For Consumers

What medical providers need to know about offering discounts to patients

If you're a medical provider and you're looking at new marketing options, it's important to avoid unintentionally violating insurance laws by having your patients pay a fee, such as annually or monthly, in exchange for services or discounts.

Some discount plans require you have an insurance license

These type of discount plans are popular among providers, and there are a variety of names used to describe them. However, depending on the details of the offer or program, it's likely that under state law (RCW 48.44.011) (leg.wa.gov) you'd need to be a licensed insurance producer to legally offer this type of program.

Under RCW 48.44.010 (leg.wa.gov), if you accept prepayment for health care services, you most likely fit the definition of a health care services contractor (HCSC). HCSCs must be licensed with the Office of the Insurance Commissioner.

As a result, if you offer these services without a license, you could face enforcement actions, including fines.

What you can legally offer without an insurance license

It's ok for you to offer plans that don't require any type of fee. For example, you can offer a "Buy one, get one at X percent off" or a "Buy Service A at full price and get a voucher for an additional Service A at X percent off, expiring in six months."

Alternately, you can include a coupon for all other services, an in-office treatment gift card with purchase, or other types of incentives. Vouchers that expire in 12 months or less will encourage patients to think of your program in annual terms.