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Consumer Advocacy

Call: 800-562-6900 (8:30 a.m. to 4:30 p.m., Monday - Friday)
Form: Ask an insurance expert

Benefits health plans must cover under Washington state law

Under Washington state law, certain individual/family and group plans must offer these benefits.

Coverage for abortion services

Abortion has been legal in Washington state since 1970. All state-regulated health plans must cover it if they also cover maternity services. 

Gender-affirming medical coverage rights

State law and the federal Affordable Care Act prevent insurers from discriminating against you based on your gender identity and related medical conditions.

Getting your health plan to cover your prescription drug

If Washington state regulates your health plan, you or your medical provider can ask to get coverage for prescription drugs your plan doesn't usually cover.

Health information and your privacy

You have the right to receive your personal health information instead of the person who pays for your health insurance.

How my premiums are determined

The cost of your monthly premium depends on the rate we approve for your insurer.

How we review health rates

We review all policies and rate requests for individual and small group plans in Washington state.

How your health insurance claims process works

Understanding the claims process can help save you time and avoid frustration.

Insurance and reconstructive breast surgery

It's your choice to rebuild your breasts after a mastectomy. Knowing your rights can help you decide.

Learn how health insurance works

Health insurance helps pay your medical bills when you seek care. Knowing what your options are can help save you time, money and frustration.

Mental health parity

If your health plan covers medical and surgical services, the Affordable Care Act also requires coverage for medically necessary mental health services.

Patient Bill of Rights

The Patient Bill of Rights is a state law that guarantees your access to quality health care.

Reproductive and birth control health rights

Washington state-regulated health plans must cover certain reproductive health services and birth control.

What consumers need to know about surprise or balance billing

You have protections in Washington state against receiving surprise bills for emergency care or certain behavioral health services.

What health insurance plans must cover

State and federal laws require that all plans cover preventive health services and preexisting conditions.

When health insurers can ask you about your health

Health insurers can't make you answer questions about your health before buying insurance. They also can't delay claims due to a preexisting condition.

Women's health insurance rights

State law ensures access to women's health providers for maternity, reproductive, gynecological and preventive care, with many services at no extra cost.

Your rights to see a medical provider

Some health plans in Washington state must include access to every type of licensed medical provider. This is known as the "Every Category" law.