Overview of Coverage Options

Washington Apple Health includes 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 for these, you must have low-income or special health needs, such as pregnancy or disability. Apple Health 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. 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.

Qualified Health Plans are commercial (private)  health insurance plans that meet health reform standards and offer federal subsidies to help with costs for those that meet income standards.  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. This program is currently closed to new enrollees, except the Medicare supplement program.