Special Enrollment

Special Enrollment

A special enrollment period is a time outside the open enrollment period when you can sign up for coverage or shop for a new plan. Certain life changes or special circumstances may qualify you for a special enrollment period. For events that don’t qualify for a special enrollment period, you’ll need to wait for the next open enrollment period to sign up or shop for a new plan. When you apply or report a change through Washington Healthplanfinder, your health plan shopping experience will depend on your qualifying life event.

Washington Apple Health enrollment is year-round and you don’t need a special enrollment period to apply. If you do not qualify for free or low-cost Apple Health, you can still qualify for a Special Enrollment to get health insurance if you have life changes that qualify you.

Qualifying life changes include if you lose job-based coverage, have income changes, have a baby, get married, have a new dependent, or have certain other life changes. 

Examples of qualifying life changes

  • Adding a household member (dependent) to your application 
  • Becoming a household member on someone else's application (dependent)
  • Losing a household member (dependent) or dependent status*
  • Filed or reconciled taxes for a year that you received health insurance premium tax credits
  • Existing enrollees who have a change in income of over $150 per month
  • Losing other health coverage (i.e., job loss, divorce, loss of Washington Apple Health or 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
  • Gaining access to a Health Reimbursement Arrangement (HRA) through your employer. More information about HRAs can be found here
  • Income changes that result in an individual being newly eligible for tax credits and cost-sharing reductions

*This is for currently enrolled customers only.

These changes do not typically count as a qualifying life event:

  • Choosing to stop other health coverage 
  • Being terminated for not paying your premium
  • Finding out your doctor isn’t covered through your plan

Washington Apple Health enrollment is year-round and you don’t need a special enrollment period to apply.

  • If you are new to Washington Healthplanfinder and believe you qualify for Special Enrollment: 
    • Create an account and apply
    • Fill out an application
    • Fill out the Special Enrollment Questionnaire
    • If you qualify, select and confirm your plan
       
  • If you already have an account or coverage with Washington Healthplanfinder and believe you qualify for Special Enrollment: 
    • Sign in to your account
    • Select "Report a change" on the dashboard 
    • Fill out the Special Enrollment Questionnaire
    • If you qualify, select and confirm your plan
       

Special Circumstances

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. Read more about survivors of domestic violence applying for coverage.
  • 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