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Washington Health Insurance Consumer Guide
We created this health insurance guide to help you understand the coverage options and potential financial assistance available to you and your family in the state of Washington.
Washington runs its own health insurance exchange (Marketplace), called Washington Healthplanfinder.
Residents who need to buy their own health insurance – including those who aren’t eligible for Medicare, Medicaid, or an affordable employer-sponsored health plan – can use Washington Healthplanfinder to compare plans and enroll in coverage.
Explore our other comprehensive guides to coverage in Washington
Dental coverage in Washington
In 2023, four insurers offer stand-alone individual/family dental coverage through Washington Health Plan Finder.1 Our guide will help you understand your dental coverage options in Washington.
Washington’s Medicaid program
Eligibility for Washington’s Medicaid program – Apple Health – was expanded under the ACA, and enrollment in the program has grown by 96% since 2013.2 As of early 2023, Apple Health covered nearly 2.2 million people.3 But enrollment began to decline at the end of May 2023, due to the expiration of the pandemic-era continuous coverage rule. Within three months, more than 340,000 people had been disenrolled from Apple Health.4
Medicare coverage and enrollment in Washington
Nearly 1.5 million Washington residents were enrolled in Medicare as of 2023.5 Our Washington Medicare guide explains the various parts of Medicare, coverage options under Medicare Advantage and Part D, and New Jersey rules regarding Medigap (Medicare Supplement) availability.
Short-term health insurance coverage in Washington
Washington implemented fairly strict new rules for short-term health insurance in 2021. And by mid-2022 there were no longer any insurers offering short-term health insurance in the state.6
Frequently asked questions about health insurance in Washington
Who can buy Marketplace health insurance in Washington?
To be eligible to enroll in private health coverage through Washington Healthplanfinder, you must:7
- Live in Washington
- Not be incarcerated
- Not be enrolled in Medicare
Under the ACA, a person must also be lawfully present in the U.S. in order to use the exchange/Marketplace in any state. But Washington has obtained federal permission to allow undocumented immigrants to enroll in health plans through Washington Healthplanfinder starting in 2024. Undocumented immigrants will not be eligible for federal subsidies, but Washington Healthplanfinder will be able to provide them with state-funded Cascade Care Savings subsidies if their income doesn’t exceed 250% of the poverty level.8
In addition to basic enrollment eligibility, there are additional parameters that must be met in order to qualify for financial assistance. To be eligible for income-based federal Advance Premium Tax Credits (APTC), state-funded Cascade Care Savings, or federal cost -sharing reductions (CSR), you must:
- Not have access to an affordable plan offered by an employer. If you are eligible to sign up for an employer’s plan and aren’t sure whether it’s considered affordable, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies for a plan obtained through Washington Healthplanfinder.
- Not be eligible for Apple Health (Medicaid/CHIP).
Beyond those basic requirements, premium subsidy eligibility depends on your household’s income and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location.
When can I enroll in an ACA-compliant plan in Washington?
In Washington, the open enrollment period begins November 1 and continues through January 15. Enrollments completed by December 15 will have coverage effective January 1, whereas enrollments completed between December 16 and January 15 will have coverage effective February 1.9
After the open enrollment period ends, you may still be able to enroll or make a plan change if you experience a qualifying life event, such as giving birth or losing other health coverage. And some people can enroll year-round even without a specific qualifying life event.
Enrollment in Washington’s Apple Health (Medicaid) is available year-round for eligible applicants.
How do I enroll in a Marketplace plan in Washington?
To enroll in an ACA Marketplace/exchange plan in Washington, you can:
- Visit Washington Healthplanfinder – the state’s health insurance exchange – to compare the health plans that are available in your area, determine whether you’re eligible for financial assistance (including federal subsidies and Washington’s Cascade Care Savings), and enroll in coverage during open enrollment or during a special enrollment period.
- Enroll in coverage through Washington Healthplanfinder with the help of an insurance agent or broker, or an exchange-certified Navigator.
You can reach Washington Healthplanfinder’s customer service team at 855-923-4633 (TTY/TDD: 855-627-9604). They are available Monday through Friday, 7:30 am to 5:30 pm.
How can I find affordable health insurance in Washington?
When you enroll in a health plan through Washington Healthplanfinder, you may find that you’re eligible for financial assistance. And for those with income up to 250% of the federal poverty level, the assistance may be more robust than it is in many other states, as both federal and state subsidy programs are available in Washington.
As a result of the Affordable Care Act (ACA), federal premium subsidies (advance premium tax credits, or APTC) are available depending on your income. If you’re eligible for APTC, it will reduce the amount you pay for your health coverage each month, as long as you select a metal-level plan through Washington Healthplanfinder.
Seventy percent of Washington Healthplanfinder’s enrollees were receiving APTC as of early 2023. These subsidies covered an average of $438/month, reducing the average enrollee’s net premium to about $160/month.10
Applicants with household income up to 250% of the federal poverty level are also eligible for federal cost-sharing reductions (CSR), which will reduce the deductible and other out-of-pocket expenses for Silver-level plans. Twenty-nine percent of Washington Healthplanfinder’s enrollees were receiving CSR benefits as of 2023.10
And Washington is among the states where additional state-funded subsidies are available. As of 2023, Washington began offering state-funded premium subsidies for applicants with income up to 250% of the poverty level, as long as they select a Cascade Care silver or gold plan. The Cascade Care Savings are available in addition to the federal premium subsidies and cost-sharing reductions.11
(Note that federal APTC can be used with any metal-level plan, federal CSR is available with any silver-level plan, and Cascade Care Savings are available with silver or gold Cascade Care plans. To receive all three benefits at once, an enrollee would need to have income up to 250% of the poverty level and select a silver Cascade Care plan.)
Depending on your income and circumstances, you may be able to enroll in free or low cost health coverage through Apple Health (Washington Medicaid). Learn more about whether you might be eligible for Medicaid in Washington.
How many insurers offer Marketplace coverage in Washington?
Twelve insurers offer 2023 exchange plans in Washington:13
- BridgeSpan Health Company
- Community Health Plan of Washington (previously Community Health Network of Washington; available in two new counties for 2023)
- Coordinated Care Corporation
- Kaiser Foundation Health Plan of the Northwest
- Kaiser Foundation Health Plan of Washington
- LifeWise Health Plan of Washington
- Molina Healthcare of Washington
- PacificSource Health Plans (expanded to 11 new counties for 2023)
- Premera Blue Cross
- Regence BlueCross BlueShield of Oregon
- Regence BlueShield
- UnitedHealthcare of Oregon
Are Marketplace health insurance premiums increasing in Washington?
For 2024, Washington’s Marketplace insurers have proposed the following average rate changes:14
Washington’s ACA Marketplace Plan 2024 Proposed Rate Increases by Insurance Company
|BridgeSpan Health Company||15.15%|
|Community Health Plan of Washington||2.5%|
|Coordinated Care Corporation||5.24%|
|Kaiser Foundation Health Plan of the Northwest||8.81%|
|Kaiser Foundation Health Plan of Washington||17.9%|
|LifeWise Health Plan of Washington||7.81%|
|Molina Healthcare of Washington||6.41%|
|PacificSource Health Plans||7.15%|
|Premera Blue Cross||15.83%|
|Regence BlueCross BlueShield of Oregon||6.51%|
|UnitedHealthcare of Oregon||2.76%|
Source: Washington Office of the Insurance Commissioner14
In addition, there are two insurers in Washington’s individual/family market – Asuris Northwest Health and Providence Health Plan – that only offer plans outside the exchange. They have proposed a 3.4% average rate decrease and a 4.7% increase, respectively.14
Across all the carriers, the overall proposed average rate change is an increase of 9.1%.14
But it’s important to note that average rate changes apply to full-price premiums, and most enrollees do not pay full price. Seven out of ten Washington Healthplanfinder enrollees were receiving premium subsidies in 2023.10 These subsidies change each year to keep pace with the cost of the second-lowest-cost Silver plan in each area.
How many people are insured through Washington’s Marketplace?
What health insurance resources are available to Washington residents?
The state-run health insurance exchange, where individuals and families can enroll in health plans and receive subsidies based on household income. Washington Healthplanfinder is also the enrollment portal for income-based Apple Health (Medicaid) and CHIP enrollment.
Washington State Office of the Insurance Commissioner
Licenses and regulates the state’s health insurance companies, brokers, and agents. Provide assistance and information to consumers who have questions or complaints about regulated entities.
Washington Statewide Health Insurance Benefits Advisors (SHIBA)
A local service that can answer questions and provide information, counseling, and assistance related to Medicare in Washington.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.Footnotes
- “Washington dental insurance guide 2023” healthinsurance.org, Accessed September 2023
- "Total Monthly Medicaid & CHIP Enrollment and Pre-ACA Enrollment" KFF. April 2023
- “May 2023 Medicaid and CHIP Enrollment Data Highlights” Medicaid.gov, May 2023
- “Continuous enrollment unwind data; Apple Health data during the unwind” Washington State Health Care Authority, Accessed September 2023
- "Medicare Monthly Enrollment" CMS.gov, April 2023
- “Availability of short-term health insurance in Washington” healthinsurance.org, Sept. 5, 2023
- ”A quick guide to the Health Insurance Marketplace” HealthCare.gov
- “Washington State Innovation Waiver” CMS.gov, Dec. 9, 2022
- “Enrollment Periods” Washington Healthplanfinder, Accessed September 2023
- “2023 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 2023
- “Washington Health Benefit Exchange announces Cascade Care Savings” Washington Health Benefit Exchange, October 2022
- “2023 OEP State-Level Public Use File (ZIP)” CMS.gov, March 23, 2023
- “Individual and family health plans and premiums” Washington Office of the Insurance Commissioner, Accessed September 2023
- “Fourteen insurers request average 9.11% rate change for 2024 individual health insurance market” Washington Office of the Insurance Commissioner, May 30, 2023
- “ASPE Issue Brief (2014)” ASPE, 2015
- “Health Insurance Marketplaces 2015 Open Enrollment Period: March Enrollment Report”, HHS.gov, 2015
- “HEALTH INSURANCE MARKETPLACES 2016 OPEN ENROLLMENT PERIOD: FINAL ENROLLMENT REPORT” HHS.gov, 2016
- “2017 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2017
- “2018 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2018
- “2019 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2019
- “2020 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2020
- “2021 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2021
- “2022 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2022