FAQs | Washington Healthplanfinder

FAQs

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If I already have coverage and want to understand my benefits

If you already have coverage through Washington Healthplanfinder, the rules in your health plan for treatment for the coronavirus emergency (officially called 2019 Novel Coronavirus or COVID-19) remain the same as any other viral infection.

  • See what Marketplace plans cover.
  • You can also check with your health insurance company for their specific benefits and coverage policy.

All Marketplace plans cover treatment for pre-existing medical conditions and can’t 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.

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.

For more information about your coverage, telehealth, payment options, and benefits related to COVID-19, visit your insurer's website directly for answers. 

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. Note: Losing coverage you have as a dependent doesn't qualify you for a Special Enrollment Period if you voluntarily drop the coverage. You also don't qualify if you or your family member loses coverage because you don't pay your premium.
  • 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. Learn how to report changes.
  • If you were furloughed: In some situations depending on the status of your health coverage from your employer, you may qualify for a Special Enrollment Period. You may be eligible for a premium tax credit to help pay for coverage too. Create an account or log in to start your application to find out if you qualify.
  • 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 Marketplace coverage. You may also qualify for premium tax credits if you end your COBRA continuation 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, so you have to pay full cost. Learn more about COBRA continuation coverage and the Marketplace.
  • If you lost your job, but didn’t also lose health coverage, because your former job didn’t offer coverage: You generally won't qualify for a Special Enrollment Period. By itself, a job loss (or a change in income) doesn't make you eligible for a Special Enrollment Period to enroll in Marketplace coverage. See if you qualify for a Special Enrollment Period another way.

     

Coverage start dates with a Special Enrollment Period due to loss in coverage

  • If you’ve already lost coverage, your Marketplace coverage can start the first of the month after you apply and enroll.
  • 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 Marketplace plan April 10, your new coverage will start May 1.

     

If I can’t pay my 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 (often one month). 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.

If your household income has changed, update your application immediately. You could qualify for more savings than you're getting now.

 

If I’m enrolled in a plan and my income has changed

  • If you’re enrolled and your household income has changed, update your application immediately. If your income goes down or you gain a household member:
    • You could qualify for more savings than you’re getting now. This could lower what you pay in monthly premiums.
    • You could qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP).

       

If I previously qualified for a Special Enrollment Period but missed the deadline because I was impacted by the COVID-19 national emergency

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 through May 8th.

To see if you’re eligible for this Special Enrollment Period, contact local help.  

 

If I want to change my current plan or enroll for the first time

  • If you’ve had qualifying life changes, like if you move, have a baby, or lose other health coverage, you may be able to enroll in coverage for the first time or change your current plan through a Special Enrollment Period.

     

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’re:
    • 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. Note: 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 Marketplace coverage, you may be able to add your child to your plan.
    • If you have coverage with savings 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 with your coverage, you can update your application and add your child.
    • If you have coverage without requesting financial help, you can put everyone on one application.

       

If I need testing and treatment of 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.

For more information about your coverage, telehealth, payment options, and benefits related to COVID-19, visit your insurer's website directly for answers. 

 

If I'm uninsured 


Hint: If you are uninsured and do not qualify for free or low-cost Apple Health or financial help (tax credits), you can contact us to request a COVID-19 special enrollment. 

 

If I want to apply for free or low-cost apple health or a Special Enrollment Period

Free or low-cost Apple Health enrollment is year-round and doesn't require a special enrollment to apply. A special enrollment period is a time outside the open enrollment period when you can sign up for health and dental coverage and apply for help paying the cost of health insurance (tax credits). Certain life changes or special circumstances may qualify you for a special enrollment period if you do not qualify for Apple Health. Learn more about who is eligible for Apple Health. 

If you already have an account: 

  1. Visit www.wahealthplanfinder.org and sign in to your account
  2. Click the quick link “Report a Change”
  3. Fill out the Special Enrollment Questionnaire
  4. If you qualify, you'll update your application, then select and confirm your plan. 

If you do not have an account: 

  1. Create an account and apply 
  2. Fill out the Special Enrollment Questionnaire
  3. If you qualify for Apple Health or a Special Enrollment, you'll complete an application, then select and confirm your plan. 

If you are uninsured and you do not qualify for Apple Health or a Special Enrollment, contact us to request a COVID-19 special enrollment. 



If I do not understand what Tax Credits are

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.

 

If my income has changed and I need to update it in my application 

  1. 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.
  2. Select "Report a Change" on your dashboard located under "Quick Links".

Report a change menu

3. 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."
4. If you want to apply for financial help: 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." 
 5. Update your income information and E-sign your application.

 

If I need to update other changes to my application

  1. 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.
  2. Select "Report a Change" on your dashboard located under "Quick Links".

Report a change menu

3. Select the change you'd like to report on the "Report your changes" screen. 
Hint: If you'd like to apply for free or low-cost Apple Health or Financial help answer "No" to the question "My household wants to apply for a full cost qualified health plan and no longer wants health insurance tax credits, cost-sharing, or Washington Apple Health. 

Report a change screen options


 

If I Need to Renew my Free or Low-cost Apple Health

Renewal processing has been delayed, as a result of the Covid-19 pandemic. Renewals during this time period will be delayed for the duration of the public health emergency.

If you had a renewal due in March or April and you did not take action to renew your coverage, your coverage will continue.

If you submit information to HCA it will still be used to determine your eligibility as long as you remain eligible.

If you submit the information that would result in your termination, no action to terminate your coverage will be taken at this time.



If you'd like to renew your Apple Health:  

1. 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.
2. S
elect "Renew" located on the left-hand side of your dashboard within "Quick Links".
3. Complete the application and E-sign to submit your renewal. 
 


If I want to 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 Apple health or financial help paying for coverage.  

Contact your insurance company directly to discuss payment options. Insurance companies in Washington with customers who applied through Washington Healthplanfinder are implementing a 60-90 day grace period for people affected by COVID-19. Some terms and conditions may apply depending on the insurance company. Contact your insurance company immediately to discuss your options before canceling at Washington Healthplanfinder. Learn about premium grace periods from the Office of the Insurance Commissioner.

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

 

If I need my 1095 tax forms

1095-B (Free or low-cost 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 a Qualified Health Plan 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.

You can view or print a digital copy of your 1095-A by

To get your 1095-A Form:

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

     

If I want to understand how Smart Planfinder works

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

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