Thanks to the Affordable Care Act’s consumer protections, financial subsidies, and associated Medicaid expansion, Washington state’s uninsured population has decreased significantly in recent years. The rate went from 14 percent in 2013—the year before the ACA went into effect—to 5.8 percent in 2015, the most recent year for which there's data. For the 2018 Open Enrollment, nearly a quarter-million Evergreen State residents enrolled in ACA Marketplace plans, shattering previous enrollment records and resulting in an eight percent increase from the previous year. If you’re new to Washington or don’t have health insurance for another reason, read on to learn about Washington Healthplanfinder and how to enroll in health insurance in WA.
Washington Healthplanfinder is the online Marketplace operated by the Washington Health Benefit Exchange, the Affordable Care Act health insurance exchange in the state of Washington. The website launched to the public on October 1, 2013, and it is used by individuals and families to enroll in private health insurance and dental plans. It is also where residents can qualify for and apply ACA subsidies like premium tax credits and cost-sharing reductions to lower their health insurance premiums and healthcare costs. Washington Healthplanfinder used to also offer small business health insurance, but that ended with the 2017 coverage year. There is also a complementary mobile app called the WAPlanfinder Mobile App where you can view your health and dental coverage from a mobile device.
HealthCare.gov is the federal Affordable Care Act Marketplace and Washington Healthplanfinder is the Washington state version of it. HealthCare.gov serves all eligible Americans except those living in Washington or one of the 11 other areas that have their own health exchanges.
Both HealthCare.gov and Washington Healthplanfinder health insurance plans cover the essential health benefits mandated by the ACA, and the definitions of Catastrophic, Bronze, Silver, Gold, and Platinum level plans are the same across both platforms. Likewise, eligibility requirements for ACA subsidies are the same.
HealthSherpa is a privately-run alternative to HealthCare.gov that has all the same plans, prices, and subsidies as you would find on the government version. HealthSherpa provides a quick and easy approach that saves you time and puts the power of finding the right plan for you and your family in your hands. In addition, HealthSherpa can help Washington residents enroll in the same plans found on Washington Healthplanfinder at the same prices and with the same subsidies. To get HealthSherpa’s free assistance, just call the customer advocate team at (855) 772-2663.
Washington Apple Health is the state’s Medicaid program. It is run by the Washington State Health Care Authority and offers free or low-cost coverage for eligible residents. Washington Apple Health covers preventative care and immunizations as well as dental services, pregnancy services, transgender health benefits, and more.
Because Washington expanded Medicaid under the ACA, Washington Apple Health eligibility is assessed by income and qualifying characteristics. Adults and children typically qualify if they are U.S. citizens, have annual household incomes lower than the Medicaid standard, and do not qualify for Medicare; certain non-citizens can also qualify. Explore these eligibility requirements for the income limits and see if you qualify.
To enroll in ACA plans in Washington, you can choose one of the following options:
All of these options will make sure your eligibility for financial assistance is assessed. That is, whether you qualify for any ACA subsidies or for Washington Apple Health. If you qualify for WA Apple Health, they’ll direct you to the right place to apply. For those who need language assistance, help is available in 175 languages if you call Washington Healthplanfinder customer service at (855) 923-4633. Their website also provides resources in 20 languages. The one exception is if you’re age 65 or older, blind, or disabled and are applying for Washington Apple Health to get coverage or to help pay for Medicare premiums and expenses. In that case, you can apply via Washington Connection.
You can enroll in an ACA plan during the annual Open Enrollment Period. The 2018 OEP for Washington Healthplanfinder started November 1, 2017 and ended January 15, 2018. If you missed that enrollment period, you may still be able to enroll if you have a qualifying life event and are eligible for a Special Enrollment Period. If you qualify, you’ll have 60 days from the date of your qualifying life event to sign up. Coverage typically starts on the first day of the next month if you enroll by the 15th of the month and on the first day of the second month if you enroll after the 15th of the month. You can apply for Washington Apple Health at any time during the year.
Whether your Washington Healthplanfinder plan renews automatically depends on whether your plan or a similar one is being offered the following year. Before Open Enrollment starts each year, you should receive a letter from your insurance company letting you know whether you're being automatically renewed, either for the same plan or a similar one you’ve been mapped to or if renewal is not possible because your plan is being discontinued. If it’s the latter, make sure to shop for a new plan. If it’s the former, you can choose to stick with the plan you’re renewed for or shop for a new one. For Washington Apple Health, renewal must be done each year to maintain coverage.