Special Enrollment Period

A special enrollment period is a time outside the open enrollment period when you can sign up for coverage or shop for a new plan. Certain life changes or special circumstances may qualify you for a special enrollment period. For events that don’t qualify for a special enrollment period, you’ll need to wait for the next open enrollment period to sign up or shop for a new plan. When you apply or report a change through Washington Healthplanfinder, your health plan shopping experience will depend on your qualifying life event.

Washington Apple Health enrollment is year-round and you don’t need a special enrollment period to apply.

SEE IF I QUALIFY

Qualifying Life Events

Once you’ve had a qualifying life event, your household has 60 days to sign up for coverage or shop for a new plan. Your new coverage will be effective depending on the type of event you report.

Examples of qualifying life events:

  • Adding a dependent or becoming a dependent
  • Losing a dependent or dependent status*
  • Filed or reconciled taxes for a year that you received health insurance premium tax credits*
  • Change in program eligibility or amount of financial help*
  • Losing other health coverage (i.e., job loss, divorce, loss of Washington Apple Health or WSHIP coverage, etc.)
  • Permanently moving from a location in the United States to Washington, or to a new county within Washington, only if you had minimum essential coverage for at least one day within the 60 days before you moved
  • Permanently moving from a location outside the United States to Washington
  • A change in citizenship or lawful presence status
  • Getting released from jail or prison
  • Tribal membership

*This is for currently enrolled customers only.

View the full list of qualifying life events.

These changes do not count as a qualifying life event:

  • Choosing to stop other health coverage
  • Being terminated for not paying your premiums
  • Finding out your doctor isn’t covered through your plan

Special Circumstances

Certain special circumstances may also qualify you for a special enrollment period.

Examples of special circumstances:

  • Survivors of domestic abuse/violence or spousal/domestic abandonment. Read more about survivors of domestic violence applying for coverage.
  • Errors of Washington Healthplanfinder (includes system errors that prevented you from getting coverage)
  • Customer working with Washington Healthplanfinder staff on an enrollment issue that did not get resolved before the end of open enrollment
  • Contract violation by the Qualified Health Plan
  • Additional exceptional circumstances as defined and approved by the Washington Health Benefit Exchange

View the full list of qualifying special circumstances.

Applying for a Special Enrollment Period

If you’re a new customer:

  1. Visit www.wahealthplanfinder.org and create an account
  2. Fill out an application
  3. If you’re eligible for a Qualified Health Plan, fill out the Special Enrollment Questionnaire
  4. If you qualify, select and confirm your plan

If you’re an existing customer:

  1. Visit www.wahealthplanfinder.org and sign in to your account
  2. Click the quick link “Report a Change in Income or Household”
  3. Fill out the Special Enrollment Questionnaire
  4. If you qualify, select and confirm your plan

If you are approved for a special enrollment period, your insurance company may ask for records that prove you qualify. Make sure you have these papers ready in case you need to show proof.