A Guide to Health Insurance in Washington (WA)

The rising cost of health care makes it imperative to get Washington Health Insurance that can protect you against the financial losses that become almost inevitable if you have to have medical treatment in Washington without health insurance.

There are various types of health insurance in Washington that are available to you, and in this article I will discuss some of those options that you have available to you.

The two main types of health care coverage that you can get in Washington are Traditional Washington Health Insurance and Managed Care Washington Health Insurance Plans.

Traditional Washington Health Insurance tends to fit the profile of what most people would typically think of as ‘health insurance’, because it is a relatively simple arrangement where you can choose to go to whichever hospital or health care provider that you like, but afterwards you would have to file a claim for reimbursement of the money that you had paid out.

Managed Care Insurance Plans are a more recent development that sprung up because insurance companies realized that the more control they had over who provided the health care itself, the better able they were to keep costs down and more effectively manage the administration of the whole process. In order to achieve this they started to negotiate with groups of hospitals and health care providers for better deals and price breaks on their services, in return for sending more business to them.

It was from here that the idea of ‘Networks of Providers’ developed, and managed care insurance plans are very much designed around the fact that the cost of the insurance is reduced, because people are forced to stay within the network in order to keep the low-cost price incentive.

Ultimately, the goal of managed care services is to be able to offer health insurance at a lower rate than that charged by Traditional Health Insurance Plans.

There are several types of Washington Managed Care Insurance Plans:


HMOs (Health Maintenance Organizations)

Under this plan the members pay a fixed amount in each month, and then have access to the healthcare services of the HMO.

If you need to visit the Doctor or the hospital than you pay a pre-determined flat fee, but unlike traditional health insurance you won’t normally have to file claims as the HMO settles the bill (as long as you have sought approval from them prior to having the treatment).

You will be allocated a Primary Care Physician (PCP) who will be your first port of call if you become ill, and he or she will then direct you to see other specialists as required.

There is considerable fluidity in the way that HMOs are structured and they tend to change form subtly quite often in order to remain responsive to the needs of consumers.

PPO / Preferred Provider Organization

With a PPO you are provided with more options, because in addition to the network of sites that the insurance company has deals with (the ‘preferred’ providers). You can also go outside the network for treatment, but you will receive less money back then you would have done had you have chosen a health care provider that WAS in the network.

POS Plans / Point of Service Plans

In many respects this is trying to be a hybrid of the HMO and PPO options.

If you only have treatment within the network of sites, then this acts like an HMO.

If you go outside then then you will receive less money back, but there are even more options than with the PPO or POS plans.


Essentially, buying a traditional Washington Health Insurance Plan means you will have less to think about initially, but it may cost more and you will most likely have to pay for treatment and then claim it back off the insurance company.

Managed Care Plans are fussier, require more up-front planning, and are not as flexible. But they may be cheaper, and will usually pay the bills (assuming pre-approval) without you having to pay out any money and then claim it back.

Take a look at several quotes from the two types and then make some considered judgments about the benefits of each before deciding between them and getting your Washington Health Insurance Cover.


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