Washington Medical Billing Rights & Protections
Everything you need to know about fighting unfair medical bills in Washington. Learn your rights, understand state laws, and take action.
Surprise Bill Protection
State + Federal
Balance Billing
Prohibited
Charity Care Law
Yes
Avg ER Cost
$2,700
Educational Content: This page provides general information about medical billing rights in Washington. Laws change frequently. This is not legal advice. Consult a qualified attorney or patient advocate for your specific situation.
Washington Medical Billing Laws
Washington has comprehensive patient billing protections. The Balance Billing Protection Act (ESSB 6243, 2019) prohibits balance billing for emergency services and for out-of-network providers at in-network facilities. Washington's Hospital Charity Care Act is one of the most generous in the nation — it requires hospitals to provide free care to patients earning up to 300% FPL and discounted care up to 400% FPL. Apple Health (Medicaid) covers adults up to 138% FPL. The Washington Office of the Insurance Commissioner handles complaints about insurance companies and has an active consumer assistance program. Washington's Cascade Care public option provides affordable standardized insurance plans.
Washington has a 6-year statute of limitations on medical debt under RCW 4.16.040. The state has some of the strongest medical debt protections in the nation. Washington's Hospital Charity Care Act (RCW 70.170) requires hospitals to provide free care to patients earning up to 300% FPL and discounted care up to 400% FPL. The state expanded Medicaid (Apple Health) covering adults up to 138% FPL. Washington also enacted the Balance Billing Protection Act (ESSB 6243) in 2019.
Your Key Protections in Washington
Balance Billing Protection Act (ESSB 6243) prohibits balance billing for emergency and surprise out-of-network services
Hospital Charity Care Act requires free care up to 300% FPL and discounted care up to 400% FPL
Apple Health (Medicaid) covers adults up to 138% FPL
Cascade Care public option provides affordable standardized insurance plans
6-year statute of limitations on medical debt (RCW 4.16.040)
Strong hospital financial assistance requirements
Office of the Insurance Commissioner consumer assistance program
How to Dispute a Medical Bill in Washington
Request an itemized bill with all billing codes from the provider
Check if you qualify for Hospital Charity Care — free care up to 300% FPL, discounted care up to 400% FPL
Verify that no illegal balance billing has occurred under ESSB 6243
Apply for the hospital's financial assistance program — Washington has the strongest requirements in the nation
Send a written dispute via certified mail to the billing department
File a complaint with the Office of the Insurance Commissioner at (800) 562-6900
Contact the Washington Attorney General's Consumer Protection Division at (800) 551-4636
Important Deadlines in Washington
6-year statute of limitations on medical debt (RCW 4.16.040)
30 days to dispute a debt with a collector under the FDCPA
180 days for internal insurance appeals
1 year before medical debt appears on credit reports
Apply for Hospital Charity Care as soon as possible after receiving a bill
Average Medical Costs in Washington
Avg ER Visit
$2,700
Avg Urgent Care
$225
Median Income
$82,905
200% FPL (Single)
$31,280