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Washington State Office of the Insurance Commissioner

Benefits related to seeing certain providers

Provider or service
Description
Type of plan
Chiropractic care

Chiropractic care must be offered on the same basis as any other care.

Individual and group
Chiropractic care – Nonreferral access

Health plans must allow enrollees to access a network of chiropractors without getting a referral.

Individual and group
Dentistry

Health plans must cover services performed by a dentist acting within the scope of his or her license, if the services would be covered if performed by other licensed providers.

Individual and group plans sold by disability carriers
Denturist services

Health plans must cover services performed by a denturist acting with the scope of his or her license if the service would be covered if performed by a dentist

Individual and group
Every category of
provider

Health plans must cover every category of licensed health care provider if the services are within their scope of practice.

Individual and group
Optometry

Health plans must cover services performed by an optometrist acting within the scope of his or her license, if the services would be covered if performed by other licensed providers.

Individual and group plans sold by disability carriers
Podiatry/Chiropody

Health plans must cover services performed by a podiatrist/chiropodist acting within the scope of his or her license, if the services would be covered if performed by other licensed providers.

Individual and group
Psychological services

Health plans must cover services performed by a psychologist acting within the scope of his or her license, if the services would be covered if performed by other licensed providers.

Individual and group plans sold by disability carriers
Registered nurses and ARNPs

Health plans must cover services performed by any RN or ARNP acting withinthe scope of his or her license.

Individual and Group
Women's Health Care
– Direct Access

Women can choose a provider of their choice for women's health care services, within a health plan's network, without getting prior approval.

Individual and group

 

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