Annual enrollment is over for this year.

You might still be eligible for special enrollment if you've had one of the following qualifying life events.

  • Involuntary loss of individual or group coverage except for failure to pay the premium
  • Marriage or domestic partnership*
  • Birth, adoption, placement for adoption or foster care of a child
  • Qualified Medical Child Support Order (QMCSO)
  • Acquisition of legal guardianship
  • Permanent move to a new PHP service area that offers different health plan options
  • Loss of coverage as a dependent due to age
  • Loss of coverage due to end of marriage or domestic partnership*
  • Involuntary loss of Medicaid or CHIP coverage
  • Newly eligible for a state- or federal- sponsored premium assistance program
  • Loss of Advance Premium Tax Credit (APTC) or Cost Sharing Reductions (CSR)
  • Survivor of domestic abuse/violence or spousal abandonment and wants to enroll in a health plan separate from the abuser or abandoner
  • Denial of Medicaid or CHIP eligibility determined after open enrollment ended or more than 60 days after a qualifying event
  • Newly gains access to an individual coverage HRA (ICHRA) or is newly provided a qualified small employer health reimbursement arrangement (QSEHRA)

*Oregon: A Domestic Partner must be a member of the Policyholder’s same sex, 18 years of age or older, and must have legally registered a Declaration of Domestic Partnership and obtained a Certificate of Registered Domestic Partnership in accordance with Oregon state law.

*Washington: A Domestic Partner must be at least 18 years of age. They must be a member of the Policyholder’s same sex, unless one of the partners is at least 62 years of age, and they must have legally entered into a State Registered Domestic Partnership and obtained a Certificate of State Registered Domestic Partnership in accordance with Washington state law.

Please note: Our acceptance of premium is not a guarantee of coverage. If you are applying directly, Providence Health Plan can request proof of your qualifying event. If applying through the Marketplace or WaHealthPlanFinder, they may also request documentation. If you enroll under special enrollment and later it is discovered you cannot prove the qualifying event, your coverage may be cancelled.

 

Oregon residents:

Open enrollment for 2021 individual and family plan coverage has ended; however, you can apply for and get health insurance coverage during the special enrollment period if you experience certain life events. See the list above for the qualifying life events.

Oregon policyholders may obtain coverage due to a special enrollment qualifying event by submitting an application for coverage to either Providence Health Plan or the Healthcare.gov Marketplace within 60 days of the qualifying event.

 

Washington residents:

Open enrollment for 2021 individual and family plan coverage has ended; however, you can apply for and get health insurance coverage during the special enrollment period if you experience certain life events. See the list above for the qualifying life events.

Washington policyholders may obtain coverage due to a special enrollment qualifying event by submitting an application for coverage to either Providence Health Plan or the Washington Health Benefits Exchange within 60 days of the qualifying event.

The effective date of coverage is determined by the qualifying event as well as the receipt of the initial premium:

  • When the qualifying event is birth, adoption, placement or court order; coverage will be effective from date of birth, adoption, or placement for adoption or foster care, provided your completed application and initial premium payment are received within 60 days of birth, placement, or court order.
  • For all other special enrollments, coverage will be effective the first day of the month per the application and effective dates table indicated below provided that Providence Health Plan receives timely payment of your initial premium.

 

If your application is not completed within 60 days of the special enrollment qualifying event, it will expire and you will no longer be eligible for special enrollment.

Questions? For Oregon Marketplace questions, contact the Healthcare.gov call center at 1-800-318-2596. For Washington Health Plan Finder questions, call 1-855-923-4633.

 

Application and effective dates are as follows:


The Effective Date of Coverage is determined by the date of your completed application as well as the date Providence Health Plan receives the initial Premium. Policyholders submitting an application directly to Providence Health Plan may request an accelerated effective date of coverage which would start on the 1st of the month following our receipt of your completed application. To request an accelerated effective date, please contact our Membership Accounting team at 503-574-5791 or 888-816-1300 (TTY: 711), 8 a.m. to 5 p.m. (Pacific Time) Monday through Friday. Examples of accelerated effective dates:

If we receive your application August 1st – 31st September 1st effective date
If we receive your application September 1st – 30th October 1st effective date
If we receive your application October 1st – 31st November 1st effective date
If we receive your application November 1st – 30th December 1st effective date
 
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