Denied Apple Health - Can I get health insurance after ESD claim approval?

ESD doesn't directly provide health insurance, but you might qualify for subsidized insurance through the WA Health Benefit Exchange (wahealthplanfinder.org). Your unemployment income counts, but the subsidies can make plans much more affordable. Be sure to report your actual expected income for 2025, not just your current situation. You might also qualify for a Special Enrollment Period since losing coverage is a qualifying life event.

ugh i got stuck in thes same boat last yr!!! the whole system is broken. i was on UI for 4 monts and had no insurance the hole time bc i made 'too much' for apple health but couldnt afford anything else. ended up with $5700 hospital bill when i got pneumonia. MAKE SURE you apply for the hospital's financial assistance if u end up needing care, most have it even if they dont advertise it!!

While you're sorting out the health insurance situation, you might want to try resolving your adjudication delay first. I was stuck in adjudication for nearly 8 weeks until I found Claimyr (claimyr.com). They got me connected to an actual ESD agent in about 20 minutes instead of waiting on hold for hours. They have a video showing how it works at https://youtu.be/7DieNd3C7zQ?si=26TzE_zGms-DODN3. Getting my claim approved actually helped me figure out my exact income for health insurance applications.

I had a similar issue when my job laid me off in January. What's your exact income level? Sometimes if you're just a little over the Apple Health limit, you can adjust things to qualify. Like if you have any work-related expenses or childcare costs, those might reduce your countable income. Just trying to help because Washington's health system is actually pretty good if you can qualify!

Just to provide some technical clarification: Washington Apple Health (Medicaid) currently has an income limit of about $20,120 annually for a single adult (138% of Federal Poverty Level for 2025). For the standard marketplace plans with subsidies, you can earn up to 400% FPL and still get some help. Don't forget that once your claim is approved, if you get retroactive unemployment payments, you need to report that income in the month you actually receive it, not spread across the weeks it covers. This is important for both ESD and your health insurance subsidy calculations.

my cousin works at a community health clinic and she says they have sliding scale fees even if you don't have insurance! might be worth looking into while you wait for real coverage. also some pharma companies have programs where you can get meds cheaper if you're uninsured. good luck!!!!

As a quick follow-up - besides the Health Benefit Exchange, also check if your previous employer is required to offer COBRA continuation coverage. It's usually expensive but provides the exact same coverage you had before. Also, once your adjudication is complete and your claim is approved, make sure to update your income information with the Health Benefit Exchange so your subsidies are calculated correctly.