Special Enrollment Periods & Qualifying Life Events

It is estimated that up to 85 percent of people eligible to enroll in coverage outside open enrollment do not take advantage of their opportunity to get covered, according to the Urban Institute.

Common life events that allow customers to sign up for a new health plan before the next open enrollment period include:

  • Getting married
  • Having a baby
  • Moving
  • Losing other health coverage

For a complete list of qualifying life events, visit www.wahbexchange.org/SEP.

Generally, you must report your life event to Washington Healthplanfinder within 60 days to qualify for a special enrollment period.

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If You’re a New Customer

Go to www.wahealthplanfinder.org and create an account. You’ll complete your application for coverage to see what you qualify for. If you are eligible for Washington Apple Health, you can enroll year-round and select your managed care plan. If you are eligible for a Qualified Health Plan, you’ll need to answer a few more questions about the type and date of the life event you’ve experienced.

If You’re an Existing Customer

Sign in to your account and report a change. Choose the qualifying life event you’ve experienced and follow the steps to see if you qualify to shop for a new plan.

For both new and existing customers, if you qualify for a special enrollment, make sure you have documentation on hand that proves you’ve had a qualifying life event. Your insurance company may ask for these records.

New Qualifying Event For Survivors of Domestic Violence

There is also a new type of special enrollment customers can qualify for. Centers for Medicare & Medicaid Services (CMS) released new guidance that survivors of domestic abuse or spousal abandonment (and their dependents) can apply for health insurance apart from their abuser or abandoner at any time during the year.

The information they provide on their application will be kept confidential and will not be shared with any third party without written consent. Survivors can also indicate that they are “Single Filing Taxes” without fear of a penalty from the IRS.

For more information about survivors of domestic violence applying for health insurance, visit www.hca.wa.gov/medicaid/publications/Documents/22-330.pdf.

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