What You Need To Know
The Affordable Care Act (ACA) is a program that allows many Washington residents to access health insurance coverage at an affordable rate and, in some instances, at no cost. The ACA was created to ensure most can get the healthcare they need. You cannot be denied health insurance coverage due to a sickness or prior health issue.
In response to the potential growth of coronavirus disease 2019 (COVID-19) cases, the Washington Health Benefit Exchange announced a limited-time special enrollment period for qualified individuals who are currently without insurance. This special enrollment period (SEP), that runs through May 8, 2020, will allow uninsured individuals an opportunity to enroll in health insurance coverage through Washington Healthplanfinder.
In addition, current Washington Exchange enrollees with income changes due to:
- a reduction in work hours during the COVID-19 state of emergency
- a lost employment altogether
can report income changes at any time during the plan year. Based on the income change you may be eligible for increased subsidy assistance to pay for Washington Health Benefit Exchange premiums or Washington Apple Health Medicaid provides healthcare at no cost. More information is available at https://www.wahealthplanfinder.org/_content/report-change.html
Individuals seeking special enrollment or to request a change can:
- Contact Washington Healthplanfinder Customer Support Center 7:30 a.m. to 5:30 p.m. Monday to Friday at 1.855.923.4633; TTY: 1.855.627.9604. Language assistance and disability accommodations are provided at no cost.
- Contact a local certified broker.
- Contact UW Medicine navigators.
- Go online at https://www.wahealthplanfinder.org/_content/find-expert-advice.html.
Apple Health Medicaid enrollments or renewals are continuous throughout the year. Based on your income and citizenship status, you may qualify for the Apple Health Medicaid program. The Apple Health for Adults coverage program provides healthcare at no cost.
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)
- maternity and newborn care
- preventive care like cancer screenings and immunizations
- and much more!
Health Benefits Exchange
Important Open Enrollment Dates
- A limited-time special enrollment period is available for qualified individuals who are currently without insurance. This special enrollment period (SEP), will allow uninsured individuals from March 10th through May 8th to enroll in health insurance coverage through Washington Healthplanfinder.
- Anyone enrolling through April 8, 2020 will have coverage effective April 1, 2020.
- Anyone enrolling from April 9, 2020 to May 8, 2020 will have coverage effective May 1, 2020.
- In general, after open enrollment and special enrollment period, you can only enroll if you have a qualifying life event. If you experience a qualifying life event (such as loss of income, loss of health insurance coverage, marriage, birth of a child or a move) it may offer an opportunity to shop for coverage or qualify for Medicaid through Washington Apple Health.
- 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 into 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 2020 Insurers
Exchange plans are offered by the following companies (listed alphabetically, by county):
- BridgeSpan Health Company: Clark, King, Klickitat, Pierce
- Coordinated Care (Ambetter): Adams, Benton, Chelan, Columbia, Douglas, Franklin, Grant, Jefferson, King, Kitsap, Kittitas, Lewis, Lincoln, Pierce, Snohomish, Spokane, Stevens, Thurston, Walla Walla, Yakima
- Kaiser Foundation Health Plan of the Northwest: Clark, Cowlitz
- Kaiser Foundation Health Plan of Washington (formerly Group Health Cooperative): Benton, Columbia, Franklin, Island, King, Kitsap, Kittitas, Lewis, Mason, Pierce, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman, Yakima
- LifeWise Health Plan of Washington: Adams, Asotin, Benton, Chelan, Clallam, Clark, Columbia, Cowlitz, Doulas, Ferry, Garfield, Grant, Island, Jefferson, King, Kittitas, Klickitat, Lewis, Lincoln, Mason, Okanogan, Pend Oreille, Pierce, San Juan, Skagit, Snohomish, Spokane, Stevens, Thurston, Walla Walla, Whatcom, Whitman, Yakima
- Molina HealthCare of Washington: Clark, Ferry, King, Klickitat, Lincoln, Mason, Pend Oreille, Pierce, Skamania, Snohomish, Spokane, Stevens, Thurston
- PacificSource Health Plans: Clark, Pierce, Spokane
- Premera Blue Cross: Franklin, Grays Harbor, King, Kitsap, Pacific, Skamania, , Wahkiakum,
- Providence Health Plan: Benton, Clark, Franklin, Spokane, Thurston, Walla Walla
"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
- RealValue EPO
- UW Medicine EPO
- MOLINA HEALTHCARE OF WASHINGTON
- MOLINA CHOICE & CORE CARE HMO
- PREMERA BLUE CROSS
- PREFERRED EPO
- PREFERRED HSA EPO
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 Monday through Friday. Call 1-855-WAFINDER (1-855-923-4633) or TTY/TDD 1-855-627-9604.
- At UW Medicine Hospitals: Harborview Medical Center, UW Medical Center and Valley Medical Center 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 utilize 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 and UW Medical Center: 206.744.3084, option 2
- Valley Medical Center: 425.656.5599 or 425.690.3578, option 5
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)