Best Health Insurance In Washington State: The Top Providers In 2022

Best Health Insurance In Washington State
Insurance Business America

As much as you do not wish to visit the hospital, some incidents can drag you there. Moreover, being healthy is the most important aspect of life because an unhealthy body can hardly do much, even as a business owner. With that, we’ll look at the best health insurance in Washington state in 2022. 

What Is Health Insurance?

Health insurance is a type of insurance coverage that compensates for medical and surgical expenses.

Is true that no one ever intends to get sick or go to the hospital, however, you must be ready in case you found yourself in a hospital bed. Private or government health insurers provide health insurance plans that cover all expenses. Ranging from medical provider visits to behavioral health care, physical therapy, and medical supplies. Though you pay a monthly price for your policy, known as a premium, and other out-of-pocket expenses such as:

Deductible: A set amount you pay before your insurance company begins to pay for healthcare expenses.

Coinsurance is a portion of the amount you pay to an insurance claim that you split with your provider.

Copay: A set amount of money you pay each time you visit the doctor or receive a prescription.

The Cost of Health Insurance Varies Depending on Factors Such As:

  • Age
  • Location
  • Income
  • Cigarette smoking habits
  • BMI (Body Mass Index) (BMI)
  • Overall health condition
  • Existing medical conditions

Meanwhile, the Centers for Medicare and Medicaid Services (CMS), is a federal body that governs these programs. They regulate your Medicare rates if you are 65 or older or below 65 and disabled according to the Social Security Administration. Depending on your circumstance, the following plans are available:

Employer Strategies:

  • From your company
  • From your spouse’s workplace
  • COBRA is a government-sponsored healthcare program (an insurance plan that you pay for after you leave a job)

Plans for Individuals or Families:

  • Healthcare.gov (insurance marketplace)
  • Directly contacting a health insurance company

Plans for the Government:

  • Medicaid is a healthcare program that (for low-income individuals or families)
  • Medicare is government-run health- (for those 65 and older or disabled and eligible for Social Security Disability benefits)

Types of Health Care Plans

The following are the two options for health care plans

#1. Plans for Health Maintenance Organizations (HMOs)

HMO plans require you to use a group of doctors, specialists, and hospitals. And if you select a provider outside the plan, you will be charged full price. You’ll also need to select a primary care physician for all routine appointments. If you need to see an expert, your referral must be from your doctor.

HMO plans emphasize health and wellness and promote optimal health. They also plan to provide fitness and weight loss programs, smoking cessation programs, and blood pressure medicine to assist you to achieve your goals. Furthermore, their plans are often less expensive than PPO plans, but they are more restrictive in terms of where you may receive care and which doctors you can visit.

#2. Plans With a Preferred Provider Organization (PPO)

PPO plans provide access to a vast network of hospitals, specialists, and doctors from which to seek treatment. You are not required to select a primary care physician, but you are urged to do so. You’ll pay cheaper if you use providers in your PPO network because those physicians and hospitals have decided to charge set fees for services.

PPO plans do not require referrals, and you can change providers at any time. If you choose medications from their preferred drug list and utilize a pharmacy from their approved pharmacy provider list, you’ll spend less on prescription drugs. PPO plans give you more flexibility, but they are often more expensive.

Health Insurance for People Over the Age of 65 and the Disabled

If you are approaching the age of 65 (including the three months before and three months after), you can enroll in Medicare, a government health insurance plan. If you are under the age of 65 and handicapped, you can also enroll in Medicare. Medicare is divided into four parts:

First Part: Inpatient hospital treatment, skilled nursing care, and limited home care are all covered.

Second Part: Outpatient treatment, doctor and specialist visits, and medical equipment and supplies are all covered.

Original Medicare is the combination of the First and Second Parts.

Third Part; also known as Medicare Advantage plans, covers everything that the First and Second Parts do plus extras like vision and hearing coverage, fitness programs, and wellness incentive plans. You can pick between an HMO and a PPO Medicare Advantage plan, which are both offered by private insurers.

Fourth Part: Prescription drug coverage provided by commercial insurance firms; purchased as a stand-alone plan in addition to Original Medicare or as part of a Medicare Advantage plan.

You can also purchase a Medicare Supplement policy to protect the gaps left by Original Medicare. Private insurers provide these plans, often known as Medigap plans. You can select a Medicare Advantage or Supplement plan by visiting Medicare.gov and using the plan finder tool.

Best Health Insurance Providers in Washington State 2022

The National Committee for Quality Assurance (NCQA), is a nondependent, non-profit organization dedicated to improving health care. As well as ranks private insurance policies in the categories of prevention, treatment, and consumer satisfaction every year. Here are their best selections for health insurance plans in Washington State in 2022:

#1. Kaiser Permanente

Kaiser Permanente is known for providing quick and easy access to care, as well as overall and preventative services, and is ranked among the top 5% in the country in terms of quality.

#2. Providence Health Care System

In the NCQA survey, Providence Health Plan’s PPO plan got a 4.0 out of 5 for exceptional specialists, claim management, and quality of care. J.D. Power also gave Providence’s plans top ratings in the 2019 Business Member Health Plan Satisfaction Research for communicating, provider choice, bill, customer service, cover and advantages, and cost. Providence provides group, individual, and family plans, as well as Medicare insurance.

#3. Regence Blueshield of Washington, INC.

In NCQA’s survey, Regence BlueShield of Washington’s PPO plan received a 3.5 out of 5 for consumer satisfaction and was ranked fourth overall. In J.D. Power’s analysis, Regence was placed fourth for great provider choice, bill, customer service, cover, and advantages. Its website includes links to dental providers, behavioral health facilities, and plan information.

#4. Aetna

Aetna’s PPO plan was placed fifth in the NCQA report, with strong grades for treatment and prevention. Aetna was also ranked eighth in J.D. Power’s research for overall satisfaction, provider choice, and customer service. Aetna, which focuses on health and wellbeing, provides users with an app that combines your health history and specific goals, allowing you to track your progress. If you meet your goals, you can receive incentives such as gift cards from famous merchants.

Average Health Insurance Cost in Washington State 

According to the Washington Office of the Insurance Commissioner, the average monthly cost per individual is $449. This value may differ depending on your age, health, and income. You’ll also pay extra if you choose a PPO plan with more benefits than an HMO plan. If you obtain your coverage through your job, you will most likely pay a significantly lower monthly cost if your business provides a significant percentage.

What Is the Cover of Best Health Insurance in Washington State 2022?

Doctor appointments, inpatient and outpatient admissions, specialist consultations, skilled nursing care, physical therapy, and some medical supplies are typically covered by insurance. When you sign up for a health plan, you’ll be given an Evidence of Coverage paperwork that details what is and isn’t covered.

What Does Health Insurance Exclude?

Not everything is covered by health insurance. Most plans do not include:

  • Medical expenses incurred as a result of illegal activity
  • If you file a fake claim or use another person’s health care, you will receive care.
  • Unless your insurer covers it, the care you receive when traveling abroad.
  • The majority of nursing home care
  • Certain vaccines are required.
  • Expensive therapies, as well as experimental medications or treatments

When Can You Get Health Insurance?

There are certain crucial dates to remember if you want to learn how to purchase health insurance. Non-Medicare enrollees have open enrollment from November 1 to December 15 every year. During your Initial Registration Period, you can register in a Medicare Advantage plan. This goes for three months before and three months after you turn 65. Every year from October 15 to December 7, you can also sign up for or change plans. In all circumstances, your new health plan will go into effect on January 1.

Check Yourself Well Before Registering.

The health insurance plan you select has a significant impact on both your health and your wallet. Before shopping for a health plan, establish a wish list and ask some questions. Is it vital for you to participate in a fitness program? Do you want to continue seeing your current doctor? Do you take a number of prescription medications? How much money can you afford to spend on a monthly premium and other out-of-pocket expenses? The answers to these questions will assist you in narrowing down your list of top contenders.

You will choose the greatest health insurance plan for you and your family if you take the time to carefully explore your alternatives.

Changes in the Cost of Health Insurance in Washington

Insurance companies determine their own rates, which they subsequently submit to state regulators for approval. The average cost of health insurance in Washington increased by 2% in 2022 compared to 2021 rates across all three levels.

Finding the Most Affordable Health Insurance in Washington

The greatest health insurance coverage for you will be determined by your income level and medical demands. Washington, in addition to individual health insurance, provides Medicaid coverage through the Apple Health program. Additionally, under the Affordable Care Act, the state has introduced laws that expand Medicaid coverage (ACA).

Households with incomes less than 138 percent of the federal poverty threshold are eligible to receive federally sponsored health care.

Before selecting a plan, you should compare premiums and deductibles for each metal tier and determine affordability depending on your earnings and savings. 

Below, we’ve taken a closer look at each metal tier and broken down the scenarios in which they make the most sense.

#1. Begin With Silver Plans

This silver plan is recommendable especially, with the low offer premiums and deductibles.

Unless you are quite healthy or anticipate a large number of high medical bills, this coverage would be ideal in most cases. In that situation, Bronze or Gold coverage may be preferable.

Silver policies are the only ones that provide cost-sharing reductions if your income is less than 250 percent of the federal poverty threshold.

#2. Bronze: Suitable for Young, Healthy People

Bronze plans are the most affordable plans available on the Washington Healthplanfinder marketplace. However these plans have modest premiums, they feature high deductibles and out-of-pocket maximums, making it difficult to achieve the coinsurance level.

As a result, Bronze-tier policies are best if you are in good health and want coverage in the event of a large, unexpected medical expense.  Anyone in Washington can get a bronze plan.

#3. Gold Plans Are Ideal if Your Medical Bills Are Significant

Gold is the highest and most expensive tier available in Washington. These plans are frequently the best if you anticipate having substantial medical expenses throughout the plan year. In this situation, because the deductible is the lowest possible, you will be able to meet it fast and then have access to coinsurance through your health plan provider.

Best Low-Cost Health Insurance Providers In Washington State 2022

On the Washington state marketplace, there are currently ten health insurance providers:

  • BridgeSpan
  • Washington Community Health Network
  • Care Coordination
  • Kaiser
  • LifeWise
  • Molina
  • PacificSource
  • Premera
  • Regence
  • Oregon UnitedHealthcare

While all of these insurance firms sell policies throughout the state, they may not have plans available in your county. Garfield County residents, for instance, can only choose between LifeWise and Coordinated Care policies.

Conclusion

Health insurance is a sort of insurance coverage that compensates for medical and surgical expenses.

Best Health Insurance In Washington State FAQs

How Much Is healthcare a month in Washington state?

Washington residents can expect to pay an average of $420 per person for a basic major medical individual health insurance plan. Prices will vary and premiums can be lower if you are in good health.

Is Kaiser good in Washington state?

Yes, it is. Moreover, Kaiser health plans received strong overall ratings from the National Committee for Quality Assurance (NCQA). The one exception is the PPO plan in Washington state, called Kaiser Options, which received a moderate performance rating of 3.5.

Is it worth to buy health insurance?

The benefits of health insurance cannot be overstated. Purchasing a health insurance policy can help you receive medical care without blowing up all your savings

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