Washington Health Benefit Exchange and Expanded Medicaid (Apple Health)

What You Need To Know

The Affordable Care Act (ACA) is a program that allows nearly all persons to get health insurance coverage at an affordable rate and, in some instances, at no cost. The ACA was created to ensure that everyone can get the healthcare they need. You cannot be denied health insurance coverage due to a sickness or prior health issue.

To obtain Washington Health Benefit Exchange coverage for 2017, open enrollment began on November 1, 2016 and ended on January 31, 2017. After January 31, 2017, and until the next open enrollment period, you can only enroll if you have a qualifying event.

Apple Health Medicaid enrollments or renewals are continuous throughout the year.  Based on your income, you may qualify for the Apple Health Medicaid program. This program provides healthcare at no cost to you.

To help you find a health insurance plan, Washington State has set up the Health Benefit Exchange website wahealthplanfinder.org. This website can help you:

  • Find and sign up for the health insurance plan that is best for you or your family.
  • Figure out how much your qualified health plan might cost you.
  • Find out what is covered by a basic level of health insurance. This may include:
    • doctor and emergency room visits
    • care for children (including dental and eye care)
    • prescriptions
    • maternity and newborn care
    • preventive care like cancer screenings and immunizations
    • and much more!

Health Benefits Exchange

Important Open Enrollment Dates

Open enrollment for 2017 started November 1, 2016 and ended on January 31, 2017.

Enroll and pay your premium by:2017 coverage effective date begins:
December 23, 2016January 1, 2017
January 23, 2017February 1, 2017
January 24 – 31, 2017March 1, 2017
  • After January 31, 2017, you can only enroll if you have a qualifying life event. If you have such an event, you have 60 days to either enroll in a qualified health plan for the first time, or change the plan you are enrolled in to more suitable coverage.
  • If you do not qualify for a life event, you will need to wait for the next open enrollment period to sign up for health insurance through Washington Healthplanfinder.

Health Benefit Exchange 2017 Insurers

Health Benefits Exchange insurers have changed for 2017. Exchange plans are offered by the following companies (listed alphabetically):

  • BridgeSpan Health Company
  • Community Health Plan of Washington (CHPW)
  • Coordinated Care Corporation (Ambetter) – UW Medicine is not contracted at this time
  • Group Health Cooperative
  • Kaiser Foundation Health Plan of the Northwest – UW Medicine is not contracted at this time
  • LifeWise Health Plan of Washington
  • Molina HealthCare of Washington
  • Premera BlueCross
  • Regence BlueShield

"In-Network" Access to UW Medicine

UW Medicine is considered "in-network" for several health insurance plans offered on the Exchange. Generally, patients pay less out-of-pocket for services when providers are in-network rather than out-of-network. Out-of-network services may require a higher co-payment or deductible than in-network services, or they may not be covered by insurance at all. IMPORTANT: When selecting an Exchange plan, please consider whether you will have access to your preferred providers at in-network rates.

UW Medicine is considered in-network for Exchange plans offered by the following companies:

UW Medicine In-Network Plans

BRIDGESPAN HEALTH COMPANY*
ALIGN EPO - UW MEDICINE
ESSENTIAL EPO -  REALVALUE
HDHP EPO - UW MEDICINE
HDHP EPO – REALVALUE
HDHP – REALVALUE
COMMUNITY HEALTH PLAN OF WASHINGTON (CHPW)
COMMUNITY HEALTHESSENTIAL PLUS
GROUP HEALTH COOPERATIVE**
FLEX
CORE HSA
VISITSPLUS HD
CORE BASIC PLUS CATASTROPHIC
LIFEWISE OF WASHINGTON
LIFEWISE ESSENTIAL EPO
LIFEWISE ESSENTIAL HSA EPO
PREMERA BLUE CROSS+
PERSONALCARE – UW MEDICINE
PREFERRED EPO
PREFERRED HSA EPO
REGENCE BLUE SHIELD*
CONNECT – UW MEDICINE
HDHP – UW MEDICINE
HDHP EPO – UW MEDICINE

* = BridgeSpan & Regence BlueShield offer multiple "Accountable Health Networks." The UW Medicine Accountable Health Network is "in-network" for UW Medicine. Members who select the Accountable Health Network will be required to select a primary care physician (PCP) within that provider network at the time of enrollment. There are no referral requirements by the PCP; however, it is essential that providers refer within the selected network the member has indicated on their member card to allow the member to receive the in-network benefit.

+ = Premera Blue Cross offers Personal Care plans that require members to seek care from their selected network.

** = UW Medicine is contracted with Group Health Cooperative’s exchange plan for specialty care services only, meaning that in-network access to UW Medicine services would require a referral from the GHC primary care physicians and authorization from GHC. 

Before enrolling in an Exchange plan, confirm with both the plan and your medical provider(s) that your providers are part of the plan's network. Since networks and provider affiliations change over time, you should also periodically confirm your provider's network status even after you've enrolled in the plan. Be aware that health plans sold inside the Washington Health Benefit Exchange (wahealthplanfinder.org) may offer different provider networks than those sold outside the Exchange.

How to Sign Up

  • Online: visit Washington Healthplanfinder
  • By Phone: Washington Healthplanfinder offers customer support to help you get the information you need to enroll in health coverage that best meets your needs and your budget. A trained representative will help educate you about your options and walk you through the enrollment process. The Washington Healthplanfinder Customer Support Center is open to enroll individuals, families and small businesses in quality health coverage and answer questions about financial help and the enrollment process. Toll-free support is available from 8:00 a.m. – 8:00 p.m. Monday through Friday. Help will be available in up to 175 different languages. Call 1-855-WAFINDER (1-855-923-4633) or TTY/TDD 1-855-627-9604.
  • In-Person: In-person support and help will be offered at many places throughout the greater Seattle and Puget Sound area, including hospitals, libraries, and various community groups. Get help enrolling here.
  • At UW Medicine Hospitals: Harborview Medical Center, Northwest Hospital & Medical Center, UW Medical Center and Valley Medical Center will have staff on-site to help you sign up. Call ahead to schedule your appointment if you plan to come to one of the enrollment sites.
  • At UW Neighborhood Clinics: You can visit or call any UW Medicine Hospital for assistance with questions or enrollment.

Enrollment Assistance, Questions, and Appointment Scheduling

UW Medicine is here to help you understand your healthcare coverage options so you can make an informed selection regarding your healthcare. Please call to schedule an appointment for assistance with your application or if you have questions:

  • Harborview Medical Center: 206.744.3084, option 2
  • UW Medical Center: 206.598.4388, option 3
  • Northwest Hospital: 206.368.6565
  • Valley Medical Center: 425.656.5599 or 425.251.5178, option 3

Before you begin, make sure you have information for all household members applying for coverage:

  • Legal names
  • Family relationships for each member of the family unit
  • Birth dates
  • Identification numbers (Social Security Number or immigration information)
  • Proof of immigration status if you're a legal permanent resident
  • Proof of tribal status if you're a registered American Indian/Alaska Native
  • Income before taxes
  • Proof of income if your income has changed since you last filed taxes
  • Tax filing status: this is what you report on your IRS tax form
  • Current health insurance information (coverage dates, group number and policy number)
  • Open Enrollment Renewal letter from the Washington HealthPlanFinder (if applicable)

UW Medicine Enrollment Sites

Location Days Times
Harborview Medical Center
8th Ave Ground West Lobby - Interview Lanes
Monday-Friday 8:30 AM - 4:00 PM
Harborview Medical Center 8th Ave Ground West Lobby
Call for an appointment (206.744.3084, option 2)
Monday-Friday 8:30 AM – 4:30 PM
University of Washington Medical Center
Admitting – Interview Lanes
Monday-Friday 8:30 AM - 4:30 PM
University of Washington Medical Center Admitting –
Call for an appointment (206.598.4388, option 3)
Monday-Friday 8:30 AM – 4:30 PM
Northwest Hospital Emergency Department Financial Counselors
(Dedicated office in the ED open 10 hours a day, seven days a week for enrollment)
Monday-Sunday 10 AM - 8:30 PM
Valley Medical Center
Main Campus: Financial Advocates
Main Admitting Department
400 S. 43rd Street
Renton, WA 98055
Monday-Friday 8 AM - 6:00 PM
Valley Medical Center
Emergency Department
400 S. 43rd Street
Renton, WA 98055
Monday-Sunday 8 AM - 6:30 PM
Valley Medical Center
Patient Financial Services: Customer Service
3600 Lind Avenue, Suite 110
Renton, WA 98058
Monday-Friday 8 AM - 4:30 PM

More Information