Skip To Content

Appeals Program

You have the right to request an appeal if you think Washington Healthplanfinder’s eligibilty decision about your health insurance coverage is wrong. An appeal is a hearing before a Presiding Officer in which you are able to present your case for your eligibility determination. For frequently asked questions about the appeals process, click here.

Eligibility decisions you can appeal include:

  • The amount of your Health Insurance Premium Tax Credit
  • The amount of your Cost Sharing Reduction
  • As an employer, whether the insurance you provide your employees meets the coverage requirements and whether that insurance coverage is affordable for your employees.
  • Failure to provide timely notice of an eligibility decision

Appeals Process

Request an Appeal: Don’t delay, you have 90 days from the date on your letter to request an appeal or you may lose your right to a hearing. The quickest way to ask for a hearing is to request a Hearing Request form. You may contact us by email, by mail at PO Box 1757, Olympia, WA 98507, by calling 1-855-859-2512 or in person. Please provide the following information:

  • Full name and birth date
  • Washington Healthplanfinder application identification number
  • A daytime phone number

Hearing: The hearing will be held on the phone, so you don’t have to attend in person. You have the right to bring documents and witnesses that support your position. You may ask someone to represent you during the appeal, although it is not required. Your representative could be an attorney, relative, or friend.

Language Interpreter: If you want a language interpreter, we will provide one at no cost to you. We will send notices and the final decision in a language that you understand. To ask for an interpreter, contact the Appeals Program at appeals@wahbexchange.org or call 1-855-859-2512.

Solicitar una apelación (En Español)

Appeals Forms

Interpreter and Translation Services

The Washington Health Benefit Exchange Appeals Program has access to comprehensive language translation services. We are committed to eliminating language barriers for Limited English Proficient (LEP) and deaf individuals.

If you let us know, we will provide telephonic interpreting and document translation, including support for American Sign Language. 

Request a Translator

Equal Access

Information for Persons with Physical or Mental Disabilities Who Need Accommodations to Access Hearings:  Anyone with a disability who needs assistance in order to participate in an appeal ask the Appeals Program for assistance. Please email or call the Appeals Program to explain why they need an accommodation and what accommodation you would like. Any medical records and medical information you give us to support your request will be sealed and held confidentially.

You may request any assistance that will help you fully and meaningfully participate in the appeals process, so please request the accommodation that will best allow you to do that. Some possible accommodations could be:

  • a sign language interpreter;
  • large print or high contrast documents and forms;
  • extended time for hearings and recesses;
  • assistive listening and seeing devices;

Notice of Equal Access/Equal Opportunity and Nondiscrimination: The Washington Health Benefit Exchange (WAHBE) is committed to providing services that embrace diversity, respect the rights of all individuals, are open and accessible, and are free of bias or discrimination based on, but not limited to, ethnicity, race, creed, color, religion, age, disability, sex, marital status, national origin, political opinions or affiliations, veteran status, and genetic information.

Anyone with questions about compliance or a complaint regarding bias, harassment or discrimination should contact the Washington Health Benefit Exchange Legal Department at:

ATTN: Legal Division Equal Access/Equal Opportunity Coordinator PO Box 1757 Olympia, WA  98507-1757

Additional Resources

U.S. Department of Health and Human Services Appeals Process

The U.S. Department of Health and Human Services (HHS) appeals entity serves as the second-level review once the Washington Health Benefit Exchange appeals process has been exhausted. Individuals who wish to appeal the Exchange's decision may file an appeal with the U.S. Department of Health and Human Services by completing and submitting the form found at the Healthcare.gov Marketplace Appeals landing page. Scroll down the page to find the appeals form.

To apply for an exemption based on coverage being unaffordable, click here.