A special enrollment period is a time outside the open enrollment period when you can enroll in a new health insurance plan or change your current plan. Certain life changes or special circumstances may qualify you for a special enrollment period. For events that don’t qualify for special enrollment, you’ll need to wait for the next open enrollment period to sign up for health insurance.
Washington Apple Health and Washington Healthplanfinder Business enrollment is year-round, and you do not need a special enrollment period to apply.
Qualifying Life Events
Once you’ve had a qualifying life event, your household has 60 days to enroll in a health plan or change your current plan. Your new coverage will be effective depending on the type of life event you are reporting.
Examples of qualifying life events:
- Adding a dependent or becoming a dependent by:
- Getting married
- Giving birth or adopting a child (including placement for adoption or foster care)
- A court order
- Losing a dependent or dependent status* through:
- Legal separation
- Filed or reconciled taxes for a year that you received health insurance premium tax credits
- Change in program eligibility or amount of financial help* (for example, if your income or number of household members change, you may lose or gain tax credits or cost-sharing reductions)
- Losing other health coverage (for example, due to a job loss, divorce, loss of eligibility for Washington Apple Health, loss of WSHIP coverage, etc.)
- Permanently moving from a location in the United States to Washington, or to a new county within Washington, only if you had minimum essential coverage for at least one day within the 60 days before you moved
- Permanently moving from a location outside the United States to Washington
- A change in citizenship or lawful presence status
- Getting released from jail or prison
- Tribal membership
*This Special Enrollment is only available to existing customers
These changes do not count as a qualifying life event:
- Choosing to stop other health coverage
- Being terminated for not paying your premiums
- Finding out your doctor isn’t covered through your insurance plan
Certain special circumstances may also qualify you for a special enrollment period.
Examples of special circumstances:
- Survivors of domestic abuse/violence or spousal/domestic abandonment
- Errors of Washington Healthplanfinder (includes system errors that prevented you from getting coverage)
- Customer working with Washington Healthplanfinder staff on an enrollment issue that did not get resolved before the end of open enrollment
- Contract violation by the Qualified Health Plan
- Additional exceptional circumstances as defined and approved by the Washington Health Benefit Exchange
Applying for a Special Enrollment Period
If you’re a new customer:
- Visit www.wahealthplanfinder.org and create an account.
- Fill out an application to see if you qualify for Washington Apple Health or a Qualified Health Plan.
- If you’re eligible for a Qualified Health Plan, select the qualifying life event that applies to you on the Special Enrollment Questionnaire.
- Select and confirm your plan.
If you’re an existing customer:
- Visit www.wahealthplanfinder.org and sign in to your account.
- Click “Report a Change”
- Answer some questions on the Special Enrollment Questionnaire about your life event to determine if your change results in a new eligibility for a Qualified Health Plan.
- Select and confirm your plan.
If you are approved for a special enrollment period, your insurance company may ask for records that prove you qualify. Make sure you have these papers ready in case you need to show proof.