How to Get Healthcare Coverage as a Self-Employed Counselor in Seattle, Bellingham, and Beyond
Owning a private therapy practice comes with many benefits—autonomy, flexibility, and the ability to shape your own professional path. However, one of the significant challenges for private practice owners is securing health insurance. Unlike traditional employment, where insurance benefits are often provided, private practice owners must navigate the complex landscape of purchasing their own coverage.
If you are a counselor in private practice in Washington State, including areas like Seattle, Bellingham, or Spokane, understanding your health insurance options is essential. This blog post explores different avenues for obtaining health insurance for therapists, resources to help with the process, and factors to consider when deciding.
When Do You Sign Up for Health Insurance?
If you've never purchased your own private practice health insurance before, it’s helpful to start by understanding when you’re eligible to sign up. For Washington residents, the state’s marketplace—Washington Healthplanfinder—offers multiple opportunities throughout the year to enroll in coverage.
Health Insurance Enrollment Periods in Washington State
1. Open Enrollment Period
- Dates: Typically November 1 – January 15
- Purpose: Main time each year to enroll in or change plans
- Deadlines:
- Enroll by December 15 for coverage starting January 1
- Enroll by January 15 for coverage starting February 1
2. Special Enrollment Period (SEP)
- Availability: Year-round, if you qualify
- Eligibility: Must have a Qualifying Life Event (QLE)
- Examples of QLEs:
- Losing employer-sponsored insurance
- Turning 26
- Marriage or divorce
- Having or adopting a child
- Moving to a new county or ZIP code
- Change in immigration status
- Other complex cases (e.g., domestic violence)
- Timeframe: 60 days from the event to enroll
3. Apple Health (Medicaid in WA)
- Open year-round
- No restrictions based on enrollment windows
- Supports income-eligible adults, children, pregnant people, elderly
4. Cascade Care and Financial Help
- Lower deductibles and predictable costs
- Eligibility for state-based premium assistance (Cascade Care Savings)
Health Insurance Options for Therapists in Private Practice
Washington Health Benefit Exchange (WAHBE)
The Washington Healthplanfinder (www.wahealthplanfinder.org) is the state’s marketplace for individual and family health plans under the ACA.
- Subsidies and Tax Credits: Based on income and household size; possible savings if income is between 100–400% of the federal poverty level.
- Plan Levels: Bronze, Silver, Gold, and Platinum.
Association Health Plans (AHPs)
Some professional associations offer group plans:
Advantages:
- Lower premiums due to group pricing
- Additional benefits like dental and vision
- Shared resources and community support
Drawbacks:
- Smaller provider networks
- Some may not be ACA-compliant
- Membership fees may apply
Health Insurance Through a Spouse or Domestic Partner
If available, this is often the most cost-effective choice despite fewer options.
Health Share Programs
Examples include Medi-Share and Liberty HealthShare.
How They Work:
- Members pay monthly shares
- Expenses are submitted for potential reimbursement
- Membership may have lifestyle or religious requirements
Risks:
- Not regulated insurance
- Limited coverage
- No guaranteed payouts
Short-Term Health Insurance
Temporary and less expensive, but offers limited benefits and is not suitable as a long-term solution.
Private Insurance Brokers
Can help find customized plans and assist with enrollment:
HSAs and High-Deductible Health Plans (HDHPs)
Great for those in good health; pre-tax savings help lower taxable income while funding medical expenses.
Educating Yourself Before Buying Insurance
Careful review of plan details is crucial. Consider the following:
- Lifetime Maximum: Some plans cap total payouts.
- Covered Services: Ensure the plan covers mental health, physical therapy, and preventive care.
- Deductible: A higher deductible lowers premiums but increases upfront costs.
- Out-of-Pocket Expenses: Include copays, prescriptions, and more.
Conclusion
Securing health insurance as a private practice owner in Washington State requires careful consideration and research. While the options may seem overwhelming, using available resources and consulting professionals can help you find a plan that meets your needs. Whether through a marketplace plan, association, or private broker, protecting your health enables you to focus on helping others through your therapy practice.
Resources for Washington State Private Practice Owners
- Washington Healthplanfinder
- Washington State Office of the Insurance Commissioner
- Small Business Health Options Program (SHOP)
- National Association for the Self-Employed (NASE)
- Professional Associations like WSPA or ACA
