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Mandated Health Insurance Benefits in Washington (WA)


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Many states require insurance carriers to include specific mandated benefits in certain types of health insurance policies. These benefits may include required coverage for specific health care services, treatments, practices, and providers. Some mandated benefits apply only to group policies, while others apply both to individual and group policies.

A list of each state's mandated benefits is available from the U.S. Centers for Medicare & Medicaid Services. Please note that these lists include only specific care, treatment, or services that a health plan must offer, and do not include the following:

  • Provider mandates, which require a health plan to reimburse specific health care professionals who render a covered service within their scope of practice;
  • Dependent mandates, which require a health plan to define dependents in a specific manner or to cover dependents under certain circumstances (e.g., newborn coverage, adopted children, domestic partners, and disabled children); or
  • State anti-discrimination requirements or state requirements relating to service delivery method (e.g., telemedicine).

For the most up-to-date and complete list of mandated benefits in your state (including provider and dependent mandates), please contact your state insurance department.
 

Please Note: The state laws summaries featured on this site are for general informational purposes only. In addition to state law, certain municipalities may enact legislation that imposes different requirements. State and local laws change frequently and, as such, we cannot guarantee the accuracy or completeness of the information featured in the State Laws section. For more detailed information regarding state or local laws, please contact your state labor department or the appropriate local government agency.