Medical review is no longer required to purchase health insurance. By law, coverage cannot be denied to people because of pre-existing or ongoing medical conditions like cancer or diabetes.
The federal government offers financial assistance for those that qualify. The amount of financial assistance will depend on your annual income and size of your household. The only way to receive federal financial assistance is by purchasing your health plan through the WA Healthplan Finder.
Choose from a range of plans to fit your needs and budget. You can pick one plan for your entire family or separate plans for each person.
You can select from three levels of coverage - Bronze, Silver, and Gold.
There’s also a catastrophic or minimum coverage plan for people under 30 or those who are able to prove financial hardship or lack of affordable coverage.
10 Essential Benefits
Healthcare reform says all health plans must include ten essential benefits. The basic benefits include:
- Outpatient Care - the kind you get without being admitted to a hospital
- Emergency Services - for issues that could lead to death or disable you if you do not treat them.
- Inpatient Care - covers room and board, tests, drugs, and care from doctors and nurses while admitted, which may include organ and tissue transplants, and hospice and respite care.
- Maternity and Newborn Care - care before and after your baby is born
- Mental Health and Substance Use Disorder Services - this includes behavioral health treatment, counseling, and psychotherapy.
- Prescription Drugs - covers retail, mail order, and specialty drugs.
- Rehabilitative and Habilitative Services - services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
- Laboratory Services - covers lab tests, X-ray services, and pathology, and imaging and diagnostics such as MRI, CT scan, and PET scan.
- Preventive and Wellness Services - including mammograms, colonoscopies, vaccines. Covered in full if you use in-network providers for care such as routine physicals, screening, and immunizations. Disease management coordinates care for diabetes, asthma, and other conditions.
- Pediatric Services - including dental care (preventive, basic, major) and vision care (eye exam, lenses, and eyewear).