Overview
Washington State has a range of options for residents who need health coverage or assistance with medical costs. These options fall into four general categories:
Washington Apple Health, including Medicaid, CHIP, and state programs. Medicaid and CHIP are medical insurance programs administered by the state and funded by the federal government and the state. The state also funds some programs and services separately. To qualify, you must have low-income or special health needs, such as pregnancy or disability. In Washington, Medicaid, CHIP, and state medical programs are also known “Washington Apple Health.” These programs are run by the state’s Health Care Authority (HCA) and Department of Social and Health Services(DSHS), in partnership with the state’s Health Benefit Exchange(known as Washington Healthplanfinder). You can apply for these programs through Washington Healthplanfinder, but some programs may require additional screening by DSHS.
Medicare is a medical insurance program administered and funded by the federal government, not the state. To qualify, you must be on Social Security Disability or Retirement Benefits (Title II). This program is run through the federal Social Security Administration, which is also where you can apply. Some Medicare enrollees purchase supplemental insurance through the Washington State Health Insurance Pool(below).
Qualified Health Plans are private health insurance plans that meet special health reform standards and offer federal subsidies to help with costs. To qualify for subsidies, you must have low-to-moderate income. These plans are regulated by the Office of Insurance Commissioner and the Health Benefit Exchange. You can buy these plans through the Washington Healthplanfinder.
Commercial Insurance Plans are private health insurance plans for individuals or employers. These plans are regulated by the Office of Insurance Commissioner. You can buy these plans directly from insurance companies or insurance brokers.
Washington State Health Insurance Pool is a health insurance program for persons with significant medical needs or seeking coverage to supplement Medicare. As of January 1, 2014, this program was largely closed to new enrollees, except the Medicare supplement program.