How to Sign Up for ACA Health Insurance in Washington

Posted on 12/20/21 by Jessica Ravitz

En español | The majority of Washingtonians are eligible to buy health insurance through Washington Healthplanfinder, the state’s Affordable Care Act (ACA) marketplace, , with open enrollment running from Dec. 16 through Jan. 15 for coverage beginning Feb. 1. And you might be able to save money on premiums, thanks to expanded federal tax credits in the March coronavirus relief bill.

Most people already enrolled in ACA marketplace plans will also see their premiums go down this year because the recently enacted American Rescue Plan increases tax credits for insurance premiums and expands the number of households that qualify for them. Every household that pays more than 8.5 percent of their household income now qualifies for federal tax credits to help them afford health insurance. Prior to the new law, such tax credits were only available to people making up to 400 percent of the federal poverty level (around $51,000 for one person). 

The average American with an ACA marketplace plan can save $50 per month with the new assistance, the federal government says. As of now, this additional federal financial assistance will only be available in 2021 and 2022. 

Who is eligible?

  • Most Washingtonians, including U.S. citizens and lawfully present immigrants with a wide range of statuses, as outlined on the Washington Healthplanfinder website, are eligible to buy health insurance regardless of whether they are currently insured.


When can I enroll?

  • Washington Healthplanfinder open enrollment runs from Dec. 16 through Jan. 15 for coverage beginning Feb. 1. 
  • You can enroll outside of open enrollment if you experience a qualifying life event, but in most situations you only have 60 days from that event to enroll. Qualifying events include certain moves, births and adoptions, loss of employer-provided coverage, marriage, divorce and other special circumstances. 


How do I sign up?

After you submit an application for coverage, you’ll receive an email invitation to select a plan online, by phone or in person. If you select a plan by the 15th of a month, your coverage will go into effect on the 1st of the following month. If you select a plan later in the month, your coverage will be delayed another month.

To apply and enroll: 

  • By phone: Call Washington Healthplanfinder customer support toll-free at 855-923-4633, where assistance is available in 175 languages. If you’re hearing impaired, call the TTY line at 855-627-9604. Customer service is available 7:30 a.m. to 5:30 p.m. PT, Monday through Friday.
  • In person: Insurance brokers can help you choose a plan, while “Navigators” can answer general questions and help you navigate the enrollment process. Both are typically available for free by phone, virtually or in person. Contact an enrollment center or supporting organization in your area to set up an appointment. The Washington Healthplanfinder website also lets you search for an insurance broker or navigator in your area to arrange a one-on-one meeting.


What is covered, and how much will it cost?

Coverage and cost depend on where you live, the type of plan you choose, your estimated household income, and the age and disability status of you and your family. 

If you qualify for Washington Apple Health, you’ll be able to get free or low-cost coverage and may not need to worry about premiums or copays, depending on your level of income. 

All Washington Healthplanfinder plans cover 10 “essential” benefits, including: 

  • Emergency services and hospitalization
  • Pregnancy, maternity and newborn care
  • Mental health and substance use treatment
  • Chronic disease management
  • Prescription drugs
  • Lab work
  • Pediatric care
  • Preventive services, including counseling, screenings and vaccinations

Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family. Deductibles and out-of-pocket costs vary between plans.

Washington law requires children to have dental coverage. Dental is included for children and adults in Washington Apple Health (Medicaid) plans, but dental policies need to be purchased separately if you enroll in a Washington Healthplanfinder plan. You can select a dental coverage plan while shopping for your health plan.

What about new federal assistance for premiums?

Every eligible household that pays insurance premiums that exceed 8.5 percent of annual income now qualifies for federal tax credits for insurance premiums.

For example, a single 64-year-old filer earning $51,000 per year could potentially save more than $8,000 with the new tax credits, according to the Kaiser Family Foundation.

Is there any other financial assistance available?

Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction that would help you pay for such out-of-pocket expenses as deductibles and copays. You must enroll in a Silver-level plan to get this assistance. 

If you’ve collected unemployment benefits this year, even for just one week, you may qualify for a $1/month premium health coverage option, thanks to the American Rescue Plan. This subsidy became available in May. If you’ve already received unemployment benefits this year while enrolled in a Washington Healthplanfinder plan, you’ll be able to claim the additional subsidies for the months prior to May when you file your 2021 tax returns. This extra financial help will expire at the end of 2021. 

What plans are available?

Washington Healthplanfinder offers several kinds of plans, including new Cascade Care plans, developed exclusively for the state. The Cascade Care plans offer on average $1,000 lower deductibles, easier access to pre-deductible care and more transparency.

All plans offered through Washington Healthplanfinder, Cascade and otherwise, offer three tiers of coverage:

  • Bronze plans have the lowest monthly premiums, the highest deductibles and copays, and cover roughly 60 to 65 percent of care costs.
  • Silver plans have moderate monthly premiums, deductibles and copays. They cover roughly 70 percent of care costs.
  • Gold plans have higher monthly premiums and lower deductibles and copays, and cover roughly 80 percent of care costs.

Washington Healthplanfinder’s Smart Planfinder tool helps you browse your options, estimate costs and benefits of various plans and check whether you might qualify for financial assistance.  

What if I already have health insurance?

If you already have coverage directly through an insurance provider but are eligible for lower premiums, you can switch to a Washington Healthplanfinder plan. But you may need to wait until open enrollment.

If you get coverage through the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) because you were terminated from a job or were put on reduced hours before Oct. 1, you may be able to save money by switching to a Washington Healthplanfinder plan during a 60-day special enrollment window. Be sure to apply and select your plan through Washington Healthplanfinder before your COBRA coverage ends to make sure there’s no gap in coverage. If you’re not sure about whether making this switch makes sense for you, ask for free advice from a certified insurance broker

Will I need to get a new doctor?

That depends. Major insurance providers, including Premera Blue Cross, Lifewise Health Plan, Coordinated Care, Kaiser Permanente and others, offer Washington Healthplanfinder plans, but not all doctors accept them. The insurance company websites include links to search for doctors in their networks, but you should double check with your doctor’s office to see whether a certain doctor or practice will accept a Washington Healthplanfinder plan. 

Will my family members qualify for the same health plan that I do?

It depends. You can enroll as a family. But in some cases, some family members may also be eligible for subsidies or other programs, depending on age, income and disability, or caregiver status. Such families, if they choose to enroll in different programs, may still be able to see the same doctor or go to the same medical practice, depending on the types of insurance plans accepted. 

If you’re not sure what makes the most sense for your family, get free advice from a certified insurance broker.

This guide, originally published on July 9, was updated on Dec. 20 with information about open enrollment dates.

Also of interest:

This story is provided by AARP Washington. Visit the AARP Washington page for more news, events, and programs affecting retirement, health care, and more.

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Find information about getting a COVID-19 vaccine in your state. CDC information is available at cdc.gov/coronavirus; additional AARP information and resources are at aarp.org/coronavirus. En español, visite aarp.org/elcoronavirus.

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