I’ve heard a lot about healthcare insurance changes. How do they affect me?

As part of the Affordable Care Act, all Americans must have health insurance.

What are the options for purchasing health insurance for my child?

Learn more about where you can buy a health plan.

What is a Health Insurance Exchange?

Since all Americans are required to have health insurance, the Health Insurance Marketplace was designed to meet that requirement. The Marketplace (also called an Exchange) is a one-stop shop to find, compare and buy private health insurance options.

Washington state’s exchange is called Washington Healthplanfinder. The next open enrollment (enrollment for anyone) is Nov. 1, 2015, to Jan. 31, 2016.

If you buy on the Exchange, you qualify for tax credits or subsidies. If you buy outside the Exchange, you do not. to learn more, visit Questions and Answers on the Premium Tax Credit.

If you live outside of Washington, go to HealthCare.gov to learn how to enroll in a health plan.

Can I enroll for insurance coverage on Washington Healthplanfinder anytime besides during open enrollment?

Open enrollment (enrollment for anyone) is Nov. 15, 2015, to Jan. 31, 2016. But, you might be able to enroll year-round if:

  • You qualify for or are renewing Washington Apple Health (Medicaid) coverage
  • You are an American Indian/Alaska Native who is an enrolled member of a federally recognized Tribe or Alaska Native Corporation
  • You are enrolling in the Small Business Health Options Program
  • You experience certain life events like:
    • Getting married
    • Having a child
    • Moving to a new area
    • Losing health coverage
  • For people already enrolled, you have a change in income

These may qualify you for a special enrollment period. If you already have an account, report a change through your Washington Healthplanfinder account.

Which insurance plans include Seattle Children’s?

What can I do if my insurance plan doesn’t cover Seattle Children’s, I was denied coverage or I am unhappy with my insurance?

You are the best advocate for your child. We encourage you to call the Office of the Insurance Commissioner (OIC) with concerns; the providers your insurance recommends; the timeframe for getting a response; or anything else about your health insurance. The OIC oversees the insurance industry and protects you as an insurance consumer.

Why is Seattle Children’s not a provider on all plans?

We are a provider with many plans. Despite our best efforts, we have found that some companies have chosen not to contract with us.

Our hope is that all health insurance plans will cover Seattle Children’s, so we can serve your child and all Washington families.

I’m an adult patient at Seattle Children’s. How do I get coverage?

Contact our financial counselors at 206-987-3333, and they will help you.

What if my child is seen at Seattle Children’s and does not have insurance?

Contact our financial counselors at 206-987-3333, and they will help you.

What should I consider when comparing health insurance?

When comparing, consider these things:

  • What is covered?
  • What is my monthly cost?
  • What is my deductible?
  • What is my coinsurance and copay?
  • Which providers can I see with this plan?
  • What is the annual out-of-pocket maximum for in-network services and annual out-of-pocket maximum for out-of-network services?

Resources

For Affordable Care Act information including the following, visit Healthcare.gov.

  • Tax credits
  • Lowering premiums
  • Qualifying for Medicaid
  • Help enrolling
  • Help choosing a plan

More Information