Choosing Health Insurance: Which Individual & Family Plan Is Best for You?

I know I need to enroll in health insurance, but I don’t know where to start.

We get it. Shopping for health insurance can be confusing. You may have questions about when you can enroll, what is available for you, and what is the difference between all the plans. We’re here to help walk you through the different options.

If you don’t have health coverage through work, you’re self-employed, or not eligible for other health coverage:

You may be eligible for Individual & Family Plans.

These are affordable health insurance plans you can buy through the state’s Washington Healthplanfinder website. Read more information about these plans below.

What are Individual & Family Cascade Care and Cascade Select plans?

Individual & Family Plans are quality health insurance plans offered on states’ Affordable Care Act health benefit “exchanges” or marketplaces for people who do not receive health insurance through their employment, and/or who don’t qualify for other coverage like Apple Health (Medicaid) or Medicare. Depending on how much you make, you may be eligible for financial help to lower your costs.

Cascade Care plans are types of Individual & Family Plan that are available in Washington state through Washington Healthplanfinder. They meet quality standards and offer standardized coverage for things like doctor visits, preventive care, and prescriptions. These plans also feature lower deductibles and more covered services without cost-sharing (deductibles, coinsurance, and copayments, or similar charges). Your out-of-pocket costs depend on the plan’s metal level: Gold, Silver, and Bronze.

Cascade Select is a type of Cascade Care plan often referred to as Washington’s “public option” plan. Cascade Select has the same standard benefit design and also meets additional standards of quality, value, and provider reimbursement. (CHPW offers Individual & Family Cascade Select Plans.)

Deductible: The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

Coinsurance: The percentage of costs of a covered health care service you pay (20%, for example) after you’ve paid your deductible.

Copayment: A fixed amount ($20, for example) you pay for a health care service, usually when you receive the service.

What is the difference between the Cascade Select Bronze, Silver and Gold plans?

The main difference is whether you want to pay less at the time you receive care, or whether you prefer to pay a lower monthly premium. Metal categories have nothing to do with the quality of care, which is the same across plans, it has to do with monthly and time of care costs. You could be eligible for subsidies and cost-savings that will bring your actual coverage costs down.

Bronze

This plan has the lowest monthly cost, but you pay more at time of care. This is a good choice for people who do not think they will need to use their coverage but want protection against the high costs of serious health events like an injury or accident.

Silver

This plan has a moderate cost at the time of care and a moderate monthly payment. This is a good choice if you get care a few times per year.

Gold

This plan provides the highest coverage and comes with the highest monthly premium. You might consider gold if you receive care frequently throughout the year or want lower costs at time of care.

When can I enroll in CHPW Individual & Family Plans?

The annual open enrollment period for coverage is November 1 through January 15. However, you may qualify for a Special Enrollment Period at any time of year if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

Who is eligible for CHPW Individual & Family Plans?

To be eligible, you must:

Live in Washington State
Not have health insurance from work or family
Not be in jail or prison

Visit our eligibility page for more details.

I don’t like my insurance plan, can I switch?

For Washingtonians who are eligible for Cascade Select, they can switch their insurance during open enrollment from November 1 through January 15.

You may qualify for other health plans if:

You have low income

Then you may qualify for Washington State Apple Health (Medicaid). Adults 19-64 years old may be eligible if their annual household income is at or below $1,616 a month or $2,186 for a two-person household. (These income levels update every April.)

Are 65 years old or have a disability or qualifying medical condition

Then you may be eligible for federal Medicare. (You may even be dual eligible for Medicaid and Medicare!)

Learn more

Learn more about the CHPW Individual & Family Cascade Select Plans
See Individual & Family Plan FAQs
Call us at 1-833-993-0181 (TTY: 711) or visit Washington Healthplanfinder to enroll in a CHPW Individual & Family Plan online.
Apple Health (Medicaid) eligibility
Learn more about Washington State Cascade Care Plans.

Comments are closed.