Health Insurance for Refugees

On Friday, December 9, the federal Department of Health & Human Services approved Washington’s section 1332 waiver to allow residents to purchase qualified health plans and standalone qualified dental plans through Washington Healthplanfinder regardless of immigration status, beginning January 1, 2024. Additionally, uninsured individuals whose income is at or below 250% of the federal poverty level will be able to access state-funded subsidies (which lower an individual’s premium costs), known as Cascade Care Savings, also without regard to immigration status. The Cascade Select plans provide standardized benefits and affordable coverage for individuals and families, meeting certain standards for quality and value.

According to the Washington Health Benefit Exchange, “ More than 105,000 Washington state residents — nearly a quarter of the state’s total uninsured population — cannot access health insurance through Washington Healthplanfinder due to federal restrictions related to their immigration status.”

This section 1332 waiver, which allows all family members to purchase coverage together through the same plan shopping and enrollment process, will reduce the need for individuals and families in Washington to rely on less affordable or less comprehensive forms of coverage, or on costly emergency room services and uncompensated care.

 Here’s are links to more information about the 1332 Waiver:

• Press Release: New first-in-kind federal waiver aims to improve access for uninsured Washingtonians | Washington Health Benefit Exchange (wahbexchange.org)
• Background handout that includes a county-level breakdown of the 105,000 Washingtonians who will be able to newly access coverage through Washington Healthplanfinder under the waiver starting in 2024: Washington Section 1332 Waiver Application Handout
• Fact Sheet that CMS prepared: WA 1332 Waiver Fact Sheet Final (cms.gov)
• Additional waiver related materials have been posted on the federal 1332 website  (toward the bottom of the page under Washington), and the Exchange 1332 website (being updated further to reflect the approval).

In the United States, immigrants and refugees may be eligible for health insurance and benefits. Eligibility is determined by refugee and immigration status. On September 30, 2021, President Biden sighed H.R. 5305 into law, thereby extending benefits to individuals from Afghanistan entering the United States under the designation of Humanitarian Parolee. To determine your eligibility for Medicaid (Apple Health in Washington State), refer to the table below.

Apple Health Eligibility by Immigration Status

*Individuals from Afghanistan paroled into the U.S. between July 31, 2021, and September 30, 2022, or paroled into the U.S. after September 30, 2022, who are their children, spouse, parent, or legal guardians are now eligible for Apple Health for adults and Refugee Medical Assistance.

How to apply for Apple Health

Submit applications for individuals under 65 years of age to the Health Care Authority:

• Online: Go to Washington Healthplanfinder and select “Apply Now”
• Email: [email protected]
• Fax: 1-360-725-1158
• Questions? Call 1-800-562-3022

Submit applications for individuals who are age 65 or older, have blindness or a disability, or need Long-Term Services and Supports (LTSS) to the Department of Social and Health Services:

• Online: Go to Washington Connection and select “Apply Now”
• Fax: 1-888-338-7410
• In-person: local community services office
• Questions? Call 1-877-501-2233

Interpreter services are available. For more information, check out this one-pager developed by the Washington State Health Care Authority.

Last Updated: 11/29/2021