Washington Health Benefit Exchange and Medicaid (Apple Health)
What You Need To Know
The Affordable Care Act (ACA) is a program that allows nearly all persons to get health insurance coverage at an affordable rate and, in some instances, at no cost. The ACA was created to ensure most can get the healthcare they need. You cannot be denied health insurance coverage due to a sickness or prior health issue.
Open Enrollment is November 1, 2017 to January 15, 2018. You can enroll into a new Qualified Health Plan or change your coverage through Washington Health Benefit Exchange.
Apple Health Medicaid enrollments or renewals are continuous throughout the year. Based on your income and citizenship status, you may qualify for the Apple Health Medicaid program. The Apple Health for Adult coverage program provides healthcare at no cost.
If you do not qualify for Apple Health, you may be provided with other health insurance plan options to choose from. What you pay for these qualified health plans on the Exchange depends on what you earn each year. You may qualify for cost-sharing reductions and/or premium assistance for plans purchased through the Exchange (please note that cost-sharing reductions are available only for Silver plans).To help you find a health insurance plan, Washington State has set up the Health Benefit Exchange website wahealthplanfinder.org. This website can help you:
- Find and sign up for the health insurance plan that is best for you or your family.
- Figure out how much your qualified health plan might cost you.
- Find out what is covered by a basic level of health insurance. This may include:
- doctor and emergency room visits
- care for children (including dental and eye care)
- maternity and newborn care
- preventive care like cancer screenings and immunizations
- and much more!
Health Benefits Exchange
Important Open Enrollment DatesOpen enrollment for 2018 is November 1, 2017 to January 15, 2018. During this period you can select and enroll in a qualified plan.
- For coverage that begins on January 1, 2018 you must enroll and pay your premium to the insurance carrier by December 15, 2017
- If you enroll and pay your premium after December 15, 2017 and before open enrollment ends on January 15, 2018, your coverage will begin on February 1, 2018.
- Once open enrollment ends on January 15, 2018 you can only enroll if you have a qualifying life event. If you have such an event, you have 60 days to either enroll in a qualified health plan for the first time, or change the plan you are enrolled in to more suitable coverage.
Health Benefit Exchange 2018 InsurersHealth Benefits Exchange insurers have changed for 2018. Exchange plans are offered by the following companies (listed alphabetically):
- BridgeSpan Health Company
- Coordinated Care Corporation (Ambetter)
- Kaiser Foundation Health Plan of Washington (formerly Group Health)
- Kaiser Foundation Health Plan of the Northwest
- LifeWise Health Plan of Washington
- Molina HealthCare of Washington
- Premera BlueCross
“In-Network” Access to UW Medicine
UW Medicine is considered “in-network” for several health insurance plans offered on the Exchange. Generally, patients pay less out-of-pocket for services when providers are in-network rather than out-of-network. Out-of-network services may require a higher co-payment or deductible than in-network services, or they may not be covered by insurance at all. IMPORTANT: When selecting an Exchange plan, please consider whether you will have access to your preferred providers at in-network rates.UW Medicine is considered in-network for Exchange plans offered by the following companies:
UW Medicine In-Network Plans
|BRIDGESPAN HEALTH COMPANY*|
|LIFEWISE OF WASHINGTON|
|LIFEWISE ESSENTIAL EPO|
|LIFEWISE ESSENTIAL HSA|
|MOLINA HEALTHCARE OF WASHINGTON|
|MOLINA MARKETPLACE HMO|
|PREMERA BLUE CROSS*|
|PERSONALCARE EPO – UW MEDICINE|
* = Premera Blue Cross offers Personal Care plans that require members seek care from their selected network. UW Medicine is one of the networks included within the Personal Care plans and the only network that UW Medicine is in-network for.
Before enrolling in an Exchange plan, confirm with both the plan and your medical provider(s) that your providers are part of the plan’s network. Since networks and provider affiliations change over time, you should also periodically confirm your provider’s network status even after you’ve enrolled in the plan. Be aware that health plans sold inside the Washington Health Benefit Exchange (wahealthplanfinder.org) may offer different provider networks than those sold outside the Exchange.
How to Sign Up
- Online: visit Washington Healthplanfinder
- By Phone: Washington Healthplanfinder offers customer support to help you get the information you need to enroll in health coverage that best meets your needs and your budget. A trained representative will help educate you about your options and walk you through the enrollment process. The Washington Healthplanfinder Customer Support Center is open to enroll individuals, families and small businesses in quality health coverage and answer questions about financial help and the enrollment process. Toll-free support is available from 8:00 a.m. – 6:00 p.m. Monday through Friday. Help will be available in up to 175 different languages. Call 1-855-WAFINDER (1-855-923-4633) or TTY/TDD 1-855-627-9604.
- In-Person: In-person support and help will be offered at many places throughout the greater Seattle and Puget Sound area, including hospitals, libraries, and other community groups. Get help enrolling here.
- At UW Medicine Hospitals: Harborview Medical Center, Northwest Hospital & Medical Center, UW Medical Center and Valley Medical Center will have staff on-site to help you sign up. Call ahead to schedule your appointment if you plan to come to one of the enrollment sites.
- At UW Neighborhood Clinics: You can utilize any UW Medicine Hospital for assistance with questions or enrollment.
Enrollment Assistance, Questions, and Appointment SchedulingUW Medicine is here to help you understand your healthcare coverage options so you can make an informed selection regarding your healthcare. Please call to schedule an appointment for assistance with your application or if you have questions:
- Harborview Medical Center/UW Medical Center: 206.744.3084, option 2
- Northwest Hospital: 206.368.6565
- Valley Medical Center: 425.656.5599 or 425.251.5178, option 3
- Legal names
- Family relationships for each member of the family unit
- Birth dates
- Identification numbers (Social Security Number or immigration information)
- Proof of immigration status if you’re a legal permanent resident
- Proof of tribal status if you’re a registered American Indian/Alaska Native
- Income before taxes
- Proof of income if your income has changed since you last filed taxes
- Tax filing status: this is what you report on your IRS tax form
- Current health insurance information (coverage dates, group number and policy number)
- Open Enrollment Renewal letter from the Washington HealthPlanFinder (if applicable)
UW Medicine Enrollment Sites
|Harborview Medical Center 8th Ave Ground West Lobby – Interview Lanes||Monday-Friday||8:30 AM – 4:00 PM|
|Harborview Medical Center 8th Ave Ground West Lobby Call for an appointment (206.744.3084, option 2)||Monday-Friday||8:30 AM – 4:30 PM|
|University of Washington Medical Center Financial Counseling – Interview Lanes||Monday-Friday||8:30 AM – 4:30 PM|
|University of Washington Medical Center Admitting – Call for an appointment (206.744.3084, option 2)||Monday-Friday||8:30 AM – 4:30 PM|
|Northwest Hospital Emergency Department Financial Counselors (Dedicated office in the ED open 10 hours a day, seven days a week for enrollment)||Monday-Sunday||10 AM – 8:30 PM|
|Valley Medical Center Main Campus: Financial Advocates Main Admitting Department 400 S. 43rd Street Renton, WA 98055||Monday-Friday||8 AM – 6:00 PM|
|Valley Medical Center Emergency Department 400 S. 43rd Street Renton, WA 98055||Monday-Friday||8 AM – 6:00PM|
|Valley Medical Center Patient Financial Services: Customer Service 3600 Lind Avenue, Suite 110 Renton, WA 98058||Monday-Friday||8 AM – 4:30 PM|