Jeffrey Wade
The cost of health insurance in Washington state varies depending on factors such as income, family size, disability, and pregnancy status. The type of plan also affects the price, with Bronze plans offering the cheapest rates, Silver plans balancing medium rates with middle-of-the-road costs, and Gold plans having expensive rates but lower costs when you go to the hospital. Additionally, seven out of ten people in Washington with coverage through the state marketplace site, Washington Healthplanfinder, are eligible for discounts, and about 14% of residents with Obamacare plans pay less than $10 per month. Kaiser Permanente is considered the best health insurance company in the state, while Ambetter sells the cheapest plans for most people.
| Characteristics | Values |
|---|---|
| Best health insurance company | Kaiser Permanente |
| Cheapest insurance company | Ambetter |
| Cheapest Silver plans in Seattle, Spokane, Vancouver, Bellevue, Kent and Everett | Ambetter |
| Cheapest plans in Tacoma | Community Health Plan |
| Cheapest Catastrophic plan | Basics Plus Catastrophic by Kaiser WA |
| Cost of Catastrophic plan | $267 per month |
| Average number of days in the hospital for Washington residents with insurance | Lower than the national average |
| Average cost of health insurance in Washington | $752 less per person than the national average |
| Average cost of health care with CON requirements | $655 more per person than without CON requirements |
| Average monthly cost of Silver plan | $394 |
| Average monthly cost of Bronze plan | $432 |
| Average deductible for Bronze plan | $6,063 |
| Income threshold for free health insurance | $21,000 per year for an individual ($44,000 per year for a family of four) |
| Percentage of people with Obamacare plans paying less than $10 per month | 14% |
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What You'll Learn
Medicaid and Medicare
In Washington State, Medicaid is a health insurance program for low-income individuals and families. It is jointly funded by the federal government and the state and is administered by the Washington State Health Care Authority. The program is called Washington Apple Health or simply Apple Health. Eligibility depends on factors such as income, family size, disability, and pregnancy status. For example, an individual must earn less than $21,000 per year to be eligible for Apple Health, while a family of four must earn less than $44,000 per year. Pregnant women, children, and people with disabilities can qualify for Apple Health with higher household incomes.
There are three categories of Medicaid long-term care programs in Washington: Institutional/Nursing Home Medicaid, Medicaid Waivers/Home and Community-Based Services (HCBS), and Regular Medicaid/Aged, Blind, Disabled. Institutional/Nursing Home Medicaid provides services only in nursing homes, while Medicaid Waivers/HCBS offers services in settings such as adult day care, adult family homes, or assisted living facilities. Regular Medicaid is an entitlement program, meaning anyone who meets the eligibility requirements can receive benefits, including long-term care services such as personal care assistance.
Additionally, Washington offers several specialized programs funded by Medicaid: the Tailored Supports for Older Adults (TSOA) Program, the Community Options Program Entry System (COPES) Waiver, the Program of All-Inclusive Care for the Elderly (PACE), and the Money Follows the Person (MFP) Program. The TSOA Program assists state residents aged 55 and above who are at risk of institutionalization, even if they are not financially eligible for Medicaid. The COPES Waiver provides services such as skilled nursing, meal delivery, and home modifications. PACE combines the benefits of Medicaid and Medicare into a single program, offering long-term care and additional services like dental and eye care. Finally, the MFP Program, also known as Roads to Community Living in Washington, helps individuals transition from institutional care to community-based living.
Medicare, on the other hand, is a federal health care program primarily for individuals aged 65 and above, as well as younger people with certain disabilities. In Washington, residents who meet these criteria are eligible for Medicare. Medicare is divided into parts, with Part A providing hospital insurance that covers inpatient care, skilled nursing facilities, hospice, and home health services. Medicare Advantage plans are offered by private companies that contract with Medicare and include a range of plan types, such as Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).
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Bronze, Silver and Gold plans
The cost of medical insurance in Washington State varies depending on the type of plan chosen. The plans are categorized into metal tiers: Bronze, Silver, and Gold. These tiers help categorize the plans based on the average percentage of healthcare costs they cover. The open enrollment period in Washington State typically runs from November 1st through January 15th. During this time, residents can shop for health insurance coverage through the Washington Health Benefit Exchange.
Bronze plans typically have the lowest monthly premiums but higher out-of-pocket costs when you need medical care. They are a good fit for individuals who are generally healthy and are comfortable with the idea that they will pay more when they access medical services. For 2025, these plans cost 11% more compared to 2024. The most affordable Bronze plan in Washington is the Ambetter Essential Care 1 from the Coordinated Care Corporation, which costs $282 per month.
Silver plans offer a balance between monthly premiums and out-of-pocket costs. They are best suited for individuals with average medical needs. Silver plans are also eligible for cost-sharing reductions (CSRs), which lower out-of-pocket costs for eligible individuals. The most affordable Silver plan in Washington is the Community Health Plan of Washington Cascade Select Silver plan, offered by Community Health Plan of Washington, which costs $394 per month.
Gold plans have expensive monthly rates, but you pay less when you need medical care. These plans are ideal for individuals with ongoing illnesses or disabilities who expect to need a lot of healthcare services in a year. Gold plans have low deductibles and caps on how much you'll pay for medical care in a year, known as an out-of-pocket maximum. In Washington State, Gold plans cost $611 per month before discounts and have an $866 deductible, on average. The most affordable Gold plan in Washington is the Ambetter Clear Gold plan from the Coordinated Care Corporation, which costs $385 per month.
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Discounts and subsidies
Washington state residents can compare and shop for health insurance through the state Health Benefit Exchange website, Washington Healthplanfinder. This website offers health and dental plans that meet the health reform standards of the Affordable Care Act. When you apply through Washington Healthplanfinder, the application will ask questions about your household and finances to see if you qualify for different health coverage programs, including free or reduced-cost plans.
About seven out of ten people in Washington with coverage through Washington Healthplanfinder are eligible for discounts, called subsidies or premium tax credits. The size of the discount is inversely proportional to the income of the applicant. About 14% of Washington residents with Obamacare plans pay less than $10 per month for coverage. You may qualify for subsidies if you make between $15,060 and $60,240 per year as a single person (or between $31,200 and $124,800 per year for a family of four). It is important to note that these discounts only apply to Bronze, Silver and Gold plans bought through Washington Healthplanfinder.
Washington state residents who earn about $21,000 per year or less ($44,000 per year for a family of four) may qualify for free government health insurance, called Washington Apple Health or Medicaid. Pregnant women, children, and people with disabilities can get Apple Health with higher household incomes. Apple Health is available year-round, and you can apply for it at any time. However, if you qualify for Medicaid, you cannot get marketplace subsidies.
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Average costs
The cost of health insurance in Washington varies depending on several factors, including the type of plan, income, family size, and medical needs. On average, health insurance costs in Washington are $752 per person below the national average.
For those seeking affordable coverage, Ambetter offers the cheapest plans in nine of Washington's ten largest cities. Their Silver plans are the most affordable in Seattle, Spokane, Vancouver, Bellevue, Kent, and Everett. Community Health Plan, on the other hand, offers the cheapest plans in Tacoma. The average cost of a Bronze plan in Washington is $432 per month with a deductible of $6,063. These plans are ideal for young, healthy individuals who can manage unexpected medical bills. Silver plans, such as the Community Health Plan of Washington Cascade Select Silver plan, offer a balance between monthly premiums and out-of-pocket costs, with an average monthly cost of $394.
For those with lower incomes, Washington Apple Health, also known as Medicaid, is available. Individuals earning $21,000 per year or less, or $44,000 per year for a family of four, may qualify for free health insurance. Additionally, about 14% of Washington residents with Obamacare plans pay less than $10 per month.
It is worth noting that the cost of healthcare in states with "Certificate of Need" (CON) boards, which minimize competition, tends to be higher. Washington is one of the states with CON requirements, which contributes to higher prices for healthcare services.
The open enrollment period in Washington typically runs from November 1st to January 15th, during which residents can shop for private health insurance that suits their needs and budget.
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Kaiser Permanente and Ambetter
Kaiser Permanente is the best health insurance company in Washington state. It has high-quality plans and gets significantly fewer complaints than the average company of its size. Kaiser Permanente has locations throughout Puget Sound and encompasses a wide array of doctors and other professionals. They offer four different medical plans: Kaiser WA Classic, Kaiser WA Value, Kaiser WA SoundChoice, and Kaiser WA CDHP. The Classic plan offers low-cost shares for services and set copayments for most services, so you pay less out of pocket. The Value plan offers set copayments for most services, so you know what you'll pay before you receive care. The SoundChoice plan offers a wide array of benefits and care from award-winning doctors. The CDHP plan is not described.
Kaiser Permanente also offers PEBB health plans, which are only available in SW Washington and northern Oregon. This division is called Kaiser Permanente NW. With Kaiser Permanente, you're required to use network pharmacies for prescription drugs; otherwise, you'll pay full price. There is a deductible for prescriptions with the Kaiser Permanente Classic, SoundChoice, and Value plans. This deductible does not apply to value or tier prescriptions. Mail-order drugs are available in all plans. Coverage is tiered: the amount you pay increases as you move up the tiers from the least expensive, generic drugs, to the more expensive, specialty drugs.
Kaiser Permanente WA Options Summit PPO plans have 3 tiers of coverage for different networks of providers. You receive the best value when you choose high-quality care from Kaiser Permanente providers. You'll have lower copays for office visits and most prescriptions if you use Kaiser Permanente Washington providers and pharmacies, and their community of specialists and hospital systems. The medical deductible is $250 per person/$500 per family for Tier 1 and Tier 2 providers; $750 per person/$1,500 per family for Tier 3 providers. The deductible does not apply to preventive care, telehealth, or prescriptions. The out-of-pocket limit is $4,500 per person/$9,000 per family.
Ambetter sells the cheapest health insurance plans for most people in Washington state. Ambetter has the most affordable health insurance for roughly 80% of people in Washington state, with Silver plans starting at $373 per month before discounts. Ambetter has the most affordable plans in almost every major city in Washington, including Seattle and Spokane. Ambetter Health has more than 4 million members nationwide and 29 state health plans. Ambetter believes that health insurance companies can best deliver quality care on a local level, so it prioritizes investing in its communities and members. Ambetter employees live and work in the communities they serve, and they're committed to partnering and volunteering with local organizations to better support the health of their community.
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Frequently asked questions
The cost of medical insurance in Washington state varies depending on the type of plan, income, and family size. On average, Bronze plans cost $432 per month with a $6,063 deductible, Silver plans cost $394 per month, and Gold plans have expensive rates. Catastrophic plans, which are designed for young adults under 30 or those with a hardship exemption, are available from $267 per month.
Ambetter sells the cheapest health insurance plans in nine of Washington state's 10 largest cities. Community Health Plan sells the cheapest plans in Tacoma.
Washington residents with all types of insurance had an average number of days in the hospital that was lower than the national average.
Yes, Washington Healthplanfinder offers free or reduced-cost insurance based on income and family size. Individuals earning less than $21,000 per year, or $44,000 for a family of four, may qualify for free government health insurance, called Apple Health or Medicaid.
The open enrollment period in Washington state typically runs from November 1st through January 15th.
