Jane Dotson
Washington state's annual open enrollment period for health insurance typically runs from November 1 to January 15. During this time, anyone can apply for health insurance through Washington Healthplanfinder. If you missed the open enrollment period, you may still enroll if you qualify for Apple Health or a special enrollment period. Special enrollment periods are granted for specific life events, such as job loss, birth, adoption, or marriage, and you have 60 days from the event to apply.
| Characteristics | Values |
|---|---|
| Annual Open Enrollment Period | November 1 to January 15 |
| Year | 2025 |
| Website | Washington Healthplanfinder |
| Contact | 800-562-6900 (8:30 a.m. to 4:30 p.m., Monday - Friday) |
| Special Enrollment Period | Available for certain life events, including job loss, birth, adoption, and marriage |
| Apple Health | Can be enrolled in at any time |
| Cascade Care Silver or Gold Plan | Can be enrolled in any month of the year without a qualifying life event |
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What You'll Learn
Annual open enrollment period
In Washington state, the annual open enrollment period for health insurance happens every year, typically between November 1 and January 15. During this period, anyone can apply for health insurance through Washington Healthplanfinder. The 2025 annual open enrollment period will run from November 1, 2024, through January 15, 2025.
During the open enrollment period, individuals can enroll, renew, and make changes to their individual health plans. For those who miss the open enrollment period, there is still an option to join a health plan if they qualify for Apple Health or a special enrollment period. Special enrollment periods are typically triggered by certain life events, such as job loss, birth, adoption, marriage, or a change in residency. Individuals have 60 days from the life event to apply for a special enrollment period.
American Indians or Alaska Natives are provided with additional flexibility, as they can enroll in health coverage at any time without requiring a special enrollment period. Moreover, they can change their health plan once a month without needing to qualify for a special enrollment period. To avail of these benefits, individuals must be enrolled Tribal members or shareholders in an Alaska Native Corporation.
It is important to note that not all life events qualify for a special enrollment period. If an individual does not qualify for a special enrollment period, they can still sign up for a health plan during the next open enrollment period. Washington Healthplanfinder assists individuals and families in finding suitable health coverage that aligns with their healthcare needs and budgetary constraints.
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Special enrollment period
Open enrollment for health insurance in Washington State typically runs from November 1 to January 15 annually. However, individuals who miss this period can still enroll if they qualify for a special enrollment period.
A special enrollment period is a window of opportunity to sign up for a health plan outside of the regular open enrollment period. This option is available when specific life events occur, allowing individuals to obtain health coverage when they need it the most. The special enrollment period is typically triggered by qualifying life events, such as losing health coverage, experiencing job loss, getting married, giving birth or adopting a child, or permanently moving to a new area. It's important to note that not all life events qualify for a special enrollment period.
To qualify for a special enrollment period in Washington State, certain criteria must be met. For example, individuals who are not already enrolled in a Cascade Care Silver or Gold plan and have a limited income but do not qualify for Apple Health (Medicaid) may be eligible. Union workers who have lost their health or dental insurance due to a strike, lockout, or labor dispute may also be eligible for a special enrollment period. Additionally, American Indians or Alaska Natives can enroll in coverage at any time without needing a special enrollment period.
It's important to act promptly when applying for a special enrollment period, as there is typically a 60-day window from the qualifying event to complete the application process. Individuals can apply for a special enrollment period through Washington Healthplanfinder, which offers an online platform to find health insurance plans that fit their healthcare needs and budget. Washington Healthplanfinder also connects individuals to Apple Health (Medicaid) coverage and provides free or low-cost coverage options for tribal members.
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Qualifying for Apple Health
Washington state's annual open enrollment period for health insurance runs from November 1 to January 15 every year. During this time, anyone can apply for health insurance through Washington Healthplanfinder. If you missed the open enrollment period, you can still enroll if you qualify for Apple Health or a special enrollment period.
Apple Health (Washington Apple Health for individual adults) is a program that provides free or low-cost health care to eligible Washington state residents. The program is administered by the Washington State Health Care Authority. To qualify for Apple Health, certain criteria must be met.
For example, to qualify for the Apple Health for Workers with Disabilities (HWD) program, a person aged 16-64 must meet the requirements of the Social Security Act, including federal disability requirements for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). Alternatively, the Department of Social and Health Services (DSHS), Division of Disability Determination Services (DDDS) must determine that the person meets the federal disability requirements for the HWD program.
Union workers who lose their health or dental insurance due to a strike, lockout, or labor dispute may be eligible for a special enrollment period. Additionally, certain life events may qualify you for a special enrollment period, such as job loss, birth, adoption, marriage, or divorce.
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Union workers losing insurance
Union workers in Washington State who lose their health or dental insurance due to a strike, lockout, or labour dispute may be eligible for a special enrollment period. This is also the case for those who lose their employer-sponsored health insurance outside of the annual open enrollment period (November 1 to January 15).
If you are losing your job-based health insurance, you have options to stay covered. You may be offered COBRA, but you can find more cost-effective and comprehensive options on Washington Healthplanfinder, like Cascade Care plans. You have 60 days before or after your employer coverage ends to sign up for a plan on Washington Healthplanfinder. Signing up before your employer coverage ends will help you avoid a gap in coverage.
If you are currently enrolled in a Washington Healthplanfinder plan when you lose your job, report a change and update your income. This will let the relevant authorities know if you are eligible for additional savings or a special enrollment period. You may be eligible for free or low-cost care through Apple Health.
If you are offered employer health insurance that is considered affordable, federal law states that you are not eligible to receive tax credits. If you fail to update your application and report that you have been offered employer-sponsored health insurance, you may have to pay back federal tax credits received.
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Tribal members' benefits
Washington State offers several benefits for Tribal members. If you are a Tribal member under the age of 65 and not on Medicare, you may qualify for free or low-cost health insurance through the Washington Healthplanfinder. This includes no copays or deductibles when you see your healthcare provider and no costs for using Indian Health Services or Contract Health Services. You can enrol or change health plans at any time during the year.
The Affordable Care Act has created regulations that benefit Tribal members who enrol in Qualified Health Plans through the Washington Healthplanfinder. These benefits include:
- No copays or deductibles if your income is within a certain range (at or below 300% of the Federal Poverty Level).
- No costs for using Tribal or urban Indian clinics or when your Contract Health Services program refers you to another doctor for more care.
Additionally, Tribal members eligible for Apple Health (Washington State's Medicaid program) can choose to be enrolled in a managed care plan and use an Indian health, Tribal, or urban Indian clinic for services in addition to their Apple Health coverage.
Community Health Plan of Washington (CHPW), a Medicare Advantage plan, also offers resources to help Tribal members take control of their health. CHPW covers primary care, specialty care, and prescription drugs, and provides access to state and local social services. CHPW also offers extra benefits like gym memberships and additional coverage for alternative medicine, including chiropractic, acupuncture, and naturopathy.
It is important to note that open enrollment for health insurance in Washington State typically occurs annually from November 1 to January 15. However, Tribal members can enrol or change plans at any time during the year through the Washington Healthplanfinder. Additionally, certain life events may qualify individuals for a special enrollment period outside of the open enrollment window.
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Frequently asked questions
Open enrollment for health insurance in Washington state begins on November 1 and ends on January 15.
Open enrollment is an annual period during which anyone can apply for health insurance through Washington Healthplanfinder.
A special enrollment period is when you can sign up for a health plan outside of open enrollment. This can be due to a qualifying life event such as job loss, birth, adoption, marriage, or a recent strike, lockout, or labour dispute. You have 60 days from the event to apply for a special enrollment period.
To apply during open enrollment, create an account and complete an application on the Washington Healthplanfinder website.
