Individual & Family Cascade Select Plan FAQs

CHPW offers Cascade Select health plans on Washington’s Health Benefit Exchange, where you can purchase health insurance coverage for you alone or you and your family.

These plans have a standard cost-sharing design across pre-determined levels (Cascade Select Gold, Silver, and Bronze), meaning they have the same deductible, copay, and coinsurance amounts regardless of the carrier.

CHPW Individual & Family Plans provide affordable coverage for health care services centered around Community Health Center clinics in neighborhoods across Washington. In several counties, CHPW plans are among the lowest-cost options available.

Cascade Select plans are designed for Washingtonians who cannot get coverage through their job or do not qualify for other health insurance programs like Apple Health (Medicaid) or Medicare. 

To be eligible, you must live in a county where CHPW Individual & Family plans are offered. Visit our Eligibility page for more details.

No. All Cascade Select plans offer the same essential health benefits and the same deductibles, copays, and coinsurance. But there may be differences in monthly premiums, provider networks, care management services, and extra benefits.

CHPW Individual & Family Plans focus on a local care network, anchored by the Community Health Center clinics closest to you. We try to keep our premiums low. Plus, we’re local, based right here in Washington.

When you call us for additional support, you’re not reaching an out-of-state call center.

You may be eligible for financial help depending on your household income and other factors.

Tax credits* are a federal “premium tax credit” that reduces your monthly premium payments for insurance plans purchased through health insurance marketplaces such as Washington Healthplanfinder. The tax credit is available to individuals and families with incomes between the federal poverty line and 400 percent of the federal poverty line. You’ll see if you’re eligible for tax credits when you apply for a plan through Healthplanfinder.

Premium savings can come from Cascade Care Savings, a state program that helps reduce the amount you pay monthly. To get these savings, your household income must be under a certain income level (under 250% the federal poverty line). Available only with Gold or Silver plans and immigration status does not impact eligibility.

Cost-sharing reductions mean you could pay less for things such as doctor’s visits, lab tests, and drugs. To qualify, your income must be below 250% of the federal poverty level, and you must choose a Silver-level plan. (American Indians and Alaska Natives can also qualify to get these cost-sharing reductions when they enroll in a Bronze or Gold plan.)

*U.S. citizens and individuals who have federally documented immigration status (often described as “lawfully present”) may be eligible to receive premium tax credits. DACA recipients and people with qualifying immigration statuses may also be eligible to receive advance premium tax credits (federal savings) based on income.

If you don’t qualify for premium tax credits because of your immigration status, you may still safely apply and qualify for state savings to reduce cost.

Go to What financial assistance is there for immigrants?

You can sign up during the Open Enrollment period or anytime if something big changes in your life. Like your income, your relationship status, or number of kids.

You can sign up for a CHPW Individual & Family plan through Washington Healthplanfinder. You can also call CHPW for help with the enrollment process. We are at 1-833-993-0181 (TTY Relay: Dial 711) from 8 a.m. and 5 p.m., Monday through Friday.

The annual open enrollment period is November 1 through January 15. For coverage starting January 1, enroll by December 15.

Certain life changes or special circumstances may qualify you for a Special Enrollment Period outside of the open enrollment period. See the Washington Health Benefit Exchange (WAHBE) website for more information on Special Enrollment Periods and qualifying events.

If you qualify for Apple Health (Medicaid) you can enroll any time of year. 

Just call your primary doctor and ask them to refer you to a specialist who is out-of-network. CHPW will cover your visit as though it was an in-network doctor after a referral is made.

Find out more about prior-authorization for non-network specialist visits.

Cascade Care is legislation that created new, affordable health insurance coverage options for Washington residents. The options are available through Washington Healthplanfinder, the online marketplace operated by the Washington Health Benefit Exchange (WAHBE).

Cascade Select is a type of “public option” health insurance plan under Cascade Care. Cascade Select plans are offered by Qualified Health Plans such as Community Health Plan of Washington under a contract with the state.

Cascade Select Gold, Silver, and Bronze are what’s referred to as “metal” categories for health plans offered through Washington Healthplanfinder. The main difference among them is whether you want to pay less at the time you receive care, or whether you prefer to pay a lower monthly premium.

Metal categories have nothing to do with quality of care, which is the same across plans. Plans in all categories provide free preventive care, and some offer selected free or discounted services before you meet your deductible.

Read more about how to find a plan that fits your health needs and your budget.

Anyone living in Washington, regardless of immigration status, can buy a health insurance plan on Washington Healthplanfinder, the online store for health insurance.

Everyone’s situation is different. You may be eligible for different plans at different times, but your whole family can get health coverage together with CHPW.

November 1 to January 15: Apply for an Individual & Family Cascade Select plan.

You may be eligible for a CHPW Individual & Family plan if you:

• Live in Washington, in one of the counties CHPW serves.
• Are not currently eligible for an Apple Health plan.

After January 15, you may be eligible for a Special Enrollment Period.

Yes. Dreamers or Deferred Action for Childhood Arrivals (DACA) recipients can shop for and buy a health insurance plan on the Washington Healthplanfinder website. This includes CHPW Individual & Family Cascade Select plans.

• Sign up from November 1 to January 15 for health coverage in the new year.
• State savings are available to help with the monthly cost of the plan (premiums) for individuals who qualify based on income.
• Federal savings (advance premium tax credits) are also available to reduce premiums based on income.

These combined savings can significantly lower costs, with health plans for less than $10 per month if you qualify.

Federal law requires many immigrants with legal status to wait five years before becoming eligible for Medicaid (5-year bar). But you can still buy a qualified health plan, like CHPW’s Individual & Family Cascade Plans. And, you may also be eligible savings and financial assistance.

This 5-year waiting period usually begins when the person receives their qualifying immigration status, not when they entered the U.S.

Currently, there are state programs available that provide no-cost health care for individuals with certain health needs or who are under 18.

They include:

• Medical Care Services (MCS)
• Alien Emergency Medical (AEM)
• Apple Health for Pregnant Individuals
• After Pregnancy Care (APC)
• Apple Health for Kids
• Apple Health Expansion

You can still get health insurance if you do not meet the requirements for a health plan through Apple Health or other state programs.

Individual and Family plans are available for everyone to buy on Washington Healthplanfinder regardless of immigration status, and you may qualify to get savings based on your income.

You can apply for these health plans for yourself or a family member through Washington Healthplanfinder, or by contacting CHPW.

Health insurance is an agreement between an individual and an insurance company. The insurance company agrees to pay for certain medical services and the individual agrees to pay a monthly fee (premium).

This agreement gives the individual more access to health care and emergency care at a much lower price, than they would pay without the health insurance plan. And it removes financial risk.

Some health insurance plans are part of state funded or federally funded programs, that help pay the monthly cost, or premium, for the individual.

There are other costs and terms you will see. Cost-share, deductible, and coinsurance are all ways that insurance companies describe how much they will pay towards a service.

These are different for each health plan. And, for plans like Apple Health (Medicaid) these costs are low (or $0).

Health insurance is an investment that protects you now and in the future. It gives you important financial security in case you have a serious accident or sickness. It can help you avoid medical emergencies, ER visits, and expensive medical bills.

And a health plan makes it easier go to a clinic or doctor for regular care, to help you prevent serious illness.

Many people do not know how much medical care can cost without a health insurance plan:

• Fixing a broken leg: Up to $7,500
• 3-day hospital stay: $30,000 on average
• Cancer care: $100,000’s +

In general, health insurance helps you pay for:

• Routine doctor visits.
• Hospital stays and surgeries.
• Prescription medications and
• Screenings to detect serious health complications like cancer.
• Treatment for diabetes, heart disease, high blood pressure and other chronic conditions.
• Urgent care and emergency room visits.
• Pregnancy care, and more.

The Health Benefit Exchange or Marketplace is an online store where people in the US shop for and buy health plans.

It was built to protect people from expensive health insurance. It also assures all the health insurance plans being sold offer fair benefits and quality care.

Every state has their own Marketplace website they manage and keep secure. If you live in Washington, the Health Benefit Exchange or Marketplace you would use to buy a health plan is called Washington Healthplanfinder.

The total cost ranges based on where you live, your age, your income, if you smoke, your family size and the type of plan you choose. Savings and financial help may be available to reduce your costs based on your income and family size.   

Each person’s situation is different. We are here to help you understand the cost, the commitment, and possible savings. For more information on how much you will pay and what types of plans you are eligible for, contact us at 1-833-993-0181 (TTY 771), Monday through Friday, from 8 a.m. to 5 p.m.

You can also connect with a local plan specialist. They are happy to meet with you in-person, over the phone, or virtually – whatever you prefer. Language assistance services are available.

Financial assistance is available based on income and other factors. State savings or Cascade Care Savings is available to all regardless of immigrations status, for help paying for Individual and Family Cascade Select plans.

Applying for state savings in Washington will not impact your immigration status, or the status of anyone in your family or living with you.

If you qualify for Cascade Care Savings, your monthly cost for your health plan (premium) will be reduced.

You may also be eligible for advance premium tax credits (new starting November 2024) if you have a qualifying income and immigration status:

• DACA recipients
• Valid nonimmigrant visa-holders
• People with a pending application for adjustment of status
• People granted employment authorization
• Family Unity Program beneficiaries
• Special Immigrant Juveniles with approved petitions
• Certain asylum applicants under age 14

To access these savings:

In your Washington Healthplanfinder application, select “Yes” to the question, “Is this household member lawfully present in the U.S.?”

You must sign up through Washington Healthplanfinder. You can do that on your own, with CHPW, or someone else can help you. During the process, you’ll be asked for information about you and your family to find out which plan might be best for you and to check for savings.  

There are a few ways you can enroll through Healthplanfinder:

• Call Washington Healthplanfinder 1-855-923-4633 TTY/TDD 1-855-627-9604 or visit wahealthplanfinder.org
• Connect with a health navigator at your local community health center.
• Schedule a call with a friendly, local plan specialist who speaks your language, or give us a call and we will help you with the process over the phone.

Call us at 1-833-993-0181  (TTY 711), Monday through Friday, from 8:00 a.m. to 5:00 p.m. or request a call back.

We are here for you. We are available to answer your questions, talk to you about your options and help with the application process.

One of our local plan specialists would be happy to meet you in-person at your clinic or chat with you over the phone at 1-833-993-0181 (TTY 771), Monday through Friday, from 8 a.m. to 5 p.m.

It’s quick and easy to schedule an in-person meeting with a plan specialist on our website. CHPW’s friendly plan experts live locally, all over Washington, and are always ready to help.

How to schedule an in-person meeting with a local enrollment specialist:

1. Visit our interactive map page.
2. Choose the county you live in on the map.
3. Then, scroll down to see who is available, their name, languages spoken, and their picture.
4. There, you will see the option to schedule a 1-on-1 meeting, the local clinics they can meet you at, and their contact information.

Find an enrollment specialist

Need more information? You can also give us a call at 1-833-993-0181 (TTY 771), Monday through Friday, from 8 a.m. to 5 p.m. and we can answer any questions you have and help you schedule a meeting at your local clinic.

If you prefer to communicate in a language other than English, no problem, just let us know.

Collectively, our team speaks many languages: Spanish, Ukrainian, Vietnamese, Chinese (Mandarin), Russian, and more. 

Across our website, you can choose your preferred language from the drop-down menu at the top, right corner of the page.

When calling, follow the prompts to choose your language.

In Washington state, you’re safe.

You’re an important part of our community. We are committed to your health, safety, and privacy.

• The information you share with CHPW and Washington Healthplanfinder will only be used to help you get health insurance and access care.
• Everyone provides the same personal information to apply for health insurance.
• Your information will not be shared with immigration enforcement.
• Your current or future immigration status will not be impacted by buying or using health insurance. Or, by applying for state savings during the enrollment process.
• Applying for a health plan on Healthplanfinder and using your benefits will not affect a green card or citizenship application, or public charge test for you or anyone in your family.

The Washington State Health Care Authority and we at Community Health Plan of Washington, are committed to keeping you and the information you provide, safe and secure.

Concerns? Questions? Schedule a call or an in-person meeting with a CHPW team member.