Washington State Office of the Insurance Commissioner

Your right to access alternative providers

All state-regulated individual and group health insurance plans in Washington state must allow you access to every category of licensed health care providers - such as licensed massage therapists and chiropractors. The providers must be licensed, registered, or certified by the state of Washington.

See the types of providers covered by this law.

How the law applies to medical conditions

In general, insurers must give you access to alternative providers for any medical condition covered by the state’s Basic Health Plan.

The law does not change WHAT conditions are covered by your plan, but it does give you more choice in WHO will treat your condition. For example, if a benefit plan covers back pain, you will have more choice in the type of provider that can treat that condition.

The law doesn't change the way your health care coverage works

Many managed care insurance plans require “gatekeeper” visits before they will refer you to another provider. This law requires health plans to maintain adequate networks containing every category of licensed provider.

Shop around – not every plan is the same

Remember, your right to access every category of providers does not mean all medical conditions are covered by your health plan. You health plan also can limit the number of times you can see a provider for certain conditions. Before you buy a health plan, compare benefits and prices.

Some health plans are not covered by this plan, including:

  • Self-funded employer plans or union trusts
  • Medicare supplement and long-term care insurance
  • Limited health care plans, such as dental, vision, specific disease, and accident-only coverage
  • Workers’ compensation coverage
  • Plans that meet a short-term limited purpose, such as college student health plans


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