Washington Health Insurance
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Facts and Figures
-
Place in State
Health Report Card 15th - Insured 5,719,728
- Uninsured 838,600
-
Insurance
Carriers 7 -
Number of
Primary Care Physicians 10500 -
Number of
Hospitals 87 -
Average Cost of
Health Insurance* $569
Breakdown of Insureds
- Employer-sponsored health insurance 62%
- Private plans 7%
- Medicaid 16%
- Medicare 13%
- Others 2%
Insurance Carriers
- Assurant Health (Formerly Fortis)
- Asuris Northwest Health Health Insurance
- Group Health Cooperative
- KPS Health Plans Health Insurance
- LifeWise Health Plan of Washington
- Premera Blue Cross of Washington
- Regence BlueShield of Washington
State Health Report Card
The rate of children living in poverty decreased from 18.0 percent to
16.1 percent in the past year. The rate of adults with diabetes has
increased from 6.3 percent to 7.6 percent in the past five years.
Currently there are 391,000 Washington residents who smoke.There are
782,000 adults in Washington who smoke. But this number has decreased.
The previous year, smoking was at 14.9 percent. The number of obese
adults increased from 18.8 percent to 26.2 percent in the past ten
years. Only 71.9 percent of high school graduate in four years.
Washington Health Insurance Laws and Regulations
Washington health insurance plans must be sold with a guaranteed renewability clause. With this, Washington residents are assured that they can renew their policies every time it expires for as long as they are faithful in paying their premiums. You can also be sure that you will not lose your coverage when you get sick. Newborn and adopted children will have automatic coverage up to 60 days if their parents are enrolled in a policy that covers dependents. If you have a condition diagnosed 6 months before applying for coverage, this condition will be considered as a pre-existing condition. Insurers can choose not to cover this condition for up to 9 months. If you want to transfer to a new insurer, the months you have waited for can be credited to the new plan. Washington health insurance providers can choose to deny coverage due to an applicant’s risk factors. These factors are also considered in setting premium rates. Small businesses with 2-50 employees can apply for any group health plan being offered to small businesses in the state. Washington health insurance quotes for group coverage can vary according to the risk factors of its members. The members must meet the requirements imposed by the insurer to be eligible to apply.
Heath Care Reform
Young adults in Washington can now stay under their parent’s policy. The new health law mandates health insurance companies to allow parents to keep their children in their policy until age 26. 52,186 young adults in Washington have benefited from this plan (as of June 2011).
Because of the new law, Medicare members no longer need to worry about their extra prescription cost. Once they reach the donut hole in 2010, they are sent a check for a $250 rebate. 62,660 seniors in Washington have received the rebate to offset the cost of their prescription drugs. A 50 percent discount was also given for brand name drugs once they’ve hit the donut hole. This resulted to an average savings of $35,999,334 for Washington Medicare members. The Affordable Care Act aims to close the donut hole by 2020.
One of the provisions of the health care reform is to provide preventive care services free of charge for Medicare members and free from cost-sharing for those enrolled under private plans. In 2011, 653,723 Medicare members and 1,239,000 private plan members in Washington have received free preventive care services like colonoscopies and mammograms.
When looking at Washington health insurance quotes, applicants are assured that at least 80 percent of the price will go directly to health care services and other related improvements. 1,788,000 Washington residents are now able to maximize their premium.
Insurers are no longer allowed to impose a lifetime limit on their members’ benefits. 2,427,000 Washington residents are now free from having lifetime limits on their coverage. Patients with chronic diseases don’t have to worry about maximizing their limit because of their accumulating medical costs.
Through the Pre-Existing Condition Insurance Plan, Washington residents who have pre-existing condition can now have affordable coverage. As of 2011, 708 residents now have a Washingtoninsurance. Without this provision, they would still remain uninsured.
Washington has received a $21.7 million grant to develop more health programs and policies.They have also received $66 million to create more health centers and to improve existing centers and the quality of health care delivered.
State Government Insurance Programs Offered
Medicaid
800-737-0617
800-562-3022
hrsa.dshs.wa.gov Coverage: Physician services, Checkups (medical and dental), Family planning, Maternity, Prenatal, and newborn care, Prescriptions, Mental health, Hospital services, Comfort care, Hospice, Dental services, Drug and alcohol treatment, Eye glasses, Hearing aids. Must be Washington residents and U.S. citizens or legal aliens. Income limits: Pregnant women: 185% FPL. Aged, blind and disabled: Singles with incomes of up to 75% FPL and asset limit of $2,000 , and couples with incomes up to 83% FPL and asset limit of $3,000. Parents/caretakers living with children ages 0–18: 74% FPL. Children ages 0–18: 200% FPL.
Washington Basic Health
800-826-2444
800-660-9840
Basic Health is a program for residents who meet certain income eligibility requirements and provides an affordable health insurance plan. Although the plan has a waitlist, some groups may be able to get coverage fast. www.basichealth.hca.wa.gov (Basic Health is no longer processing applications. There is now a waiting list for applicants, with some exceptions.)
Washington Apple Health for Kids
877-543-7669
800-562-3022
hrsa.dshs.wa.gov/ applehealth – Washington Apple Health for Kids provides health coverage for uninsured children. – Ambulance, urgent or emergent care, Eye exams, Well-child checkups, Home health care, Hospital care, Immunizations (shots), Lab services, Maternity care, Medical supplies & equipment, Office visits, Respiratory therapy, Prescription drugs, Physical therapy, Occupational therapy, Speech therapy, Surgery, Specialty care, X-ray, Dental”
Washington Medicare
800-633-4227
Seniors looking for Washington health insurance can get coverage through Medicare Advantage, Supplement and Original Medicare.
Medicaid
800-737-0617
800-562-3022
Physician services, Checkups (medical and dental), Family planning, Maternity, Prenatal, and newborn care, Prescriptions, Mental health, Hospital services, Comfort care, Hospice, Dental services, Drug and alcohol treatment, Eye glasses, Hearing aids
Washington State Health Insurance Pool (WSHIP)
800-877-5187
No maximum lifetime benefits. Choose from Medicare and non-Medicare plans. There is a 6- month pre-existing condition exclusion period. Exceptions apply (if applicant signs up through a portability policy)