Healthcare Coverage
Get high-quality coverage starting at $25 per month!
Taking care of your own wellness is just as important as caring for others—stay healthy by enrolling in healthcare coverage.
You must work 80 paid hours or more a month for 2 months in a row to become eligible for individual coverage.
Jump to
Coverage Plan Options
Choose to cover just yourself or add Coverage for Kids for your dependent children.
Learn about eligibility, when and how to apply for coverage.
Individual Coverage
Medical and Dental
$25/mo.
Monthly Co-premium
Get high-quality medical and dental coverage for yourself for just $25 a month.
Individual Coverage
+ Coverage for Kids
Medical and Dental
$125/mo.
Monthly Co-premium
Get medical and dental coverage for yourself, plus your kids, for just $125 a month.
Whether your covering 1 kid or 4, the cost is the same!
Individual Coverage
+ Coverage for Kids
Dental-Only
$35/mo.
Monthly Co-premium
Get medical and dental coverage for yourself, plus dental coverage for your kids, for just $35 a month.
Whether your covering 1 kid or 4, the cost is the same!
Healthcare coverage includes:
- Medical & Preventive Care
- Dental & Orthodontia
- Prescription Drug
- Mental Health
- Vision & Hearing
- Family-building & Reproductive Health
- Wellness Coaching & Programs
Massage & Chiropractic
- Physical Therapy
New & Improved Benefits
Grace Months
Caregivers now receive 2 Grace Month credits per year. Each credit extends healthcare coverage for 1 month if you don’t meet required work hours—providing continuous coverage for you and your dependents.
Progyny Adoption Benefit
Get up to $15,000 for adoption-related expenses (lifetime benefit).
Lowered Prescription Costs
Reduced costs for non-preferred brand inhalers, EpiPens, and HIV post-exposure drugs and therapies.
Gender-Affirming Care Benefits
All plans now cover a variety of procedures and therapies.
Select a plan for additional coverage details.
Not sure which plan is yours?
Your plan is assigned by ZIP code. Enter yours below to find your plan.
Aetna is the plan available for your zip code.
Kaiser Permanente of the Northwest (KPNW) is the plan available for your zip code. See plan highlights.
Kaiser Permanente of Washington (KPWA) is the plan available for your zip code.
Zip code not found.
Frequently Asked Questions
How do I become eligible for coverage?
Individual Coverage:
You must work 80 paid hours or more a month for 2 months in a row to become eligible for individual coverage.
Coverage for Kids:
You must work 120 paid hours or more a month to become eligible for Coverage for Kids.
When can I apply?
There are 3 times when you can apply for coverage:
1. Initial Eligibility: Within 60 days of the date on your newly eligible enrollment materials. Initial eligibility is when you become eligible for the first time.
2. Open Enrollment: July 1-20 each year.
If you’re already enrolled your coverage renews automatically, no action is needed unless you want to make changes.
3. Qualifying Life Event (QLE): Within 30 days of a QLE that changes your health insurance needs. Examples of QLEs include adopting a baby, losing other healthcare coverage or getting a divorce.
How do I apply?
The easiest way to apply or make changes is online.
Learn how to access your Health Benefits Account.
If you receive a Health Benefits Application you can mail or fax the completed application to the address or fax number listed on the application. U.S. postage is required.
You’ll receive an application receipt by email or through your health benefits account within 1 day and a coverage decision by letter or email within 30 days. If not, call 1-877-606-6705.
When will coverage begin?
Open Enrollment:
Submit applications or changes by July 20 for coverage starting August 1.
Initial Eligibility and Qualifying Life Events:
Coverage begins on the 1st of the month after your application is received and processed, which takes about 2 weeks. For example, if your completed application is received:
- by March 15, coverage will begin April 1.
- between March 16 – 31, coverage will begin May 1.
Coverage for Kids can’t begin until after your dependent verification is received and processed.
What if I'm already enrolled?
If you’re keeping your current plan or not adding coverage, no action is needed.
You can make change your dental plan or add coverage for kids during Open Enrollment (July 1-20) each year.
Changes can only be made during Open Enrollment or with a Qualifying Life Event.
How do I maintain my coverage?
Once you have coverage, you must do the following to maintain continuous healthcare coverage.
1. Work your required hours.
- You must work 80 paid hours or more per month to keep your individual coverage.
- You must work 120 paid hours or more per month to keep Coverage for Kids (dependent coverage).
- If your hours fall below 120, but remain above 80, you will lose Coverage for Kids but keep your own coverage.
2. Report your hours on time.
- You’ll lose coverage if you don’t report your work hours on time.
- You must submit late hours or adjustments with your employer within 60 days of the worked month.
3. Pay your full monthly co-premium.
How the hours you work affect your coverage.
Once you’re enrolled in coverage, the hours you work in one month determine your coverage status 2 months later.
Example: January’s hours determine coverage in March.
WORK MONTH | COVERAGE MONTH |
|---|---|
The paid hours you work in: | Determine coverage status in: |
January | March |
February | April |
March | May |
April | June |
May | July |
June | August |
July | September |
August | October |
September | November |
October | December |
November | February |
December | February |
How do Grace Months work?
Unpredictable schedules can make it difficult to meet required work hours. The Grace Months benefit helps ensure continuous healthcare coverage, even when you’re unable to work as planned.
How Grace Months Work:
- You get 2 Grace Months per coverage year (August–July).
- Each Grace Month extends coverage for 1 month if you don’t meet the required work hours. A Grace Month covers both you and your dependents’ coverage.
- Grace Months apply automatically—no action is needed.
- You can check your available Grace Months anytime by logging into your health benefits account.
When do my Grace Months reset?
They reset on August 1 of each year and are available as soon as you’re enrolled.
Do unused Grace Months carry over to the next year?
No. Each year on August 1, you receive 2 Grace Months. Unused Grace Months don’t roll over.
Can I use my Grace Months for consecutive months?
No, you cannot use Grace Months 2 months in a row.
What if I work enough hours for individual coverage, but not enough for Coverage for Kids?
In this case 1 Grace Month will be applied to extend your children’s coverage for that month.
If I use a credit, do I still pay my monthly co-premium?
Yes, you are still responsible for your co-premium that month.
What if I want to end coverage?
To end coverage for yourself or your children, call 1-877-606-6705 to request a Waive Coverage form.
Waivers received:
- by the 15th ends coverage on the 1st of the next month.
- after the 15th ends coverage on the 1st of the second month.
Important: You can only re-enroll during Open Enrollment or after a Qualifying Life Event. Waivers received before July 1 of the current year reset during Open Enrollment. If you had coverage in the past 12 months, you will be automatically re-enrolled unless you submit a new Waive Coverage form.
What happens if I lose coverage?
You’ll receive information about COBRA (Consolidated Omnibus Budget Reconciliation Act), administered by Ameriflex (1-877-606-6705). COBRA allows caregivers and their children to maintain coverage for a monthly payment.
If you stop caregiving and need long-term coverage, check eligibility for free Washington Apple Health or explore other options at wahealthplanfinder.org.
Health Benefits Account
- Check your eligibility for health benefits.
- Apply for or manage healthcare coverage.
- Get live chat support.
- Access plan documents & forms.
Health Benefits Support
Get help with coverage, eligibility, applying and more by visiting the support page or calling Customer Service at 1-877-606-6705.
Coverage for Kids
If you work 120 hours or more per month, your kids get all the same great benefits you do, including emotional well being, orthodontia, wellness visits and much more.
Common Healthcare Coverage Terms
Learn the definitions of common insurance terms and definitions to better understand your insurance plan.
Submit a Healthcare Coverage Appeal
Learn how to file an appeal if your health coverage eligibility or enrollment was denied.