7429 East Heather Way, Everett, WA  98203-5424

Washington State Medical Insurance

Many inferior Washington State medical insurance plans do not offer significant out of pocket protections and instead limit the insurance companies exposure while letting the policy holder keep the risk.  Many offer little in the way of prescription coverage or provisions for extended hospital stays. If you or someone who shares your policy is apt to experience such an event, it's essential that you own coverage that will support you through this kind of calamity.  Here at Benefits NW, Inc., we can help you zero in on policies that offer some of the most generous protection in the state.

Of course, if you're in good health and don't anticipate this kind of tragedy, you may want to invest in insurance with a higher deductible/premium ratio. Further factors that can affect the decision include the cost of healthcare in your area, size of the plan you're seeking and whether you prefer specific doctors. Bring such questions here to Benefits NW, Inc., and you can expect prompt and cogent answers in a matter of minutes.

Our considerable experience throughout the state means we can give you better access to the providers in your area, including major brands such as Regence Blue Shield, Premera Blue Cross, Asuris Northwest, Aetna Healthcare &  United Healthcare.   Big providers such as these tend to offer a number of plans and rates, many of which may have overlapping benefits. If you want a clearer overview of everything that's available, simply ask us for a sound explanation.

Don't hesitate to contact the experts here at Benefits NW, Inc. if you have any questions about the many options throughout Washington State. We help employers and individuals find better plans every day, securing lower premiums and better coverage without breaking the bank. We're available by phone at (877) 455-7591 or by email us at our MARKETING DEPARTMENT.

In addition to the links below where you can get online information, quotes and the ability to apply, we will send you Washington State Medical Insurance quotes and packets by US mail because we will send you more than 15 sets of quotes with all the pertinent details along with the Washington State Standard Health Questionnaire for each member of your household.

If you want more information about the Washington State Health Questionnaire and its scoring, please go to www.ship.org/shq.asp   If you & any dependents are required to complete a Standard Health Questionnaire, you may not exceed 324 points per individual on their scale to get the coverage that we send you. Otherwise, you will be offered the Washington State Health Insurance Pool's plans at higher rates. You can See page 1 of the Questionnaire for exceptions when this document is not necessary to complete. Please reply with questions or call us locally at (425) 353-9763 (Everett), toll-free at (877) 455-7591 or (206) 965-9609 (Greater Seattle).

We will send you packets from Regence Blue Shield or Asuris NW Health (sister companies) and Lifewise Health Plan of Washington (sponsored by Premera Blue Cross). These are the largest and most popular individual medical insurance carriers in Washington State.

If you reside in  Kitsap, Mason, Jefferson or Clallam counties, we will also send you KPS Health plans.  

We will send you individual/family dental plans if requested.

You may also sign up online below and we can follow up on your application process and check status for you to make sure everything is going well and service your account.  THERE IS NO ADDITIONAL CHARGE FROM USING OUR SERVICES.  IT IS THE SAME RATE GOING THRU US OR DIRECTLY TO THE INSURANCE CARRIER.  We give you the personal attention that you deserve and save you time and money.

Online Link to apply online with Lifewise HealthPlan of Washington (Part of Premera Blue Cross) which is:  https://lwwa.inshealth.com/ehi/Alliance?allid=Lif25311&sid=101923  Lifewise HealthPlan of WA offers coverage in ALL OF WASHINGTON STATE.

Online Link to apply online with Regence Blue Shield which is:

Regence Blue Shield of WA offer coverage in all of Western WA with the exception of Clark County. In Eastern WA, Regence offers coverage in Yakima, Klickitat, Walla Walla & Columbia counties. For most of Eastern WA, see Asuris NW below & Lifewise above.

Online Link to apply for Asuris Northwest is https://shop.asurisnorthwesthealth.com/action/new-from-broker?agentNumber=M32839&dispatch=medical      Asuris NW is a sister company with Regence Blue Shield and offers coverage primarily in Eastern WA with the EXCEPTION of Yakima, Klickitat, Walla Walla & Columbia counties AS THESE ARE REGENCE BLUE SHIELD COUNTIES.

ONLINE DENTAL PLANS:

The following are individual/family dental plans.  Contact us if you are an employer group with at least 2 employees. 

Online link to apply for Primestar Dental (allows you to see any dentist)  https://www.starsdental.com/starsdental/online.aspx?agnt=SLSL2G3Q

Online link to apply for SmartSmile Dental (https://www.dentalhealthservices.com/becomewa.asp?agent=W806

Online link to apply  with various discount dental plans (lowest dental plan cost)-online application link (Click on the following)  www.dentalplans.com/afftracker.asp?affid=20398 .

RATE CHANGES

Annually each carrier changes rates across the board for all health plans.    Regence Blue Shield/Asuris NW Health rates are stable until July 1 of each year,   Lifewise of Washington rates change January 1 of each year.  KPS rates change March 1 of each year. 
Most Regence/Asuris NW plans have a $1 million lifetime maximum benefit for covered expenses. The exception are the newer Regence Breakthru /Asuris NW Clarity  and HSA plans which have a $2 million lifetime maximum. All of LifeWise Health plans have a $2 million lifetime maximum benefit.  The KPS plans are all $1 million maximum. 

PRESCRIPTIONS
Regence Blue Shield/Asuris NW's maximum prescription benefit is either $3000 or $0 for most plans.  For those Lifewise plans that have more than a discount prescription benefit, the plans cover generic drugs with an unlimited maximum. Brand names are covered with a $3000 annual benefit maximum.   KPS health plans have a $2,000 maximum benefit for rx. 

ON THE JOB COVERAGE FOR THE SELF-EMPLOYED  If you are self employed and have opted to not be covered by Washington State Labor and Industry coverage for on the job injuries and illnesses, please be aware that all Lifewise plans cover on the job for the self employed. Only the Regence Breakthru  and HSA & Asuris NW Clarity & HSA  plans (subscriber only) automatically includes the medical coverage for on the job injuries and illnesses. The other Regence Blue Shield/Asuris NW Health plans do not cover on the job injuries or illnesses for the self employed.    None of the KPS plans include on the job coverage for the self-employed.

In order to get maximum benefits, Regence Blue Shield's Selection plan requires you to pick out a primary care physician and be referred to specialists while the Regence Breakthru and PPO plans and all Assuris NW plans allow you to go directly to the specialist on the preferred provider list (PPO). With Regence Selections, you must go to your primary care physician first to get maximum benefits.
Please see the respective carrier's website for a list of providers. 

If you choose to apply by US Mail, please mail your medical insurance applications directly to the insurance carrier so that they are postmarked by 20th of the month to begin the following first of the month. Please do not send the applications to Benefits NW, Inc. as US mail can get hung up and we may not be able to turn it around to the carrier in time.

For dental insurance applications, please send them on to the respective insurance carrier.

Please note that each carrier compensates us by various means though there is no increased charge to you the subscriber. The rates are the same whether you go thru the carrier direct or apply through Benefits NW, Inc.   Benefits NW, Inc. may participate in programs in which we receive payments and other items of value and incentives to place business with them. We welcome your contact with any questions or concerns. Thank you once again.

Note:  We do not intentionally send unwanted or "spam" emails.  If you do not want any additional emails from us on this topic please email us at our MARKETING DEPARTMENT  and place in the subject heading:  

unsubscribe Washington Standard Individual Insurance

You know how valuable health-care coverage can be. Not only will it help you protect your health, it will also help you protect your finances. Without it, an unexpected illness or injury can cause serious financial hardship. When you buy a health-care plan, you'll also get the peace of mind that comes with knowing you're protected against the unexpected.

We at Benefits NW, Inc. can offer you many great services, including:

Choosing the right plan
Suggesting ways to save on taxes
How to check online for provider networks for each insurance carrier.

We offer Health Insurance Plans that offer:

convenient access to cost-saving provider networks
online provider directory
online resources for health and wellness information, health topics, treatment options and hospital comparisons
personalized online pharmacy services
responsive well-trained customer service staff
worldwide emergency coverage
24-hour toll-free health line
dental and life insurance products

With the following begin a series of lessons on the topic of "HOW TO BUY Washington Medical / HEALTH INSURANCE" to give you tools to be a better informed consumer.

LESSON 1.  BUY A POLICY THAT WILL COVER THE CATASTROPHIC EVENTS.

Too often I talk with people who are only interested in a health insurance policy that will cover office visits, preventive care  and have a strong prescription plan since that is how they have used  the healthcare system in the past.  Generally these are healthier people. Yes, health plan benefits that cover such expenses  save us money, however, what is most important is that you have an insurance policy that will cover the rare, but very expensive CATASTROPHIC EVENTS such as major illness & major accidents. 

The cost of a few office visits or even regular prescriptions for the most part will not bankrupt us.  What will  take us down is the unusual and rare event that can hit overnight and costs tens if not hundreds of thousands of dollars or even over a million dollars.  The unusual & costly events are what will put us financially under.  I'm talking about the costs of major injuries such as a traumatic, near death automobile accident.   Costs of major illnesses such as cancer or liver disease or needing an organ transplant.  I know various individuals who were in hospitals for weeks at a time for either traumatic injuries or major illnesses and racked up hundreds of thousands of dollars in medical bills.  You need coverage that will provide the big dollars with preferably multimillion dollar lifetime limits and limit your out of pocket exposure by having language such as "coinsurance maximum" or "out of pocket maximum" amounts.

These type of health insurance policies with multi million dollar lifetime limits need not be expensive either.  You can combine them with medium and high deductible plans to make the premiums affordable. 

You know how valuable health-care coverage can be. Not only will it help you protect your health, it will also help you protect your finances. Without it, an unexpected illness or injury can cause serious financial hardship. When you buy a health-care plan, you'll also get the peace of mind that comes with knowing you're protected against the unexpected.
 

LESSON 2.  BUY A POLICY THAT WILL BE AFFORDABLE NOW AND IN THE FUTURE. 

Two realities that every health insurance buyer should know:   1.  The price goes up with age.  2. Prices go up with time.  These facts are true regardless of your health history.  

The healthiest 60 year old with ideal weight/ height ratio and no health issues will still pay over three times more than an overweight, smoking but otherwise healthy 23 year old for the same insurance policy.  Actuaries make computations based on history of large groups of populations at various ages to know what insurance companies need to charge to cover future medical claims.

In the long run, health insurance premiums mirror the healthcare inflation rate and that has been averaging over 6% a year for a long time.  Using the rule of 72's  premiums will more than likely double in 12 years just from the cost of healthcare alone.       

Therefore, if you plan on keeping a policy for awhile, you should factor these increases in.  Take a look at what you spent in the past year and determine which policy will best meet your needs and still be affordable for the future.   If you are anywhere near age 65 and plan on keeping the policy when Medicare should kick into gear, then make sure the policy you pick will be one that will meet your needs over the interim. 

Example questions that you need answers for are : 

How often did we see the doctor this past year?  What procedures will I need in the next year or two?  Are we expecting to have any more children? 

If in doubt, between two plans, choose the one with the  LOWER COST-HIGHER DEDUCTIBLE PLAN.  Why do I say that?  Because insurance is a fixed expense and whether you use it or not you will pay each and every month.  I'd much rather pay a little extra on those months I actually use the plan  rather than be stuck with a regular high premium obligation.               

Health insurance plans will not cover every expense. To get a true idea of what your costs will be under each plan, you need to look at how much you will pay for your premium and other costs.

• Are there deductibles you must pay before the insurance begins to help cover your costs?
• After you have met your deductible, what part of your costs are paid by the plan?
• Does this amount vary by the type of service, doctor, or health facility used?
• Are there co-payments you must pay for certain services, such as doctor visits?
• If you use doctors outside a plan's network, how much more will you pay to get care?
• If a plan does not cover certain services or care that you think you will need, how much will you have to pay?
• Are there any limits to how much you must pay in case of major illness?
• Is there a limit on how much the plan will pay for your care in a year or over a lifetime? A single hospital stay for a serious condition could cost hundreds of thousands of dollars.

You can't know in advance what your health care needs for the coming year will be. But you can guess what services you and your family might need. Figure out what the total costs to your family would be for these services under each plan.

LESSON 3.  BUY A POLICY THAT HAS A LARGE PREFERRED PROVIDER ORGANIZATION (PPO) AND USE THE PREFERRED PROVIDERS.  

The preferred provider organization has the best of both worlds of traditional fee-for-service plans and managed care plans. Like a fee-for -service plan, you may see most specialists direct without a need for a referral from a primary care provider such as a family physician.   Like a managed care plan, there are a network of  of doctors and hospitals to choose from. When you use those providers (sometimes called "preferred" providers, other times called "network" providers), most of your medical bills are covered.  Find a PPO plan with a large network of providers so that you will have many to choose from.  

When you go to doctors in the PPO, you present a card and do not have to fill out forms. Usually there is a small copayment for each visit. For some services, you may have to pay a deductible and coinsurance.  Even for those expenses that require a deductible to be paid,  there is a significant discount by staying within the PPO for covered expenses.

Most PPOs cover preventive care. This usually includes visits to the doctor, well-baby care, immunizations, and mammograms.

In a PPO, you can use doctors who are not part of the plan and still receive some coverage. At these times, you will pay a larger portion of the bill yourself (and also fill out the claims forms). Some people like this option because even if their doctor is not a part of the network, it means they don't have to change doctors to join a PPO.

Questions to Ask About a PPO

• Are there many doctors to choose from? Who are the doctors in the PPO network? Where are they located? Which ones are accepting new patients? How are referrals to specialists handled?  You can generally find this information at the PPO's website.
• What hospitals are available through the PPO? Where is the nearest hospital in the PPO network? What arrangements does the PPO have for handling emergency care?
• What services are covered? What preventive services are offered? Are there limits on medical tests, out-of-hospital care, mental health care, prescription drugs, or other services that are important to you?
• What will the PPO plan cost? How much is the premium? Is there a per-visit cost for seeing PPO doctors or other types of copayments for services? What is the difference in cost between using doctors in the PPO network and those outside it? What is the deductible and coinsurance rate for care outside of the PPO? Is there a limit to the maximum you would pay out of pocket

LESSON 4.  BUY A POLICY FROM A COMPANY THAT HAS THE FINANCIAL STRENGTH TO ENDURE THE HARD TIMES.