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.
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:
- Visit www.wahealthplanfinder.org and create an account
- Fill out an application
- If you’re eligible for a Qualified Health Plan, fill out the Special Enrollment Questionnaire
- If you qualify, select and confirm your plan
If you’re an existing customer:
- Visit www.wahealthplanfinder.org and sign in to your account
- Click the quick link “Report a Change in Income or Household”
- Fill out the Special Enrollment Questionnaire
- 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.