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.
Open Enrollment is November 1, 2019 to December 15, 2019. You can enroll into a new Qualified Health Plan or change your coverage through Washington Health Benefit Exchange (Wahealthplanfinder.org).
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.
If you do not qualify for Apple Health, you may be provided with other health insurance plan options to choose from. What you pay for these qualified health plans on the Exchange depends on what you earn each year. You may qualify for cost-sharing reductions and/or premium assistance for plans purchased through the Exchange (please note that cost-sharing reductions are available only for Silver plans).
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
Open enrollment for 2020 is November 1, 2019 to December 15, 2019. During this period you can select and enroll in a qualified health plan.
- For coverage that begins on January 1, 2020 you must enroll and pay your premium to the insurance carrier by December 15, 2019.
- Once open enrollment ends on December 15, 2019, 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.
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
* = Bridgespan Health Company offers RealValue and UW Medicine Exclusive Provider Option (EPO) plans that require members seek care from their selected network. 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 7:30 a.m. – 8:00 p.m. Monday through Friday. 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 other 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 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
- Northwest Hospital: 206.668.6565
- 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)