Washington State Health Insurance Exchange Guide for Residents

Washington State has its own health insurance exchange, known as Washington Healthplanfinder, which is a great resource for residents to find affordable health insurance.

The exchange offers a range of plans from different insurance providers, including Premera Blue Cross, Kaiser Permanente, and UnitedHealthcare.

You can enroll in a plan through Washington Healthplanfinder if you're a Washington State resident, and you can do so during the annual open enrollment period, which typically runs from November to January.

You can also enroll if you've experienced a qualifying life event, such as losing your job or getting married.

A record high of 272,494 people selected plans through the Marketplace during the 2024 open enrollment period.

The enrollment number was a significant increase from previous years, and it's not surprising given the continued enhancement of premium subsidies under the American Rescue Plan and Inflation Reduction Act.

These subsidies made health insurance more affordable for many Washington residents, which likely contributed to the high enrollment numbers.

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In fact, the "unwinding" of the pandemic-era Medicaid continuous coverage rule also played a role in the increased enrollment, with 68,594 Washington residents transitioning from Medicaid to Marketplace coverage by February 2024.

The Washington Healthplanfinder is the state's health insurance exchange, where residents can shop for and enroll in health plans.

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The Washington State Health Insurance Exchange offers a range of plan options to fit different needs and budgets.

The exchange is open to individuals and families who are uninsured or underinsured, including those who are self-employed or have a small business with fewer than 50 employees.

You can enroll in a plan through the exchange during the annual open enrollment period, which typically runs from November to January, or during a special enrollment period if you experience a qualifying life event, such as losing your job or getting married.

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The Washington Healthplanfinder received initial operational and implementation funding through federal grant dollars totaling $302,333,310.

This significant funding was used to develop the IT system critical to determining eligibility for and enrolling residents in health plans, as well as support activities such as the development of the navigator program and a marketing campaign.

The Exchange was required to be self-sustaining beginning in 2015 and has been appropriated funds by the state legislature. Its sustainability is tied to three funding sources established in statute.

These funding sources include a 2 percent tax on health insurance premiums sold through Washington Healthplanfinder, reimbursement for activities performed on behalf of Washington Apple Health (the state's Medicaid program), and an agreed upon carrier assessment.

The Exchange received $110 million for operation in the 2015-17 biennial budget.

Here are the three funding sources established in statute for the Exchange's sustainability:

The Washington Health Care Authority has received two federal grants: an Exchange Planning grant of almost $1 million and a Level One Establishment grant of approximately $23 million.

These grants were used for operational planning and to develop an information technology system for critical Marketplace functions related to eligibility, enrollment, and information exchange.

In May 2012, the state was awarded a $127.8 million Level Two Establishment grant to fund Marketplace development through December 2014.

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The Exchange is run by an 11-member bipartisan board, composed of a chair and eight voting members appointed by the Governor.

This board has expertise in various health care areas, including employee benefits, health economics, consumer advocacy, individual insurance, small group insurance, and health plan administration.

The Director of the Health Care Authority and Insurance Commissioner are ex-officio, non-voting board members.

There are 10 stakeholder committees, technical advisory committees, or workgroups, including a technical advisory committee for key program areas.

These committees cover important topics like the navigator program, agents and brokers, health equity, and outreach.

There are also three workgroups that address plan management, consumers, and tribal issues.

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In Washington State, you can enroll in a health insurance plan through the Washington Healthplanfinder website or mobile app. The open enrollment period begins November 1 and continues through January 15.

To enroll, you can visit Washington Healthplanfinder, compare plans, and determine your eligibility for financial assistance, including federal subsidies and Washington's Cascade Care Savings. You can also enroll with the help of an insurance agent or broker, or an exchange-certified Navigator.

If you're eligible, you can enroll in coverage during open enrollment or during a special enrollment period. The customer service team at Washington Healthplanfinder is available Monday through Friday, 7:30 am to 5:30 pm, and can be reached at 855-923-4633 (TTY/TDD: 855-627-9604).

You can also apply for or renew Apple Health (Medicaid) coverage online through Washington Healthplanfinder if you're an adult age 19 to 64, applying for children, a parent or caretaker applying with children, pregnant, or applying for someone who is pregnant.

You can establish your health insurance coverage by visiting Washington Healthplanfinder, the state's health insurance exchange, to compare available plans and determine eligibility for financial assistance.

Washington Healthplanfinder is available online or with the help of an insurance agent or broker, or an exchange-certified Navigator.

To enroll in coverage, you can visit Washington Healthplanfinder's website or call their customer service team at 855-923-4633 (TTY/TDD: 855-627-9604) Monday through Friday, 7:30 am to 5:30 pm.

To apply for or renew Apple Health (Medicaid) coverage, you can use the Washington Healthplanfinder online platform. You can also apply by phone, mobile app, paper, or in-person with the help of local resources.

You're eligible to apply if you're an adult between 19 and 64 years old, applying for children, a parent or caretaker with children, or pregnant.

The application process is straightforward and can be completed in various ways: online, mobile app, phone, paper, or in-person.

You'll need to provide some required information, including your household monthly income, immigration information, dates of birth for each household member, and Social Security numbers for each household member who has one.

If you're accepted, you'll receive a ProviderOne services card within two weeks and coverage will begin on the first day of the month your application was submitted.

Here are the options to apply for or renew Apple Health coverage:

In Washington, the open enrollment period for ACA-compliant plans begins November 1 and continues through January 15.

To enroll in an ACA Marketplace/exchange plan, you can visit Washington Healthplanfinder to compare plans, determine eligibility for financial assistance, and enroll in coverage. You can also enroll with the help of an insurance agent or broker, or an exchange-certified Navigator.

You can reach Washington Healthplanfinder's customer service team at 855-923-4633 (TTY/TDD: 855-627-9604), available Monday through Friday, 7:30 am to 5:30 pm.

To be eligible to enroll in private health coverage through Washington Healthplanfinder, you must live in Washington, not be incarcerated, and not be enrolled in Medicare.

To enroll, you can visit Washington Healthplanfinder or call their customer service team.

You can enroll in a qualified health plan for individuals and families through Washington Healthplanfinder, with options including BridgeSpan, Community Health Plan of Washington, and Kaiser Permanente Washington.

Some people can enroll year-round even without a specific qualifying life event, including those who are experiencing a qualifying life event, such as giving birth or losing other health coverage.

You can also enroll in a qualified health plan for small businesses through Washington Healthplanfinder, with options including Kaiser Foundation Health Plan of the Northwest and UnitedHealthcare.

A record high of 272,494 people selected plans through the Marketplace during the 2024 open enrollment period, with the majority of those enrolling in a qualified health plan for individuals and families.

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In Washington State, you have several options for health insurance coverage. Twelve insurers offer Marketplace plans in Washington as of 2024.

To enroll in a Marketplace plan, you can visit Washington Healthplanfinder to compare plans and determine your eligibility for financial assistance. You can also enroll with the help of an insurance agent or broker, or an exchange-certified Navigator.

Some of the qualified health plans available in Washington include BridgeSpan, Community Health Plan of Washington, and Kaiser Permanente Washington. For small businesses, Kaiser Foundation Health Plan of the Northwest, Kaiser Permanente Washington, and UnitedHealthcare are options.

You can reach Washington Healthplanfinder's customer service team at 855-923-4633 (TTY/TDD: 855-627-9604) for help with enrollment.

If you're looking for affordable health insurance options in Washington, you're in luck. Over seven out of ten Washington Healthplanfinder enrollees qualified for federal premium subsidies in 2024, which reduced their average monthly premium to about $160.

You may be eligible for financial assistance, including federal subsidies and Washington's Cascade Care Savings, when you enroll in a health plan through Washington Healthplanfinder. This is because the state offers additional state-funded subsidies for applicants with income up to 250% of the federal poverty level, as long as they select a Cascade Care silver or gold plan.

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To get a better idea of your options, here are the qualified health plans for individuals and families in Washington: BridgeSpan, Community Health Plan of Washington, Coordinated Care, Kaiser Permanente Washington, Health Alliance Northwest, Kaiser Foundation Health Plan of the Northwest, LifeWise Health Plan of Washington, Molina Health Care of Washington, Premera Blue Cross, Regence BlueShield of Washington, and UnitedHealthcare.

If you're a small business owner, you may want to consider the following qualified health plans: Kaiser Foundation Health Plan of the Northwest, Kaiser Permanente Washington, and UnitedHealthcare.

To enroll in a Marketplace plan, you can visit Washington Healthplanfinder or reach out to an insurance agent or broker, or an exchange-certified Navigator. They can help you compare plans and determine your eligibility for financial assistance.

It's worth noting that some insurers are exiting the Washington market, including PacificSource, which is leaving the market at the end of 2024. If you're currently enrolled in a PacificSource plan, you'll need to select a new plan during open enrollment.

Medicare coverage and enrollment can be a bit overwhelming, but don't worry, I'm here to break it down for you.

Medicare is a federal health insurance program available to eligible individuals in Washington, including those 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD).

In Washington, you can choose from a variety of Medicare plans, including Original Medicare, Medicare Advantage, and Medigap coverage.

Medicare Advantage plans, also known as Part C, are offered by private insurance companies and provide an alternative to Original Medicare.

The state of Washington has its own set of regulations for Medicare supplement (Medigap) coverage, which can help fill gaps in Original Medicare coverage.

Medigap plans are standardized and labeled with letters, such as A, B, C, and so on, to make it easier to compare plans.

Medicare coverage and enrollment can be completed online, over the phone, or through a local Social Security office.

It's essential to research and compare different plans to find the one that best suits your needs and budget.

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Short-term health insurance plans are designed to provide temporary coverage for individuals who may be without comprehensive insurance. These plans are available in Washington.

In some cases, short-term plans can be a good option for people who are between jobs or waiting for their new insurance to kick in. They often have lower premiums compared to traditional health insurance.

However, it's essential to note that short-term plans typically don't provide the same level of coverage as comprehensive insurance, so you may still be responsible for paying out-of-pocket for certain services.

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