $4,750 deductible and $6,550 maximum out-of-pocket expenses with 20% coinsurance.

Premera Blue Cross Personal Care Bronze – $6,350 deductible with $7,850 maximum out-of-pocket expenses and 20% coinsurance. $50 pcp office visit copay.

Premera Blue Cross Preferred Bronze HSA  – HSA-eligible plan with $5,250 deductible and $6,700 maximum out-of-pocket expenses with 40% coinsurance.

BridgeSpan Bronze HDHP 6000- HSA-eligible plan with $6,000 deductible and $6,750 maximum out-of-pocket expenses with 30% coinsurance.

LifeWise Essential Bronze EPO 6350 – $6,350 deductible with $7,850 maximum out-of-pocket expenses and 40% coinsurance. $50 pcp office visit copay.

 

Silver Tier

Ambetter Balanced Care 4 (Coordinated Care) – $7,050 deductible with $7,050 maximum out-of-pocket expenses and 0% coinsurance. Office visit copays are $30 and $60. The Urgent Care copay is $100. Generic and preferred drug copays are $15 and $50 ($45 and $150 for mail order).

Ambetter Balanced Care 2 (Coordinated Care) – $6,500 deductible with $6,500 maximum out-of-pocket expenses and 0% coinsurance. Office visit copays are $30 and $60. The Urgent Care copay is $100. Generic and preferred drug copays are $15 and $50 ($45 and $150 for mail order).

Ambetter Balanced Care 1 (Coordinated Care) – $5,500 deductible with $6,500 maximum out-of-pocket expenses and 20% coinsurance. Office visit copays are $30 and $60. The Urgent Care copay is $100. Generic and preferred drug copays are $10 and $50 ($30 and $150 for mail order).

Ambetter Balanced Care 3 (Coordinated Care) – $3,000 deductible with $6,750 maximum out-of-pocket expenses and 30% coinsurance. Office visit copays are $30 and $60. The Urgent Care copay is $100. Generic and preferred drug copays are $25 and $50 ($75 and $150 for mail order).

Molina Choice Silver – $5,350 deductible with $7,900 maximum out-of-pocket expenses and 30% coinsurance. Office visit copays are $30 and $75. The Urgent Care copay is $50. Tier 1 and Tier 2 drug copays are $20 and $60.

LifeWise Essential EPO 4000 – $4,000 deductible with $7,350 maximum out-of-pocket expenses and 30% coinsurance. Office visit copays are $30 ($0 for first two visits) and $60.  Tier 1 and Tier 2 drug copays are $20 and $60.

 

Sample Monthly Rates

 

30 Year-Old Residing in Seattle (King County) With $23,000 Income

$52 – Kaiser Bronze – $7,150 deductible with $7,150 maximum out-of-pocket expenses and 0% coinsurance.

$58 – Kaiser Flex Bronze – $7,000 deductible with $7,150 maximum out-of-pocket expenses and 20% coinsurance. $40 pcp office visit copay for first three visits. $25 copay for preferred generic drugs ($20 copay for 90-day mail order).

$60 – Kaiser Core Bronze HSA – HSA-eligible plan with $5,500 deductible and $6,550 maximum out-of-pocket expenses and 20% coinsurance.

$108 – Coordinated Care Ambetter Balanced Care 4 – $1,850 deductible with maximum out-of-pocket expenses of $1,850 and 0% coinsurance. Office visit copays are $0 and $5, with $10 Urgent Care copay. Preferred brand drug copay is $25 ($75 copay for 90-day mail order).

$118 – Coordinated Care Ambetter Balanced Care 2 – $1,750 deductible with maximum out-of-pocket expenses of $1,750 and 0% coinsurance. Office visit copays are $1 and $5, with $10 Urgent Care copay. Preferred brand drug copay is $25 ($75 copay for 90-day mail order). Generic drug copay is $1 ($3 copay for 90-day mail order).

 

40 Year-Old Married Couple (2 Persons) Residing in Tacoma (Pierce County) With $40,000 Household Income

$207 – Kaiser Bronze – $7,150 deductible with $7,150 maximum out-of-pocket expenses and 0% coinsurance.

$223 – Kaiser Flex Bronze – $7,000 deductible with $7,150 maximum out-of-pocket expenses and 20% coinsurance. $40 pcp office visit copay for first three visits. $25 copay for preferred generic drugs ($20 copay for 90-day mail order).

$226 – Kaiser Core Bronze HSA – HSA-eligible plan with $5,500 deductible and $6,550 maximum out-of-pocket expenses and 20% coinsurance.

$253 – Coordinated Care Ambetter Balanced Care 4 – $5,250 deductible with maximum out-of-pocket expenses of $5,250 and 0% coinsurance. Office visit copays are $15 and $40, with $75 Urgent Care copay. Generic and preferred brand drug copays are $15 and $50 ($45 and $150 copay for 90-day mail order).

$274 – Coordinated Care Ambetter Balanced Care 2 – $5,000 deductible with maximum out-of-pocket expenses of $5,000 and 0% coinsurance. Office visit copays are $25 and $50, with $75 Urgent Care copay. Generic and preferred brand drug copays are $15 and $50 ($45 and $150 copay for 90-day mail order).

 

50 Year-Old Married Couple With Two Children (4 Persons) Residing in Tacoma (Tacoma County) With $78,000 Household Income

$522 – Kaiser Bronze – $7,150 deductible with $7,150 maximum out-of-pocket expenses and 0% coinsurance.

$552 – Kaiser Flex Bronze – $7,000 deductible with $7,150 maximum out-of-pocket expenses and 20% coinsurance. $40 pcp office visit copay for first three visits. $25 copay for preferred generic drugs ($20 copay for 90-day mail order).

$558 – Kaiser Core Bronze HSA – HSA-eligible plan with $5,500 deductible and $6,550 maximum out-of-pocket expenses and 20% coinsurance.

$590 – Coordinated Care Ambetter Balanced Care 4 – $5,250 deductible with maximum out-of-pocket expenses of $5,250 and 0% coinsurance. Office visit copays are $15 and $40, with $75 Urgent Care copay. Generic and preferred brand drug copays are $15 and $50 ($45 and $150 copay for 90-day mail order).

$630 – Coordinated Care Ambetter Balanced Care 2 – $5,000 deductible with maximum out-of-pocket expenses of $5,000 and 0% coinsurance. Office visit copays are $25 and $50, with $75 Urgent Care copay. Generic and preferred brand drug copays are $15 and $50 ($45 and $150 copay for 90-day mail order).

 

History of Obamacare In The Evergreen State

Nine carriers had said they were going to participate in the original 2014 Healthplanfinder. Bridgespan and Premera Blue Cross were two of a handful of companies that had submitted their prices for the Exchange. Preliminary monthly rates were approximately $220 for a 21-year old and $600 for a 60-year old. Of course, the federal subsidy was not included in those prices, and rates subsequently reduced for most applicants.

The Washington Health Benefit Exchange Board discussed, reviewed and approved seven companies that offered consumers coverage beginning in 2014. Prices and other specific details were electronically entered in a database that were able to be viewed  in October (2013).

The seven approved companies for the inaugural year (2014) were  BridgeSpan, Premera Blue Cross, Group Health Cooperative, Kaiser, LifeWise of Washington, Community and Molina. They offered between 30 and 40 plans on the Marketplace. Coordinated Care became the eighth approved company. Kaiser Health Plans are also extensively covered on our website.

It’s unclear how each of these carriers will continue to handle illegal immigrants in the state. “Apple Health”  (Medicaid)  (see below) will cover women who are pregnant and any child between the ages of 0 and 17. For  some legal immigrants that don’t speak English fluently, it will be a challenge to understand Enrollment procedures. However, steps are being taken to help, including  hiring many staff members that can speak and understand Spanish.

As plans and benefits (and prices) change, we will keep you updated. Currently, there are many affordable individual and family policies available. We make it easy for you to compare and apply for coverage. Providing your zip code is the first step.

 

Senior Washington Medigap Coverage

 

Medicare Supplement

Standardized Supplement plans help persons that have reached age 65, cover many out-of-pocket expenses, including  hospital coinsurance, deductible, hospice coinsurance (Part A) and coinsurance or copay, deductible, and excess charges (Part B). Illustrated below are current monthly rates (Age 65 and older) for popular Medicare Supplement plans from several major carriers:

Plan A

$105 – Globe

$122 – AARP-UnitedHealthcare

$130 – Kaiser

$135 – USAA

$136 – Transamerica

$142 – Aetna

$146 – First Health And Life

$151 – Regence Blue Shield

$153 – United American

$154 – Asuris Northwest Health

$170 – Mutual Of Omaha

$172 – Premera Blue Cross

$174 – State Farm

$174 – Loyal American

$204 – Humana

$205 – Colonial Penn

$210 – Assured Life

$225 – Gerber

$258 – Sentinel

 

Plan B

$165 – Globe

$167 – Aetna

$179 – AARP-UnitedHealthcare

$179 – Transamerica

$216 – United American

$216 – Humana

$242 – Sentinel

$267 – Colonial Penn

 

Plan C

$191 – Globe

$196 – Western United Life

$211 – AARP-UnitedHealthcare

$212 – Transamerica

$215 – Regence Blue Shield

$220 – Regence BCBS

$223 – Government Personnel Mutual

$251 – Humana

$254 – United American

$262 – State Farm

$300 – Sentinel

$323 – Standard Life

 

Plan D

$196 – Transamerica

$233 – Assured Life

$237 – Standard Life

$239 – United American

 

Plan F (High Deductible)

$44 – United American

$46 – Standard Life

$47 – Globe

$68 – Mutual Of Omaha

$72 – Colonial Penn

$78 – Humana

$90 – Premera Blue Cross

 

Plan F

$193 – Globe

$200 – First Health And Life

$202 – Aetna

$203 – USAA

$210 – AARP-UnitedHealthcare

$211 – Premera Blue Cross

$213 – Transamerica

$214 – Cigna

$214 – Loyal American

$216 – Regence BCBS

$221 – Asuris Northwest Health

$229 – Mutual Of Omaha

$231 – Loyal American

$251 – Group Health

$256 – United American

$256 – Humana

$265 – State Farm

$273 – Gerber

$296 – Colonial Penn

$303 – Sentinel

 

Plan G

$171 – Loyal American

$177 – GPM Health

$177 – Regence BCBS

$177 – Mutual Of Omaha

$182 – AARP-UnitedHealthcare

$186 – First Health And Life

$186 – Aetna

$187 – Regence Blue Shield

$188 – Transamerica

$213 – United American

$233 – Gerber

$235 – Assured Life

$273 – Colonial Penn

 

Plan K

$57 – AARP-UnitedHealthcare

$87 – Group Health

$113 – Humana

$115 – Regence Blue Shield

 

Plan L

$122 – AARP-UnitedHealthcare

$164 – Humana

 

Plan N

$129 – Cigna

$129 – Loyal American

$140 – Mutual Of Omaha

$141 – Group Health

$145 – Regence Blue Shield

$155 – Humana

$162 – Transamerica

$162 – Premera Blue Cross

$194 – United American

 

Medicare Part D Prescription Drug

Prescription drugs from Medicare can be obtained from an Advantage plan or a stand-alone Part B plan. Each policy has a list of covered drugs (Formulary), which are placed into different “tiers.” The lower the tier, the lower are your out-of-pocket expenses. Shown below are options for the state of Washington. Prices can change each year. If a change is made to the formulary, and you are actively taking the prescription, 60 days advanced notice must be provided.

AARP UnitedHealthcare Medicare Rx Walgreens –  Monthly premium of $28.00 with $415 deductible. Tier 1 drugs covered at 100%. Tier 2 preferred 30-day and 90-day cost-sharing copays are $5 and $15. Tier 3 preferred 30-day and 90-day cost-sharing copays are $30 and $90. 2,884 formulary drugs available.

AARP UnitedHealthcare Medicare Rx Saver Plus –  Monthly premium of $33.80 with $415 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $1 and $3. Tier 2 preferred 30-day and 90-day cost-sharing copays are $6 and $18. Tier 3 preferred 30-day and 90-day cost-sharing copays are $25 and $75. 2,954 formulary drugs available.

AARP UnitedHealthcare Medicare Rx Preferred–  Monthly premium of $76 with $0 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $5 and $15. Tier 2 preferred 30-day and 90-day cost-sharing copays are $10 and $30. Tier 3 preferred 30-day and 90-day cost-sharing copays are $40 and $120. 3,367 formulary drugs available.

Aetna Medicare Rx Saver –  Monthly premium of $32.60 with $320 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $1 and $3. Tier 2 preferred 30-day and 90-day cost-sharing copays are $2 and $6. Tier 3 preferred 30-day and 90-day cost-sharing copays are $30 and $90.

Asuris Script Medicare Basic – Monthly premium of $100 with $210 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $5 and $10. Tier 2 preferred 30-day and 90-day cost-sharing copays are $15 and $30. Tier 3 preferred 30-day and 90-day cost-sharing copays are $47 and $117.50.

Asuris Script Medicare Enhanced – Monthly premium of $160.50 with $0 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $2 and $4. Tier 2 preferred 30-day and 90-day cost-sharing copays are $5 and $10. Tier 3 preferred 30-day and 90-day cost-sharing copays are $42 and $105.

Cigna-HealthSpring Rx Secure – Monthly premium of $28.70 with $405 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $1 and $3. Tier 2 preferred 30-day and 90-day cost-sharing copays are $5 and $15. Tier 3 preferred 30-day and 90-day cost-sharing copays are $35 and $105.

Cigna-HealthSpring Rx Secure Extra – Monthly premium of $49.40 with $0 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $4 and $12. Tier 2 preferred 30-day and 90-day cost-sharing copays are $10 and $30. Tier 3 preferred 30-day and 90-day cost-sharing copays are $42 and $126.

EnvisionRxPlus –  Monthly premium of $12.60 with $300 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $1 and $2. Tier 2 preferred 30-day and 90-day cost-sharing copays are $6 and $18. Tier 3 preferred 30-day and 90-day cost-sharing copays are $34 and $102.

Express Scripts Medicare Saver –  Monthly premium of $22.60 with $405 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $1 and $3. Tier 2 preferred 30-day and 90-day cost-sharing copays are $4 and $12. Tier 3 preferred 30-day and 90-day cost-sharing copays are 18%.

Express Scripts Medicare Value –  Monthly premium of $49.60 with $405 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $1 and $3. Tier 2 preferred 30-day and 90-day cost-sharing copays are $3 and $9. Tier 3 preferred 30-day and 90-day cost-sharing copays are $18 and $54.

First Health Part D Value Plus –  Monthly premium of $52.60 with $0 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $2 and $6. Tier 2 preferred 30-day and 90-day cost-sharing copays are $5 and $15. Tier 3 preferred 30-day and 90-day cost-sharing copays are $47 and $141.

Humana Walmart Rx Plan –  Monthly premium of $20.40 with $405 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $1 and $3. Tier 2 preferred 30-day and 90-day cost-sharing copays are $4 and $12. Tier 3 preferred 30-day and 90-day cost-sharing copays are both 24%.

Humana Preferred Rx Plan –  Monthly premium of $32.50 with $405 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $0 and $0. Tier 2 preferred 30-day and 90-day cost-sharing copays are $1 and $3. Tier 3 preferred 30-day and 90-day cost-sharing copays are both 20%.

SilverScript Choice –  Monthly premium of $30.40 with $0 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $3 and $7.50. Tier 2 preferred 30-day and 90-day cost-sharing copays are $10 and $25. Tier 3 preferred 30-day and 90-day cost-sharing copays are $34 and $85.

SilverScript Plus –  Monthly premium of $69.10 with $0 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $1 and $2.50. Tier 2 preferred 30-day and 90-day cost-sharing copays are $5 and $12.50. Tier 3 preferred 30-day and 90-day cost-sharing copays are $35 and $87.50.

Symphonix Value Rx –  Monthly premium of $28.10 with $405 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $1 and $3. Tier 2 preferred 30-day and 90-day cost-sharing copays are $3 and $9. Tier 3 preferred 30-day and 90-day cost-sharing copays are $29 and $87.

WellCare Classic –  Monthly premium of $30.30 with $405 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $0 and $0. Tier 2 preferred 30-day and 90-day cost-sharing copays are $1 and $3. Tier 3 preferred 30-day and 90-day cost-sharing copays are $29 and $87.

WellCare Value Script –  Monthly premium of $37.20 with $405 deductible. Tier 1 preferred 30-day and 90-day cost-sharing copays are $0 and $0. Tier 2 preferred 30-day and 90-day cost-sharing copays are $0 and $0. Tier 3 preferred 30-day and 90-day cost-sharing copays are $25 and $75.

 

What Is Washington Apple Health?

Apple Health is the State Medicaid program that is available at any time throughout the year. You do not have to wait for the Open Enrollment period. Qualification is based upon your household income and your citizenship and state residency status, if applicable. You do not have to apply in person, since  you can apply online here. Typically, the process takes less than an hour.  Eligibility applicants must be between ages 19 and 64, a US citizen, not be currently incarcerated, and also not Medicare-qualified. The maximum monthly income allowed for a single person is approximately $1,317.

After you sign up for coverage, a comprehensive booklet is sent, which includes specific benefit information, including how to prepare for the first visit to your primary-care physician. A “ProviderOne” ID card shows your unique policy number and when the coverage was effective. Generally, each year, you must re-renew. Benefits will start on the first day of the month that your enrollment application was submitted.

The six available plans that are offered through Apple Health are Columbia United Providers, Molina Healthcare, UnitedHealthcare Community Plan, Amerigroup, Community Health Plan of Washington, and Coordinated Care Corporation.

 

Dental Coverage For Children

You can purchase private affordable individual and family dental plans (off-Marketplace) from several major companies including  UnitedHealthcare, Nationwide, IHC, and AlwaysCare. Monthly premiums typically range from $20-$70 per month. Waiting periods and annual maximum benefits will apply.

Qualified pediatric dental coverage is also available (Washington Healthplanfinder). Both federal and state mandates have been met. We have summarized below several of the best options:

Delta Dental Of Washington Kids Plan – Offered in all counties. $75 deductible and $350 out-of-pocket maximum. $0 copay for exams. Estimated monthly cost – $37.

Dental Health Services FirstSmile  Early Care – Offered in 29 Western Counties with no deductible and a $350 out-of-pocket maximum. The copay is $10 and the estimated monthly rate is $26.

Dental Health Services FirstSmile Early Care Plus – Similar to prior plan with $3 copay (instead of $10) and premium of $30 (instead of $26).

Kaiser Permanente KP WA Pediatric Dental 100 – Only available in Cowlitz and Clark Counties.$50 deductible and $350 maximum out-of-pocket maximum. No charge for exams. Monthly rate is $30.

Lifewise Individual Pediatric Dental – Available in all counties. $65 deductible with maximum $350 out-of-pocket maximum. 10% coinsurance on exams. Monthly rate is $27.

Premera Blue Cross Individual Pediatric Dental – Offered in all counties except Clark.  Same basic benefits and price as previous plan.

 

Dental Coverage For Adults

Dental Health Services SmartSmile – No deductible. $7 copay for exams and $25 copay for cleanings and x-rays. $47-$65 copay for filling a cavity and $325 copay for root canal. Approximate monthly premium of $18-$20.

Dental Health Services Super SmartSmile – No deductible. $5 copay for exams and $10 copay for cleanings. No copay for x-rays. $25-$47 copay for filling a cavity and $350 copay for root canal. Approximate monthly premium of $24-$27.

Dental Health Services  SmartSmile Plus – No deductible. $5 copay for exams and $10 copay for cleanings. No copay for x-rays. $25-$47 copay for filling a cavity and $325 copay for root canal. Approximate monthly premium of $24-$27. Similar to previous plan, but with lower copays for nitrous oxide ($40 vs. $20) and gum treatment ($70 vs. $45).

Delta Dental Family Essential Plus  – $50 deductible with $1,000 maximum yearly benefit. Exams, cleanings, fluoride, sealants, and x-rays covered at 100%. Coinsurance is 50%. Approximate monthly premium of $38-$42.

Dentegra Dental PPO Family Basic Plan – $50 deductible with $1,000 maximum yearly benefit. Routine care covered at 100% after deductible has been met. Restorative care covered at 50% after deductible has been met. Approximate monthly premium of $26-$30.

 

Washington Healthplanfinder For Small Businesses

Kaiser and Moda are the two exclusive companies offering coverage for 2015 and 2016. Between 15 and 25 plans are offered to employers who can earn a potential 50% tax credit on Marketplace premiums they pay for their employees. Owners can determine the carrier, plan and coverage that is offered to their workers.  Unlike the enrollment period for private plans, small employers can enroll all 12 months of the year.

There are several different types of plan choices. For example, you can choose a single policy that will be utilized by all employees. Also available is an “Employee Choice” option that provides multiple options with specified benefits and costs. This type of policy is popular when workers have various types of needs (ie high-deductible low-premium vs. more expensive no-deductible).

Other advantages of the Healthplanfinder Business tool are the easy comparison between products, flexible billing options, and quick and efficient sign-up and termination of coverage. Rates are typically very competitive with private policies offered on and off the Exchange.

2015 Washington State Healthcare Options

2015 State Of Washington Health Plan Filings

 

PAST UPDATES:

More than 200 new plans for 2015 have been filed for the Washington Healthplanfinder Marketplace. The average rate hike is just above 8 percent, although there are wider variations, depending on the carrier and area of the state.

Both in and outside-Exchange plans were submitted for approval which should give consumers a wide choice of policies to choose from during Open Enrollment later in the year. It typically takes about two months for rate proposals to be studied and approved (or disapproved).

Time Insurance (Assurant) had the largest price increase request at 26% followed by Group Health Options at 14.2%. UnitedHealthcare is one of three new carriers requesting admission for 2015.

15 companies have filed requests to offer plans on (and off) the 2015 Washington Health Insurance Exchange.  If approved, more than 60 new policies would be available to consumers. The graphic above lists each company and the Metal plans they will be offering.  New carriers for 2015 include: Columbia United Providers, Health Alliance Northwest, and UnitedHealthcare (UHC).

Enrollment in student medical plans at colleges in the Seattle area is dwindling. Although there are several explanations, the availability of subsidized Marketplace plans and options to stay on a parent’s plan are the main reasons. International students, who often are not eligible for Exchange coverage, are sometimes highly dependent on University benefits.

Seattle Pacific and Washington State Universities have already terminated their undergraduate medical policies and more schools are expected to follow.

2016 Washington Health Marketplace prices are rising. Although not all plans are substantially increasing, we have listed below carrier rate change requests that have not yet been approved by the Department of Insurance.

49.61% – Time Individual Medical Plan

19.63% – Moda On-Exchange Gold/Silver

17.98% – Moda Off-Exchange Gold/Silver

14.34% – Premera Blue Cross Multi-State In-Exchange Gold

14.21% – Aetna Fee For Service Full Group

13.21% – Aetna PPO Bronze Saver Small Group

11.50% – Health Net of Oregon PPO Small Group

10.39% – Premera Blue Cross Multi-State In-Exchange Silver

More than 1.5 million persons have enrolled in coverage so far this year through the Washington Health Benefit Exchange. The vast majority of persons have obtained coverage through Medicaid (Apple Health). The average tax subsidy has averaged more than $200, saving state residents millions of dollars in premiums. Also, the total number of uninsured persons in the state has dropped about 10% over the last three years.