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Overview of the Available Plans

Max Income Threshold

Premera Blue Cross:    Benefit Summary       Provider Lookup      Not available in Snohomish/Pierce

Hospitals Include:  Swedish, Evergreen, Overlake, UW Medicine, Multicare, Providence, Children's, Highline, Overlake, UW Medicine, Virginia Mason, Harborview, SCCA)

Of the available individual plans, Premera offers the broadest access to providers  (details on provider lookup).  Unfortunately, Premera is only available in King and a few rural counties.  For King County, although it has the largest network, it's also the most expensive plan.

 

Kaiser Permanente:  Benefit Summary    Provider Lookup      Online Enrollment (non exchange, no subsidy)

Kaiser has plans available INSIDE and OUTSIDE of the state exchange.

The Kaiser Permanente plans are HMO (Health Maintenance Organization) health Plans.  Kaiser acquired Group Health Coop in 2017.  Typically, the Kaiser plans are the least expensive option.  You must select a primary care provider and then receive a referral to see a specialist.  Most care is received at the Kaiser owned facilities (formerly GHC), however, there are circumstances where Kaiser providers perform services at outside hospitals.  Only Kaiser has the low-cost HSA compatible plans.  Only Kaiser allows you to enroll directly with them outside of the exchange.  If you are not subsidy eligible and would like an HSA plan or other Kaiser plan, Enroll Here.

Ambetter by Coordinated Care:  Benefit Summary    Provider Lookup  

Hospitals Include:  Swedish, Evergreen, Providence, Children's, CHI Franciscan, Highline (NOT:  Everett Clinic, Overlake, UW, Virginia Mason, SCCA)

The Ambetter health plans are HMO (Health Maintenance Organization) health plans.  You are required to establish a PCP, also known as a primary care physician. However, you are not required to receive a referral from your PCP to see a specialist. Ambetter is the only plan in Snohomish county that does offer access to Swedish & Providence.

Molina Market Place:  Benefit Summary    Provider Lookup              

Hospitals Include:  Molina covers most hospitals except Evergreen.

The Molina plans are HMO (Health Maintenance Organization) health Plans.  Molina offers a Gold, Silver and Bronze plan.  You must select a primary care provider and then receive a referral to see a specialist.  Your PCP, also known as your primary care physician, is the main doctor you will see for most of your medical care. This includes your checkups, sick visits and other basic health needs.

Lifewise Health Plans:  Benefit Summary    Provider Lookup                

Hospitals Include:  Swedish, Everett Clinic, Providence, CHI Franciscan (NOT: Overlake, Evergreen, UW, Multicare, Virginia Mason or SCCI)

Lifewise is an EPO (Exclusive Provider Network) plan, and requires a PCP, also known as a primary care physician.  Your PCP is the main doctor you will see for most of your medical care. This includes your checkups, sick visits and other basic health needs.

Regence Blue Shield:  Benefit Summary    Provider Lookup     Not Available in Snohomish County           

Direct Online Enrollment (not on exchange, no subsidy available)  or   Enrollment Form (fillable pdf)

Non-Exchange Direct Enrollment

Hospitals Include:  UW Medicine Network only if located in King County, MultiCare only if in Pierce.

Regence is only available OUTSIDE of the Exchange which means there is no subsidy available if lower income.  If income is above max threshold and UW Medicine only is acceptable this is a preferred plan.

BridgeSpan Health:  Benefit Summary    Provider Lookup     Not Available in Snohomish County           

Hospitals Include:  UW Medicine Network only if located in King County, Multicare only if in Pierce.

Asuris NW Health:  Benefit Summary    Provider Lookup     Only available in certain eastern WA counties