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
  • Gaining access to a Health Reimbursement Arrangement (HRA) through your employer. More information about HRAs can be found here
  • Income changes that result in an individual being newly eligible for tax credits and cost-sharing reductions

*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.

View the Special Enrollment Period Checklist