Frequently Asked Questions | Washington Healthplanfinder

Frequently Asked Questions

What are my health insurance options if I am uninsured?  

Apply for free or low-cost Washington Apple Health (Medicaid) year-round.  
See the eligibility requirements for free or low-cost Washington Apple Health. ​​​​
​​​
How to apply for free or low-cost Washington Apple Health:

  • New?
    Create an account and apply. 
  • Existing account?
    Sign in and update (report a change) your income to see if you qualify for free or low-cost Apple Health or other financial help (tax credits). 

If you do not qualify for free or low-cost Washington Apple Health, you may still qualify for a Special Enrollment to get health insurance if you have life changes that qualify you. Qualifying life changes include losing job-based coverage, have income changes, have a baby, get married, gain a new household member (dependent), or have certain other life changes. See more qualifying life changes.

How to apply for a Special Enrollment:

  • New?
    Create an account and apply. ​​​​
  • Existing account?
    Sign in and update (report a change) your income to see if you qualify for free or low-cost Washington Apple Health or other financial help (tax credits). 

 

How does COVID-19 impact my current coverage?

If you already have coverage through Washington Healthplanfinder, the rules in your health plan for treatment for the COVID-19 (Coronavirus) pandemic remain the same as any other viral infection.

  • All plans cover treatment for pre-existing medical conditions and cannot terminate coverage due to a change in health status, including diagnosis or treatment of COVID-19.
  • While your coverage benefits will remain the same, you should log in to update the application if COVID-19 impacts your income or household. You may be able to change your plan or get financial help (tax credits) if certain situations apply.

Contact your health insurance provider directly for more information about:

  • How COVID-19 impacts your coverage
  • Telehealth appointments
  • Payment options or grace periods
  • Benefits related to COVID-19

Wahington Apple Health Members
Bridgespan Health Members
Kaiser Permanente Members
Molina Healthcare Members
Lifewise Health Plan of Washington Members
Premera Blue Cross Members
Providence Health Plan Members
Coordinated Care Members
PacificSource Health Plan Members

 

What are my options if I lost my job or experienced a reduction in hours due to COVID-19?

  • If you lost your job-based health plan: 
    You may qualify for a Special Enrollment Period if you lost health coverage through your employer or the employer of a family member in the past 60 days OR you expect to lose coverage in the next 60 days, including if you lose health coverage through a parent or guardian because you're no longer a dependent.
  • If your employer reduced the hours you work and you’re enrolled through Washington Healthplanfinder: 
    Update your application immediately within 30 days to report any household income changes. You may qualify for more savings than you’re getting now. 
  • If you were furloughed: 
    Depending on the status of your health coverage from your employer, you may qualify for free or low-cost Washington Apple Health or a Special Enrollment with financial help (tax credits) to help pay for the cost of coverage. 
    • Free or low-cost Washington Apple Health can be a temporary coverage option until you return to work. 
    • Hint: When reporting income during your furlough/unpaid leave: 
      • Enter your employer information and enter an income amount of “$0.01” (if you enter $0 as your income you will not be able to proceed).
    • Employer Coverage: Even if you have employer coverage, you may be eligible for free or low-cost Washington Apple Health. This program coordinates with your employer to help lower your costs.

Hint: Update your Washington Healthplanfinder account as your circumstances change (example: you return to work).

  • If you have COBRA continuation coverage:
    If you’re entitled to COBRA continuation coverage after you lost your job-based coverage, you may still qualify for a Special Enrollment Period due to loss of coverage. You have 60 days after your loss of pre-COBRA job-based coverage to enroll in coverage. 
  • If you're enrolled in COBRA continuation coverage:
    You may qualify for a Special Enrollment Period if your COBRA continuation coverage costs change because your former employer stopped contributing. 
  • If you lost your COBRA continuation coverage more than 60 days ago:

     

What if I lost my health insurance coverage or I am about to?

  • If you’ve already lost coverage:
    Your coverage can start the first of the month after you apply and enroll or sooner depending on the circumstances. 
  • If you know you’ll lose coverage within the next 60 days:
    You can submit an application before you actually lose your coverage to help make sure there’s no gap in coverage. For example, if you know you’ll lose coverage on April 30, and apply and enroll in a plan April 10, your new coverage will likely start May 
     

What if I can’t pay my monthly premiums because of hardship due to COVID-19?

Check with your insurance company about extending your premium payment deadline or ask if they will delay terminating your coverage if you can’t pay your premiums.

Most of the time, if you aren’t receiving financial assistance with your premiums, you have a grace period determined by state law. If you’re getting financial assistance, you have a three-month grace period during which your coverage can’t be terminated for not paying your premiums.

Contact your health insurance provider directly for more information about:

  • How COVID-19 impacts your coverage
  • Telehealth appointments
  • Payment options or grace periods
  • Benefits related to COVID-19

Washington Apple Health Members
Bridgespan Health Members
Kaiser Permanente Members
Molina Healthcare Members
Lifewise Health Plan of Washington Members
Premera Blue Cross Members
Providence Health Plan Members
Coordinated Care Members
PacificSource Health Plan Members

 

What if I previously qualified for a Special Enrollment Period but missed the deadline because I was impacted by the COVID-19 pandemic?

If you qualified for a Special Enrollment Period but missed the deadline due to COVID-19 (like if you were sick with COVID-19 or were caring for someone who was sick with COVID-19), you may be eligible for another Special Enrollment Period. 
 

What if my child is now living with me after their college sent them home early?

Your child can generally qualify for a Special Enrollment Period due to change in residence if they:

  • Still enrolled in a student health plan that counts as qualifying health coverage, but the coverage and benefits don’t extend to your area.
  • Had qualifying health coverage or lived in a foreign country or a U.S. territory for at least one of the 60 days before the date of their move. 
    Hint: This requirement doesn’t apply to members of a federally recognized tribe or Shareholders of Alaska Native Corporations.
  • If your child is under 26 and you’re already enrolled in coverage, you may be able to add your child to your plan.
  • If you have coverage with financial help (tax credits) and don’t plan to claim your child as a tax dependent on your federal tax return, your child should set up their own account and submit a separate application.
  • If you plan to claim your child as a tax dependent on your federal tax return, and you currently have financial help (tax credits) with your coverage, you can update your application and add your child.
  • If you have coverage without requesting financial help (tax credits), you can put everyone on one application.
  • If you have free or low-cost Washington Apple Health, you can update your application and add your child. 
     

Does my coverage cover the cost of treatment and testing for COVID-19?

Insurance companies providing coverage through Washington Healthplanfinder have stated that they will cover the costs (or provide care at zero costs) of COVID-19 treatment deemed medically necessary.

Contact your health insurance provider directly for more information about:

  • How COVID-19 impacts your coverage
  • Telehealth appointments
  • Payment options or grace periods
  • Benefits related to COVID-19

Washington Apple Health Members
Bridgespan Health Members
Kaiser Permanente Members
Molina Healthcare Members
Lifewise Health Plan of Washington Members
Premera Blue Cross Members
Providence Health Plan Members
Coordinated Care Members
PacificSource Health Plan Members

 

I received my federal stimulus payment, do I need to report this income?

No.

  • Do not include this payment ($1,200 per adult and $500 per dependent child) when reporting your income.
     

If I am enrolled in Washington Apple Health, should I report an income change (For example, I start receiving unemployment income) in Washington Healthplanfinder?

No.

  • Existing Washington Apple Health customers should not report changes in their application during the COVID-19 pandemic.
  • Families who have members on Washington Apple Health and members receiving tax credits or qualified health plan coverage should continue to report changes in income to see if they qualify for free or low-cost Washington Apple Health or financial help (tax credits).

 

My family has some members with Washington Apple Health, and some members receiving tax credits. Should I report an income change? (For example, I start receiving unemployment income)

Families who have members on Washington Apple Health and members receiving tax credits or qualified health plan coverage should continue to report changes in income to see if they qualify for free or low-cost Washington Apple Health or financial help.


Should I report the additional $600 per week in unemployment benefits as income? What unemployment income should I enter?

Report the entire amount you are receiving from Employment Security Department. This includes the state-calculated weekly benefit amount and the additional $600 per week in additional benefit received under the CARES Act.

To locate this amount, login to your SecureAccess account on the Employment Security Department website. Once logged in, navigate from the ‘summary’ tab to the ‘weeks summary’ tab. This will display your entire weekly benefit amount. 

This is the amount that should be reported in Washington Healthplanfinder. The additional $600 per week CARES Act amount will be automatically deducted when determining your eligibility for Washington Apple Health, as required by federal law.

Review our Reporting Unemployment Income in Washington Healthplanfinder [PDF] for more information. 

Additionally, we have built a tool to assist in figuring out impact to taxes. Download the income calculator tool today at www.wahbexchange.org/tax-credit-tools.


If I previously did not report the $600 additional unemployment income received under the CARES Act, should I report a change to the application in Washington Healthplanfinder, and include the entire weekly benefit amount?

Yes, individuals should report the entire weekly amount received from Employment Security Department. This includes the state-calculated weekly benefit amount and the additional $600 per week in additional benefit received under the CARES Act.

To locate this amount, login to your SecureAccess account on the Employment Security Department website. Once logged in, navigate from the ‘summary’ tab to the ‘weeks summary’ tab. This will display your entire weekly benefit amount. Report this amount in Washington Healthplanfinder

The additional $600 per week CARES Act amount will be automatically deducted when determining your eligibility for Apple Health, as required by federal law.

Review our Reporting Unemployment Income in Washington Healthplanfinder [PDF] for more information. 

Additionally, we have built a tool to assist in figuring out impact to taxes. Download the income calculator tool today at www.wahbexchange.org/tax-credit-tools.
 

Who is getting the additional $600 per week? How do I know if I am receiving the additional $600 per week or when it started? How do I look up my unemployment benefit information?

Under the federal CARES Act, nearly everyone on unemployment will receive an additional $600 per week for up to four months.

  • For more general information visit: https://esd.wa.gov/newsroom/covid-19
  • You can access your unemployment benefit information on the Employment Security Department website.
  • Your typical weekly benefit amount is listed under the “Summary” tab in your SecureAccess Washington account.
  • This amount will not include the additional $600. If you are receiving the additional $600 per week, the total weekly amount listed under the “weeks summary” tab will be your typical amount plus $600.
     

What are Tax Credits? 

The premium tax credit is a refundable tax credit designed to help eligible individuals and families with low or moderate income afford health insurance purchased through Washington Healthplanfinder. The size of your premium tax credit is based on a sliding scale. Those who have a lower income get a larger credit to help cover the cost of their insurance.

For detailed information about tax credits, visit the IRS website.
 

How do I update my income?

  • Sign in to your account.
    Hint: If you forgot your username or password: Do not create a new account. Reset your password or retrieve your username.
  • Select "Report a Change" on your dashboard located under "Quick Links".

Report a change menu

  • Select "YES" to the question "My household income has changed by $150 or more, and it's expected to last at least two consecutive months."
  • If you want to apply for financial help or Washington Apple Health: Select "No" to the question "My household wants to apply for a full cost Qualified Health Plan and no longer wants health Insurance Premium Tax Credits or Apple Health." 
  • Update your income information and E-sign your application.
     

How do I renew my Washington Apple Health?

You do not need to take any action to renew. Renewal processing has been delayed because of the COVID-19 pandemic for the duration of the public health emergency.

  • Individuals should disregard termination notices dated on or after March 18, 2020 until further notice.
  • ​​​​​​Individuals will not lose Washington Apple Health (Medicaid) coverage or have a decrease in benefits during the emergency unless they move out of state or request termination.
  • This includes individuals who had Washington Apple health as of March 18, 2020 and new enrollees.
  • Additionally, during this time, individuals are not required to submit requested information to maintain their coverage.
     

How do I cancel my coverage?

Before Canceling:

  • If you have trouble paying your monthly insurance costs due to COVID-19, we recommend that you update your income in your application.
  • Your change in income may qualify you for free or low-cost Washington Apple health or financial help paying for coverage. 
  • Contact your insurance company directly to discuss payment options. 

Contact your health insurance provider directly for more information about:

  • How COVID-19 impacts your coverage
  • Telehealth appointments
  • Payment options or grace periods
  • Benefits related to COVID-19

Washington Apple Health Members
Bridgespan Health Members
Kaiser Permanente Members
Molina Healthcare Members
Lifewise Health Plan of Washington Members
Premera Blue Cross Members
Providence Health Plan Members
Coordinated Care Members
PacificSource Health Plan Members

How to Cancel:
View a step-by-step guide on how to cancel coverage. 
 

Where do I find my 1095 tax forms?

1095-B (Free or low-cost Washington Apple Health Members):

  • Customers enrolled in free or low-cost Washington Apple Health (Medicaid) coverage for one or more months of the last tax year will receive an IRS tax form 1095-B from Washington State Health Care Authority.
  • The form is not available in your Message Center on Washington Healthplanfinder.
  • If you lost or did not receive your form, you can request your form online or call the Health Care Authority at 1-800-562-3022. 

To get your 1095-B Form: 

1095-A (Other health and dental insurance Members): 

  • Customers enrolled in other Health insurance will receive a 1095-A tax form by early February.
  • If you were enrolled in more than one plan during the year, you’ll get a 1095-A for each plan.
  • Customers enrolled in a catastrophic health plan will not receive a 1095-A.
  • If you or a household member used tax credits, you must file a federal income tax return.

To get your 1095-A Form:

  • Sign in to your account
  • Go to your Message Center 
     

What is Smart Planfinder?

Smart Planfinder is a tool to help you find the best health coverage for you and your family

  • When you are shopping, use Smart Planfinder to answer a few questions about your household's care needs and preferences.
  • Smart Planfinder will recommend a few health plans that are most likely to meet your needs based on the information you provide. 

More information about Smart Planfinder. 
 

More questions?

See more Frequently Asked Questions about COVID-19 and health insurance.