Washington Health Insurance

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Washington Health Insurance Information

Logo Washington Health Plan Finder

Washington State has simplified the process of searching for health insurance through both the state’s Medicaid program and the state’s exchange program. Washington Health Plan Finder is easy to use and helps identify publicly available plans.

Health Insurance and State Programs

Apple Health is the Washington State Medicaid program. For those who qualify, Apple Health provides a wide range of benefits and services. The Washington State Health Care Authority website provides information about eligibility, coverage plans, benefits, and related links for assistance. The Washington HCA has developed a quick reference pamphlet which may be useful for determining your eligibility for Apple Health.

If you have any questions about Apple Health, Statewide Health Insurance Benefit Advisers (SHIBA; 1-800-562-6900) are free, unbiased, and confidential support resources provided through the Office of the Insurance Commissioner of Washington State.

If you’re interested in applying, you’ll need:

  • Your household monthly income.
  • The Social Security numbers and dates of birth for each member of your household.
  • Your immigration information, if that applies to you.

Once accepted, you'll receive a ProviderOne services card in roughly two weeks. The first day of the month in which the application was received will be the start date for coverage. You can choose a managed care plan online or be automatically enrolled in one.

The Washington State legislature passed a public plan option called Cascade Care which meets the requirements of the Affordable Care Act (ACA). Multiple Cascade Care plans are available with varying premiums, deductibles, co-insurance, and maximum out of pocket expense (About WA Health Plan Finder plans). The Washington Health Plan Finder website provides comprehensive information and frequently asked questions and has an easy to use tool to help you find a plan that meets your needs. If you would prefer to speak with a person, call 1-855-923-4633 or TTY/TTD 1-855-627-9604.

There are many private health insurance companies licensed to provide plans within Washington State. A licensed independent insurance agent will be able to assist you in locating a plan with many of these companies. The Office of the Insurance Commissioner for Washington State maintains an updated searchable list of all licensed agents and agencies.

You may also contact private insurance companies directly. The follocawing private insurance companies offer both private plans and participate in the Cascade Care Plans:

Please note that listing in this section does not constitute Seattle University's endorsement of a particular company, plan, or service. The companies listed above have chosen to participate in Cascade Care, a program of Washington State.

Washington State offers specific health care programs for individuals with low incomes or those who need additional help with health care costs. The Office of the Insurance Commissioner for Washington State maintains a list of these program.

In Seattle, Washington, Community Health Clinics serve low-income families without insurance with free, high-quality medical treatment. Washington Healthcare Access Alliance links many different clinics located in several counties. Washington 2-1-1 is a community resource with trained operators who have access to public and non-profit programs throughout the state. It is a one-stop helpline designed to assist with many different concerns from healthcare to housing insecurity.

A Quick Guide to Understanding Insurance Terms

  • Premium: This is the fee that you (the insured) pay to the insurance company to carry insurance for you. Even if you do not use the services, the insurance company charges this amount. It is typically billed on a monthly, semiannual, or annual basis.
  • Deductible: This is the amount of money that you will need to pay out of pocket before the insurance company begins paying your bills. This amount resets each year. Depending on your plan, not all services will be subject to a deductible. It is common for insurance companies to only charge a copay for primary care visits in order to encourage individuals to visit their healthcare provider before a condition worsens.
  • Copay: This is a set amount that you pay to a provider for a visit or service. Copays may vary depending on the specific type of provider, usually divided by primary care or specialists.
  • Coinsurance: This is a percentage of the service bill for which you are responsible. This amount is based on the negotiated rate between the provider and the insurance company, not on the provider's billing.
  • Out of Pocket Maximum: This is the maximum amount that the insurance company can ask you to pay before the company fully covers your costs. This is the sum of all deductibles, copays, and coinsurances.
  • In-Network / Out-of-Network: Insurance companies have lists of providers with whom they contract for services. A provider with an agreement with a particular insurance company is said to be in-network. If the provider does not have a contract with a particular insurance company, they are said to be out-of-network. Insurance companies will typically pay less, if any, of an out-of-network providers’ bill.
  • Plan year: The contract dates of a plan which also determines when deductibles and out of pocket expenses reset. Often, this is January 1 to December 31 of a calendar year, but may vary depending on the plan.