As part of our ongoing COVID-19 response efforts, the Exchange has opened a time-limited, extended enrollment opportunity for customers who have lost health coverage during the public health emergency.
Typically, customers losing coverage mid-year have 60 days before and after their coverage end date to sign up through Washington Healthplanfinder. During COVID many have reported enrollment barriers, including delays in receiving federal or state unemployment insurance payments. To help address these barriers, the Exchange is giving customers experiencing a gap in coverage more time to enroll.
Individuals who have lost health insurance coverage after March 1, 2020 during the public health emergency will have until September 30, 2020 to sign up for coverage through Washington Healthplanfinder. Loss of coverage includes loss of minimum essential coverage (including employer-sponsored health coverage or COBRA) and loss of coverage from short-term limited duration plans or health sharing ministries.
To sign up, customers must call the Washington Healthplanfinder Customer Support Center or contact their local navigator or broker. Customers who sign up by September 15 can get coverage starting October 1. After September 15, coverage starts November 1.
Washington Healthplanfinder Customer Support Center:
Help is available in over 175 languages. Language and disability accommodations are provided at no cost. Business Hours: Monday – Friday from 7:30 a.m. to 5:30 pm. Phone:1-855-923-4633 TTY: 1-855-627-9604
Below are answers to frequently asked questions during the COVID-19 (Coronavirus) pandemic:
Coverage Options
Washington Healthplanfinder will determine if you qualify for Washington Apple Health (Medicaid) coverage, which is available year-round, or qualified health plan coverage, which is available during an open enrollment period and during the year if you experience a qualifying event.
You have 60 days of your employer coverage end date to enroll in coverage through WAHealthplanfinder.org or WAPlanfinder app. Washington Apple Health coverage is available year-round if you qualify.
Reporting loss of coverage:Washington Healthplanfinder will guide you through reporting your change in coverage. This can be done entirely online. You can report your loss of employer coverage in Washington Healthplanfinder up to two months before it ends. This will help you avoid gaps in coverage.
COBRA: Before enrolling in COBRA, review your coverage options. Washington Healthplanfinder can provide affordable options to maintain coverage. If you enroll in COBRA and your employer stops helping pay for your COBRA premiums, report this change of income. This change can open a special enrollment period. If you enroll in COBRA and decide to end your COBRA coverage early, it is not a change that opens a special enrollment period.
If your COBRA coverage end date is within 60 days, report your loss of coverage in Washington Healthplanfinder. Reporting this change can open a special enrollment period. Reporting an upcoming loss of coverage (up to 60 days before it occurs) will help you avoid gaps in coverage. You can also report your loss of coverage within 60 days after your coverage ends.
Tip: Use SmartPlanFinder to help choose a plan that covers your existing providers and prescriptions.
Job loss could make you newly eligible for free or low-cost coverage through Washington Apple Health. Report your current income when applying for coverage through Washington Healthplanfinder.
Note: If you also lost coverage from your employer, this opens a special enrollment period for you to shop for a plan. Plan selection must occur within 60 days from the qualifying life event.
Coverage Start Date: Washington Apple Health coverage starts the month you enroll and can typically be used within 24-hours to obtain care or prescriptions.
Tip: Washington Apple Health can help with recent unpaid medical bills up to 3 months old, if you meet eligibility requirements.
A reduction of work hours could make you newly eligible for free or low-cost coverage through Washington Apple Health. Report your current income when applying for coverage through WAHealthplanfinder.org or WAPlanfinder mobile app.
Have employer coverage: Even if you have employer coverage, you may be eligible for free or low-cost coverage through Washington Apple Health. This program coordinates with your employer to help lower your costs.
Have Qualified Health Plan coverage through Washington Healthplanfinder: Report the change of income, you may qualify for extra financial help.
Tip: Update your Washington Healthplanfinder account as your circumstances change (example: your household income has changed).
Keep your account up to date with your current income. You may be eligible for free or low-cost care through Washington Apple Health, or more financial help paying for your qualified coverage.
a. Yes, if you currently receive coverage from an off-Exchange carrier and have become newly eligible for the federal subsidies exclusively available through Washington Healthplanfinder, you may qualify for a special enrollment period to sign up for more affordable coverage.
b. A single person making up to $50,000 can qualify for federal premium tax credits ($67,600 for a couple; $85,300 for a family of three, $104,800 for a family of four, and so on).
c. To see if you are eligible for federal subsidies and to sign up for coverage, you will need to create a new account at wahealthplanfinder.org or through WAPlanfinder, our mobile app. Once your account is created, select “Report a Change”. Answer the questions that apply to you and follow the pages to update your information.
How do I know if I qualify for federal subsidies through Washington Healthplanfinder that would make health coverage more affordable for me and my family?
d. If you currently receive minimum essential coverage from an off-Exchange carrier and have become newly eligible for the federal subsidies exclusively available through Washington Healthplanfinder, you may qualify for a special enrollment period to sign up for more affordable coverage.
e. To see if you are eligible for federal subsidies and to sign up for coverage you will need to create a new account at wahealthplanfinder.org or through WAPlanfinder, our mobile app. Once your account is created, select “Report a Change”. Answer the questions that apply to you and follow the pages to update your information.
If you purchased coverage through a health sharing ministry that has received a cease and desist order from the Washington Office of the Insurance Commissioner for fraudulent activity, you may qualify for a special enrollment period to sign up for coverage through Washington Healthplanfinder. To request this special enrollment, contact an Exchange certified Navigator, Broker, or Enrollment Center, and share that you need to replace your health care sharing ministry plan. You can find a local expert to set up a phone appointment and find the right health plan at: https://www.wahealthplanfinder.org/_content/find-expert-advice.html
You can also contact the Customer Support Center between 7:30 a.m. to 5:30 p.m. Monday-Friday at 1-855-923-4633; TTY: 855-627-9604.
The Health Care Authority (HCA) and its partners will stop the termination of coverage for all recipients of Washington Apple Health unless the individual:
Requests termination;
Is no longer a Washington state resident; or
Is deceased
Apple Health recipients are encouraged to complete their renewal during the public health emergency (PHE).The Health Care Authority (HCA) will be extending Washington Apple Health coverage to households through the end of the PHE. Individuals will have 90 days from the date of closure to complete their renewals and prevent any gap in coverage.
Apple Health coverage will be extended to households through the duration of the public health emergency.
Individuals will not lose free or low-cost Apple Health (Medicaid) coverage or have a decrease in benefits during the emergency unless they move out of state or request termination.
This includes individuals who had Apple Health as of March 18, 2020 and new enrollees.
Individuals should disregard termination notices dated on or after March 18, 2020 until further notice.
Individuals should continue to submit any requested information during this time.
If you have been affected by COVID-19, you may have your CHIP balances written off if you are:
Unable to pay CHIP premiums, or
Not currently eligible for CHIP due to past due CHIP premium payments
Contact HCA to request a write off of your CHIP premium.
No. Do not include this payment ($1,200 per adult and $500 per dependent child) when reporting your income in Washington Healthplanfinder.
Reporting Unemployment Income
Yes. Existing Washington Apple Health customers should continue to report changes in their application during the COVID-19 pandemic.
Families who have members on Apple Health and members receiving tax credits or qualified health plan coverage should continue to report changes in income to see if they qualify for no cost or lower-cost care.
Families who have members on Washington Apple Health and members receiving tax credits or qualified health plan coverage should continue to report changes in income to see if they qualify for no cost or lower-cost care.
Weekly payment for this program has ended (except for certain retroactive payments). This benefit is not countable for Washington Apple Health. Report your current base weekly benefit amount received in unemployment income.
To locate this amount, login to your SecureAccess account on the Employment Security Department website. Once logged in, navigate from the ‘summary’ tab to the ‘weeks summary’ tab. This will display your entire weekly benefit amount.
Someone who received income during the calendar year before reporting can also enter the amount received to date as projected annual income.
Washington Healthplanfinder has developed a tool to help you estimate your premium tax credit. If your household income changes during the year providing an estimate of the changes to the premium tax credit amount. This tool does not calculate the actual premium tax credit, your eligibility to receive the tax credit, or provide legal, tax or accounting advice.
No, individuals should report the base weekly amount received from Employment Security Department. This includes the state-calculated weekly benefit amount without the additional $600 per week in additional benefit received under the CARES Act or the $300 per week received under the Lost Wages Assistance FEMA payments.
To locate this amount, login to your SecureAccess account on the Employment Security Department website. Once logged in, navigate from the ‘summary’ tab to the ‘weeks summary’ tab. This will display your entire weekly benefit amount. Report this amount in Washington Healthplanfinder.
If your State unemployment benefits have not changed and you are still receiving unemployment benefits you do not need to change your income. The Washington Healthplanfinder system automatically supports appropriate eligibility for the additional $600 per week received March 4 through July 25, 2020.
If your State unemployment payments have changed, you should update your previous unemployment record with accurate end dates and create a new unemployment record with the new start date and the total amount of State unemployment benefits received.
Washington Healthplanfinder has developed a tool to help you estimate your premium tax credit. If your household income changes during the year providing an estimate of the changes to the premium tax credit amount. This tool does not calculate the actual premium tax credit, your eligibility to receive the tax credit, or provide legal, tax or accounting advice.
Do not include the Lost Wages Assistance FEMA payment when reporting your weekly benefit amount in unemployment. The duration of the benefit is undefined (contingent on weekly federal approval) and recipients receive the payments retroactively for eligible weeks.
For brokers and navigators: The Lost Wages Assistance FEMA payment is not countable for Washington Apple Health eligibility, but is countable for tax credit and cost-sharing reduction subsidies. Customers may choose to adjust their tax credits by adjusting the amount of tax credits to apply to their premium in Washington Healthplanfinder.
Seeking COVID19 Related Care
Washington Apple Health offered through Washington Healthplanfinder will cover testing and treatment deemed medically necessary.
All qualified health plans offered through Washington Healthplanfinder will cover the costs of testing for COVID-19. The following qualified health plan carriers have stated that they will cover the costs (or provide care at zero cost) of COVID-19 treatment for their enrollees:
Bridgespan Health Company
Coordinated Care Corporation
Kaiser Foundation Health Plan of Washington
Kaiser Foundation Health Plan of the Northwest
LifeWise Health Plan of Washington
Molina Healthcare of Washington
Pacific Source Health Plan
Premera Blue Cross
Health plans have different effective dates for this financial relief. Please contact your health plan or visit their website for details about how your COVID-19 costs will be paid for.
If you are concerned about whether or not you should be tested, read the guidance from the Department of Health and call your providers first. Copays and deductibles will still apply if you need treatment.
If you are a member of a health sharing ministry, your coverage may be limited. Check the language of your coverage to understand what’s covered and what’s excluded.
The Office of the Insurance Commissioner has instructed health plans to allow for a one-time early refill for most prescriptions. You should check with your health plan if your prescription is included.
The federal government is directing Medicare Part D (prescription drug plans) and Medicare Advantage plans to allow early refills, but you should check with your plan for more details.
Commissioner Kreidler has instructed all state-regulated health plans (PDF, 251KB) to waive deductibles and copays for people who need testing for COVID-19. State law gives him the authority (leg.wa.gov) to do so, once the governor has issued an emergency proclamation. The waiver only applies to the testing for COVID-19 and the provider visit to order the testing. People who suspect they need testing should check with the Department of Health (doh.wa.gov) and contact their provider’s office first. People who do not test positive for COVID-19 may still need to meet their deductibles and pay a copay.
If you are quarantined in Washington State, you may qualify for coverage and treatment for COVID-19. Please call the Health Care Authority at 1-800-562-3022 for more information.
Sign up for Coverage through Washington Healthplanfinder
Washington Healthplanfinder asks questions that are used to determine in real-time your eligibility for public and commercial qualified health plan coverage options. You receive your eligibility as soon as you submit the application.
Documents can be uploaded through your mobile device. Smart Planfinder is an online tool that can help you find a plan that covers preferred providers and prescriptions.
Qualified Health Plan Coverage: You may be eligible for financial assistance through federal subsidies. Washington Healthplanfinder will calculate if you qualify for subsidies that lower your premiums and cost-sharing. Insurers include: BridgeSpan, Coordinated Care, Delta Dental, Dentegra, Kaiser Permanente, LifeWise, Molina, PacificSource, Premera, and Providence. Depending on where you live will depend on your options.
Washington Apple Health:Washington Healthplanfinder will determine if you qualify for free or low-cost care through Washington Apple Health. Apple Health can be a temporary coverage option until you return to work. It is important to update your application as your situation changes within 30 days. Washington Apple Health insurers: Amerigroup, Community Health Plan of Washington (CHPW), Coordinated Care, Molina, and United HealthCare.
Individuals who have recently lost their job or employer coverage, face a change in income, or experienced a different qualifying event can visit WAHealthplanfinder.org or use the WAPlanfinder Mobile App to sign up online. Apple Health enrollment is year-round.
Enrollment centers are where you can get free assistance from a registered broker or certified navigator. Call ahead for an appointment today.
Registered brokers are licensed professionals that often live in and support their local communities. Brokers can help you fill out the application and can recommend a plan for you. Brokers may charge a small fee, unless they help you enroll in a Washington Apple Health plan.
Navigators are trained to help you complete an application and answer any questions as you enroll. You can get assistance in-person and over-the-phone from a Navigator.
You can search for free help with someone in your community on our mobile app, WAPlanfinder! Find brokers and navigators near you to get help enrolling in a health or dental plan. You can also manage your coverage on the go, get all your important messages, view coverage details, and upload documents with the snap of a photo.
Additionally, our Customer Support Center can help individuals, families, and small businesses fill out the application or answer questions about financial help and the enrollment process. Help is available in 175 different languages.
Toll-Free: 1-855-923-4633
TTY/TDD: 1-855-627-9604
Yes. All uninsured Washington residents can see if they qualify for a special enrollment or Apple Health.
Washington Healthplanfinder has a network of customer support across Washington State to help you enroll in coverage that meets your needs and budget. Whether you prefer to receive assistance online, over the phone, or in-person, trained representatives are available to help educate you about your options and walk you through the enrollment process.
A special enrollment period (SEP) is a time outside the yearly open enrollment period when you can sign up for qualified health and dental coverage. You qualify for a special enrollment period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child. The special enrollment period does not apply to free or low-cost Washington Apple Health coverage. If you qualify, you can get free or low-cost Washington Apple Health coverage year-round.
Registered brokers are licensed professionals that often live in and support their local communities. Brokers can help you fill out the application and can recommend a plan for you. Brokers may charge a small fee, unless they help you enroll in a Washington Apple Health plan.
Navigators are trained to help you complete an application and answer any questions as you enroll. You can get assistance in-person and over-the-phone from a Navigator.
You can search for free help with someone in your community on our mobile app, WAPlanfinder! Find brokers and navigators near you to get help enrolling in a health or dental plan. You can also manage your coverage on the go, get all your important messages, view coverage details, and upload documents with the snap of a photo.
Additionally, our Customer Support Center can help individuals and families fill out the application or answer questions about financial help and the enrollment process. Help is available in 175 different languages.
Toll-Free: 1-855-923-4633
TTY/TDD: 1-855-627-9604
If you qualify for an SEP, you usually have up to 60 days following the event to enroll in a plan. If you miss that window, you have to wait until the next open enrollment period to apply.
You may qualify for a special enrollment period if you or anyone in your household had certain life changes in the past 60 days:
Loss of income
Got married
Had a baby, adopted a child, or placed a child for foster care
Got divorced or legally separated and lost health insurance. (Divorce or legal separation without losing coverage doesn’t qualify you for a special enrollment period.)
Loss of a member in your household. You’ll be eligible for a special enrollment period if someone dies and as a result, you’re no longer eligible for your current health plan
Moving from a location outside of Washington state or moved counties within Washington State
Yes. We are granting an additional 30 days to provide the requested information. You may contact Health Care Authority at 1-800-562-3022 or Department of Social and Health Services at 1-877-501-2233.
