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An Overview on Medical Insurance in Washington

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Medical Insurance in Washington

Medical Insurance in Washington

Introduction: The overall health insurance condition in Washington is average. In accordance to a survey conducted by The Center for Disease Control, more than 14% of the total Washington individuals did not get any coverage under Washington medical insurance policies per year, between 2001 and 2003.

Some important Washington medical insurance regulations and Washington medical insurance alternative options are discussed in the below-mentioned article.

Regulations for Washington Medical Insurance

There are some regulations introduced by Washington department of insurance that the Washington medical insurance companies should abide by.

  • A Washington individual having medical insurance under an employer or group can not be refused or restricted access to that employer or group Washington medical insurance policy.
  • Washington individuals looking for individual Washington medical insurance plan can be refused or restricted obtaining coverage on the basis of some potential risk factors.
  • Washington medical insurance companies can impose pre-existing condition waiting periods.
  • As per Washington medical insurance law, a pre-existing condition is an illness for which an individual has been or should have been treated, received medical advice or otherwise diagnosed within 6 months, before the starting of new Washington medical insurance policy.
  • Continual coverage can be sometimes credited towards new Washington medical insurance plan for pre-existing condition waiting period; provided there was no breakage in coverage.
  • Washington medical insurance organizations can not impose a pre-existing condition waiting period for more than 12 months.
  • A Washington individual should complete a medical questionnaire before his or her application for medical insurance coverage gets approved.
  • If the questionnaire score is high or more than 288, then the individual is not entitled to get coverage under Washington medical insurance policy. However, the respective Washington medical insurance company definitely issues a written credential stating that the individual can avail Washington State Health Insurance Pool.
  • If the questionnaire score is below 288, then the Washington individual is eligible to get Washington medical insurance options.
  • Washington medical insurance rates differ on the basis of family size, age, demographics and the type of policy. However, the rates do not differ based on health.
  • According to Washington medical insurance law, pregnancy is granted as a pre-existing condition and therefore subject to an exclusion period.
  • Newborns and adopted children can remain under coverage of parent's individual Washington medical insurance policy that offers dependant coverage. However, they can avail this facility, automatically, for the initial 60 days from the day of birth or adoption and after that, the policy should be adjusted, according to requirement.
  • Disabled and handicapped dependants should get coverage under parent's Washington medical insurance plan, even if they have crossed the upper age limit.
  • Washington individuals, who are between insurance plans or employers, are able to access temporary Washington medical insurance policies offered by some of the Washington medical insurance companies.

Washington Medical Insurance Alternative Options

Washington individuals facing difficulties having or paying for Washington medical insurance can avail any of the Washington medical insurance alternative programs, according to eligibility.

  • Healthy Kids Now!: This plan is available to children and teens. Children belong to families that are not able to afford the cost of Washington medical insurance or not qualified for Washington Medicaid.
  • Basic Health & Basic Health Plus for Kids: The program offers health insurance options to the uninsured Washington individuals; provided they should meet the qualifying criteria.
  • Washington State Health Insurance Pool or WSHIP: This is the Washington's high risk pool that lets uninsurable Washington individuals buy individual Washington medical insurance. Pre-existing condition may be applied.
  • Washington Medicaid: This is applicable to all Washington individuals who meet all the eligibility as well as income criteria.
Washington Office of the Insurance Commission

Mailing address:
P.O. Box 40255
Olympia, Wash. 98504-0255


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