Washington Healthplanfinder Plans and Subsidies

What Healthplanfinder is

Washington Healthplanfinder is the state-run marketplace where residents shop for individual and family health coverage. It is also the only place you can claim a federal premium tax credit, which is the subsidy that reduces your monthly cost based on household income and size.

Washington also offers Cascade Care, a set of standardized plans where the deductibles, copays and coinsurance are set by the state. Because the cost-sharing is identical across carriers at a given metal level, those plans are unusually easy to compare on the things that actually differ: premium and provider network.

Metal levels, in plain terms

• Bronze. Lowest premium, highest deductible. Suits people who rarely use care and want protection against a catastrophe.
• Silver. Middle ground, and the only level where cost-sharing reductions apply if your income qualifies. Frequently the best value for that reason alone.
• Gold. Higher premium, lower out-of-pocket. Often the better total cost for people who see doctors regularly or take ongoing medication.

The subsidy detail catches people out every year. If your income falls in the range that qualifies for cost-sharing reductions, those savings are only available on a Silver plan. Buying Bronze to save on premium can leave real money on the table.

Deadlines

Open enrollment for the following plan year typically runs from early November into mid-January, with an earlier deadline for coverage effective January 1. Outside that window you need a qualifying life event to enroll.

Confirm the current year’s exact dates with us or on the Healthplanfinder site before you rely on them, because they have shifted in the past. If you have had a qualifying event, do not wait for open enrollment.

Apple Health

If your household income falls below the Medicaid threshold, Healthplanfinder will route you toward Apple Health, Washington’s Medicaid program, rather than a subsidized private plan. Apple Health enrollment is open year round. We will tell you if that is where you belong, even though it is not a plan we are paid on.

Where a broker helps

The site handles the transaction well. What it does not do is tell you whether your oncologist is in the network you just picked, or whether the plan two rows down covers your medication at a lower tier for four dollars more a month. That comparison is the part we do, and our reading of it is free. We also wrote a longer guide to using Healthplanfinder on our blog.