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Open Enrollment for Children’s Health Insurance in Washington State

By on March 16th, 2011
Filed: Children, Facts, Health Insurance, Health Reform, You

We’ve been highlighting open enrollment periods for children’s health insurance plans on a state by state basis this year. So far, we’ve looked at CA, CO, MD, and OR. Next up is Washington state.

Washington will have two separate open enrollment periods for child-only health insurance in 2011. The first began yesterday, March 15, 2011, and will continue through April 30, 2011. A second open enrollment period will begin September 15, 2011 and continue through October 31, 2011.

We’ve compiled answers to common questions about the Washington open enrollment period below. Read on to learn more – and remember that by “child-only” plans, we privately purchased health insurance plans made available to children under age 19 with no parent or guardian listed on the same policy.

Question: “The federal health reform law is supposed to allow me to enroll my child in private health insurance regardless of my child’s health condition. When can I begin doing that in Washington?”

Answer: Beginning in 2011, the state of Washington has established two open enrollment periods for child-only health insurance policies. The first occurs from March 15, 2011 through April 30, 2011 and the second occurs from September 15, 2011 through October 31, 2011. During these enrollment periods, any child under age 19 can be enrolled in a private, individual health insurance plan.

According to guidance issued by the Washington State Insurance Commissioner, these biannual open enrollment periods will recur each year until 2014. In addition to these special enrollment periods, it may also be possible to enroll children under age 19 in individual health insurance in the following circumstances:

  • Birth
  • Adoption
  • Loss of coverage due to divorce of a parent
  • Loss of employer-sponsored coverage
  • Loss of coverage resulting from a move to a locale where the prior plan is not available

Outside of the biannual enrollment periods or qualifying events noted above, health insurance companies are not required to accept applications for child-only plans.

Question: “Why do there need to be specific enrollment periods? Why aren’t children simply allowed to enroll in child-only individual health coverage any time of year?”

Answer: A number of states have established annual enrollment periods for child-only health insurance policies to prevent consumers from simply waiting until a child gets sick before signing them up for coverage. If children were only enrolled when ill, it could possibly cause a spike in the cost of child-only coverage. The creation of specific biannual enrollment periods for child-only health insurance policies may be an effort by the state of Washington to promote broader consumer access to individual health insurance for children under the age of 19.

Question: “Are rates for child-only health insurance policies going to change?”

Answer: It is not yet clear how federal health care reforms or Washington state regulations will affect the cost of premiums over the long term.

Question: “What counts as a pre-existing medical condition?”

Answer: A pre-existing medical condition may be any past or present medical diagnosis, whether or not the child is still suffering from or being treated for the condition. Not all medical conditions are of concern to health insurance carriers and different carriers may be more, or less, concerned by different conditions.

Question:  “Will a sick child with documented health problems pay the same monthly health insurance premium as children in good health if enrolled during the open enrollment period?”

Answer: In Washington, yes. While some other states may allow insurers to charge children with pre-existing medical conditions more for their coverage, this is not the case in the state of Washington. Rates may vary depending on the child’s age and where he or she lives, but not based on the child’s health history.

Question: “Where can I go to find health insurance policies for children in Washington during the new enrollment periods?”

Answer: eHealthInsurance.com is a good resource for consumers who want to find, compare and enroll in child-only health insurance plans during the Washington state open enrollment periods. eHealthInsurance.com offers support from licensed agents and allows consumers to compare health insurance policies side by side, find plans accepted by their favorite doctors, and apply for coverage online.

New child-only products may be added to the eHealthInsurance.com website throughout the year. Consumers interested in a particular insurance company whose products are not currently listed on the eHealthInsurance website can contact the insurer directly or contact eHealthInsurance’s Customer Care Center for more information.

To learn more about your options, you may wish to contact the Washington State Office of the Insurance Commissioner online or by phone.

About Amir Mostafaie

Amir Mostafaie plays a lead role in training and educating new and existing agents in our customer care center, and over the past 9 years has enjoyed helping numerous people find health coverage that fits their needs. His background in the medical field and expertise in the health insurance marketplace allows him to provide unbiased assistance and insight on a broad range of health insurance topics.

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