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WDIA NEWS · FALL 2014 · Special enrollment period on the Washington Exchange

Special enrollment period on the Washington Exchange for those who have experienced difficulty enrolling

Washington Healthplanfinder is offering a special enrollment period for people who have experienced difficulty enrolling in individual medical insurance through Washington’s Exchange, or who have had billing or payment issues.

The special enrollment period will run through November 14. Only people who attest to having enrollment, billing, or payment issues with an Exchange plan may change plans during this time. 

People with Washington Apple Health are not eligible for this temporary special enrollment period. 

Consumers who choose to leave the Exchange and switch to a health plan sold outside of the Exchange will lose their premium and cost-sharing subsidies. Consumers may also lose any credit toward their cost-sharing deductible or out-of-pocket maximum. 

During this limited special enrollment period, if you have experienced difficulty getting or keeping health coverage through the Exchange, you can:

Stay with your health insurer but switch to a plan sold outside of the Exchange (you will lose your subsidy) 

Switch to a new health insurer outside of the Exchange (you will lose your subsidy)  

If you decide to change your coverage – either inside or outside of the Exchange, you must select a plan with the same “metal level” that you have today. Metal level refers to the type of coverage and cost-sharing requirements. 

Everyone must re-enroll or select a new plan for 2015 during the general open enrollment period, November 15, 2014 – February 15, 2015, even people who use this special enrollment to change plans now.

The Annual Open Enrollment Period for Individual Medical coverage begins November 15, 2014

The annual open enrollment period for obtaining individual or family medical coverage will begin November 15, 2014 and end February 15, 2015. Enrollments from November 15-December 31, 2014 will be for a January 1, 2015 effective date.

After February 15th, you will not be able to apply for individual medical insurance inside or outside of the Exchange until November 15, 2015. There are exceptions for being able to purchase coverage outside of the open enrollment period such as loss of coverage, births, adoptions, etc.  If you do not have medical coverage by the end of the enrollment period as required by the federal mandate, you will be subject to the financial penalty for lack of coverage.

Also, please be aware that many carriers have changed their provider networks in 2014.  Please be sure to verify that your health providers and the hospitals in your area are in-network providers with your medical insurance plan.  Some carriers have no limit on your out-of-pocket costs from out-of-network providers and hospitals.

For more information or to apply for individual medical coverage, please contact WDIA at: (206) 441-6824 or 800-282-9342 or
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