• Assurant
• Blue Cross
• Health Net

Click for more options

• Kaiser Permanente
• Regence BlueShield

• Medicare Advantage Insurance
• Blue Cross and Blue Shield
• LifeWise Health Plan

Click for more options

• SecureHorizons by UnitedHealthcare
• Sterling Insurance
• Universal American
• WellCare

Individual & Family Washington Health Insurance Coverage

Coverage for individuals and family

If you need health insurance and are not eligible for Medicare, there are plans available that you can buy.

Most health insurance sold in Washington state operates as either health maintenance organizations (HMOs) or through preferred provider networks.

If you choose an HMO, the plan requires you obtain all your care from a list of providers (except some emergency care). Your plan may require your primary care doctor to provide a referral before you can see a specialist or go to the hospital.

If you choose a preferred provider network, you pay less if you obtain care from doctors or hospitals that contract with the insurance plan. These providers are referred to as "network" providers. It will cost you more if you go to a doctor or hospital not listed in the plan's network.

Plans may differ greatly from one another. They also may use different copayment systems (an upfront charge the consumer pays for each office visit).

A plan's premium often covers educational and wellness programs, some preventive exams and routine services, and diagnostic services and treatment.

In addition to the premiums, you may have out-of-pocket copayments, deductibles or coinsurance for some services. For services not approved or covered by the plan, you pay the full amount.

Ask about the features of any plan before you enroll and make sure you understand how they work.

Pre-existing condition waiting periods

Individual plans may require a nine-month waiting period for any condition you received advice or treatment for during the previous six months.

If you are switching plans, you may receive credit towards the waiting period for a pre-existing condition. If your prior plan is equal to or better than the new plan, the insurance company must credit your enrollment in that plan toward the waiting period (catastrophic plans are not considered creditable coverage). For example, if you had nine months of coverage under your most recent plan, the insurance company would waive your waiting period. If you had four months coverage, you would have to wait five months for the new insurance to cover a pre-existing condition.

Need more help? Call our toll-free Insurance Consumer Hotline at 1-800-562-6900.