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Last revised 7/24/15
1. I heard that on September 24th, Washington Healthplanfinder will no longer accept premium payments for Qualified Health or Dental plan coverage. How can I start paying my health and dental insurance company directly?
This change does not impact Washington Healthplanfinder Business (SHOP) customers. Impacted customers include individuals or families covered by QHPs and QDPs not offered through the Small Business Health Options Program.
Starting September 24, 2015, all individual and family customers must make their monthly premium payments directly to their Qualified Health Plan and Dental Plan insurance company. Washington Healthplanfinder will no longer accept customers' premium payments for health and dental insurance. Current customers are encouraged to get started right away paying monthly premium payments directly to their health and dental insurance company.
Any financial help (including tax credits or cost-sharing reductions) that customers have been determined eligible for through Washington Healthplanfinder will not be impacted by this change.
Premium payments will continue to be accepted by Washington Healthplanfinder until 4:59 p.m. on the 23rd of September for coverage for the month of October. As for future monthly payments, deadlines may vary by insurance company.
More information including payment information for all Washington Healthplanfinder health and dental insurance companies is available at www.wahbexchange.org/payments.
2. Can I still apply for a 2015 Qualified Health Plan? Can I get coverage outside of Open Enrollment?
Outside of Open Enrollment, you can enroll in a Qualified Health Plan through Washington Healthplanfinder only if you have certain life events that qualify you for a Special Enrollment period. Some of these life events include getting married, having or adopting a baby, moving to a new address, or losing other health care coverage.
The following Washington Healthplanfinder customers may enroll in coverage year-round:
- Those who qualify for or are renewing Washington Apple Health (Medicaid) coverage
- American Indians/Alaska Natives who are enrolled members of a Federally-recognized Tribe or an Alaska Native Corporation
- Those enrolling in the Small Business Health Options Program also known as Washington Healthplanfinder Business
The next Qualified Health Plan Open Enrollment is Nov. 1, 2015 to Jan. 31, 2016.
3. As an existing Qualified Health Plan customer, what life events should I report to Washington Healthplanfinder since they may change my eligibility for coverage?
If you have had a change to your household composition (such as a birth, adoption, or death) or you've had a change in income, you may be eligible to change your health plan. You'll need to sign in to your Healthplanfinder account and report the change so that we can redetermine your eligibility. You can submit a change at any time; however, eligibility for a special enrollment period requires an individual to report a change within 60 days of the event.
4. Can I make non-eligibility changes to my Washington Healthplanfinder account after I've enrolled in coverage?
Yes, you can. Here are some of the changes you should be able to make that will not affect your eligibility:
- Update your account contact information: physical or mailing address, phone number, email address
- Update the Broker or Navigator you are partnered with
- Update your notification preference to email or USPS mail
- Update the Health Insurance Premium Tax Credit amount applied to your monthly premium
5. I got a IRS Letter 5591. What do I need to do?
If you received advance payments of the premium tax credit in 2014 under the health care law, you should file your 2014 tax return as soon as possible this summer to ensure you can timely receive advance payments next year from Washington Healthplanfinder. More information about this process including some tips is available at www.irs.gov.
6. What is Washington Apple Health Managed Care Plan Selection?
Managed care is a term used to describe the health care organizations and plans that provide medical services for Apple Health (Medicaid). Each managed care plan contracts with a network of health care providers (such as hospitals and additional physicians). You will need to select a primary care provider from the managed care plan you enroll in. Your primary care provider will help you manage and coordinate your health care.
There are no copays or deductibles with any Apple Health coverage. Apple Health for Kids may require a low-cost monthly premium. Other Apple Health coverage has no premiums.
All Washington Apple Health managed care plans must cover the same standard benefits.
As of May 11, new and renewing Washington Apple Health customers can review managed care plan choices available in their area, examine information about the past performance of those plans, and locate providers, hospitals, or clinics available in each plan in order to choose a plan that will best meet their needs. These functions are all available on the new Washington Apple Health plan selection screens after eligibility has been determined.
More information is available at www.hca.wa.gov/medicaid/Pages/Medicaid_Plan_Selection.aspx.
7. What do I do if I forgot my Washington Healthplanfinder password or username?
To get your password, click on “Forgot your password?” from the Washington Healthplanfinder homepage in the Sign In box. You will be prompted to enter your username and answer one of the security questions that you established when you set up your account. After correctly answering the question, Washington Healthplanfinder will allow you access to your account.
To get your username, click on “Forgot your username?” from the Washington Healthplanfinder homepage in the Sign In box. Washington Healthplanfinder will send you an email with your username so that you can log back into your account.
If you tried to reset your username or password yourself and still need help, contact Washington Healthplanfinder Customer Support at 1-855-923-4633, Monday – Friday 7:30 a.m. to 8 p.m.
- Checklist: What to Ask When Choosing Health Insurance
- Checklist: What You Need When Applying for Health Insurance
For additional Washington Healthplanfinder FAQs, click here.
If you are having difficulty enrolling in health coverage through Washington Healthplanfinder, you may: