Who Is the Marketplace for?
Washington Healthplanfinder is the state's Marketplace for health insurance, where you can shop for and buy insurance in person, online, or by phone. The state is running the Marketplace, which is mainly for people who:
- Don’t have insurance
- Aren’t insured by their employer
- Aren’t included in their spouse’s employer insurance
- Have pre-existing conditions and may have had trouble getting insurance before
- Have private insurance but want something less expensive
- Own a small business
The Affordable Care Act requires that most Americans have health insurance starting in 2014. Generally, you don't need to buy insurance through the Marketplace if you are currently covered by Medicaid, Medicare, TRICARE, or an employer-sponsored plan.
When You Can Enroll: The next open enrollment period will be from Nov. 15, 2014, to Feb. 15, 2015.
If you have a life-changing event -- such as the birth of a child, losing your job, or moving to a new state -- you don't have to wait for the next enrollment period. You can sign up or change coverage within 60 days of the event.
Plans and Costs
Types of plans: All the insurance plans on the Marketplace are sold by private companies or co-ops. They can offer four types of coverage: bronze, silver, gold and platinum. These “metal level” plans all cover the same kinds of benefits in Washington. What differs is how much they pay on average toward the costs of healthcare services. Here’s how it works:
- Bronze Plan: You pay 40% and the plan pays 60%.
- Silver Plan: You pay 30% and the plan pays 70%.
- Gold Plan: You pay 20% and the plan pays 80%.
- Platinum Plan: You pay 10% and the plan pays 90%.
Low cost - or catastrophic - plans are available, especially for people who are under 30 and are healthy. These plans cost less up front, but they don’t give you as much coverage. They generally require you to pay more out-of-pocket costs.
Costs: Companies on the Marketplace can vary costs based on your age, where you live in the state, and your tobacco use. They cannot charge you more because of your sex or your health condition.
Washington is divided into five regions. Rates vary by region, plan level, and age. For example, a 40-year-old non-tobacco user living in the Seattle area will pay $300 a month for a silver level plan from BridgeSpan Health Company or $357 a month for a Premera Blue Cross plan. The expected cost of a bronze plan plan for a 21-year-old living in Spokane County ranges from $159 a month from Group Health to $182 from BridgeSpan . A silver plan for a 40-year-old would range from $269 a month to $294 a month, also in Spokane County.
Washington allows companies to charge tobacco users 50% more than non-tobacco users.