Healthcare Cost Assistance for

Approved Medical Plans on the Marketplace

Have medical coverage, be healthy.

Healthcare Cost Assistance Benefit Summary

Carewell SEIU 503 Healthcare Cost Assistance helps eligible care providers in approved health insurance Marketplace plans pay:

  • The net cost of your monthly medical premium (see FAQ for definition).
  • Out-of-pocket costs like deductibles, copayments, coinsurance, and prescription costs for services covered by your approved individual plan. Up to $8,000 of out-of-pocket medical expenses are covered in 2026.

This benefit applies only if you are enrolled in a Carewell-approved Marketplace plan for your area:

Please note that the Moda health insurance plans are no longer available as approved plans in 2026. Care providers on Moda need to switch to a Carewell-approved plan for their county to request Healthcare Cost Assistance benefits for 2026.

r
Not on a Carewell-approved plan?

Temporary Healthcare Cost Assistance may be available if you become eligible for Carewell benefits outside of Open Enrollment (generally between November 1 – January 15) and you’re on a non-approved health (medical) insurance plan.

  1. If you become eligible for Carewell SEIU 503 benefits (like Dental, Vision and Hearing, and Employee Assistance Program) after the end of the last Open Enrollment period, AND
  2. You’re enrolled in a non-approved plan through a health insurance Marketplace; you may receive temporary Healthcare Cost Assistance (HCA) benefits to help within the costs of your premiums and out-of-pocket medical expenses for your current health insurance plan.

However, to remain eligible for HCA benefits, you must enroll in a Carewell-approved Marketplace plan for your area

  • during the next Open Enrollment period, or
  • a Special Enrollment Period (SEP) if you experience a  qualifying life event  (like termination of coverage).

More information can be found in this FAQ.

If you have confirmed that you’re not enrolled in a  Carewell-approved plan for 2025, give us a call at 1-844-503-7348, 8am to 6pm (PST), Monday-Friday.

Healthcare Cost Assistance is only available to eligible homecare workers, personal care attendants, and personal support workers, not to family members. If your family is included in your health insurance policy, Healthcare Cost Assistance only covers the portion of the monthly premium that applies to your individual coverage. More information can be found in the Use This Benefit section below. If you are eligible for Healthcare Cost Assistance, you receive a Benefit Convenience Card (a Mastercard credit card) to pay for your monthly premium and covered out-of-pocket expenses. The card comes from Ameriflex (the Benefits Convenience Card Administrator). For more information about the Benefit Convenience Card and how to use it, click here.

Important Things to Know
  • This benefit pays for the net monthly premium for qualifying individual plans purchased through the Marketplace. It also covers up to $8,000 in 2026 in out-of-pocket medical expenses for claims covered by your approved individual plan. Carewell SEIU 503 Healthcare Cost Assistance benefits are not employer-sponsored or group health insurance coverage.
  • When you enroll, the Health Insurance Marketplace offers you several plans to choose from. You can choose any plan you wish, but in order to receive Healthcare Cost Assistance benefits, you must enroll in the Carewell-approved plan for your area.
  • Ameriflex mails you a Benefit Convenience Card that you can use to pay your monthly premiums. You can also use it to pay your eligible medical copays, coinsurance, and prescriptions.

Check Your Eligibility

This information is for people who are eligible and need to sign up for a Carewell-approved plan on a Health Insurance Marketplace.

To see if you qualify, please complete this eligibility questionnaire.

A Carewell eligibility questionnaire on a mobile phone screen

Healthcare Cost Assistance Benefits

Request Healthcare Cost Assistance Benefits 

This section has information to help you request 2026 Healthcare Cost Assistance benefits when you:

  • Did NOT have an appointment with Valley Insurance Professionals during 2026 Open Enrollment; or
  • Need to update your information (like income or demographics); or
  • Need to request Healthcare Cost Assistance benefits for the first time

Every year you need to provide proof of your Marketplace plan to receive Healthcare Cost Assistance benefits. Trust rules require you to provide proof of your Marketplace plan by submitting:

  1. Your Marketplace Eligibility Notice (from your HealthCare.gov account); and
  2. Either your premium bill (from your insurance carrier) or the “My plans & programs” page from your 2026 Marketplace (HealthCare.gov) application.

If you have an active Benefit Convenience Card (BCC) and you don’t provide these supporting documents by May 31, your BCC is switched to “temporarily inactive” until the required documents are submitted. This means you have to pay your own medical premiums or covered out-of-pocket medical expenses with your own funds until the required documents are submitted to Carewell. 

r
IMPORTANT

With the upcoming 2026 pay raise negotiated by your SEIU 503 Homecare Worker Bargaining Team, your income might be higher in 2026 than it was in 2025. If it is, be sure to update your estimated household income on your Marketplace application to avoid financial surprises at tax time. Income levels may impact how much Advance Premium Tax Credit (APTC) is applied to your premium. And if APTC levels are impacted, Healthcare Cost Assistance benefits adjust to cover any changes to your individual net monthly premiums.

How to submit required documents

There are 3 ways to submit the required documents to request Healthcare Cost Assistance benefits.

You can get support from our insurance partners, Valley Insurance Professionals (VIP)

If you’d like help with providing the required documents, we can help you schedule an appointment with our partner insurance agents at Valley Insurance Professionals (VIP). They can review your Marketplace application with you and make sure that you’re receiving the correct Advance Premium Tax Credit (APTC) amount to apply to your premium. VIP can also assist with checking your eligibility for HCA benefits. If eligible, they can submit the required information on your behalf.

Before you meet with VIP, you must complete the 2026 Annual Paperwork or your appointment may be cancelled.

Access Form

Call 1-844-503-7348 to schedule an appointment with VIP.

You can log in to your MyCarewell503 account

You can submit the required documents for Healthcare Cost Assistance benefits in 2026 by logging in to your MyCarewell503 account (currently available in English) and following these steps:

  1. On the dashboard, go to the Health Insurance Information section
  2. Next, click on “View or Update Health Insurance Info”
  3. Select from the dropdown menu your Health Insurance Type
  4. Enter the Health Insurance Effective Date (do not enter an end date)
  5. Enter the Health Insurance Plan Name from the dropdown menu (the Carrier Name will auto populate)
  6. Enter the number of people on plan, Premium Amount, Advance Premium Tax Credit (APTC), and the net premium will be auto calculated
  7. Click on Choose file(s) button to upload your Marketplace Eligibility Notice and the “My plans & programs” page or your premium bill
  8. Click “I agree” to the Healthcare Cost Assistance Care Provider Agreement Terms pop-up box
  9. You are then redirected to the main page. Click “Save” to finalize your submission.

Use MyCarewell503

You can submit the Healthcare Cost Assistance Benefits Request Form

You can complete the Healthcare Cost Assistance Benefits Request Form and upload the required documents.

Access Form

Where can I find the necessary information to submit the required documents?

  • Log in to your Marketplace application at HealthCare.gov and download a copy of your Marketplace Eligibility Notice and the “My plans & programs” page.
  • Check your mail. The Marketplace sent you a hard copy of the Marketplace Eligibility Notice and your health insurance carrier sent a copy of your premium bill.

If you don’t have a copy of your premium bill, ask your carrier (like Kaiser or Regence). They may have sent you that information by mail, or it may be available in your online portal. You can also call — phone numbers for carriers can be found  here.

See samples of the Marketplace Eligibility Notice, the “My plans & programs” page, and premium bills here.

Since the Providence premium bills do not contain the plan name, if Providence is your insurance carrier, you need to submit:

  • the “My plans & programs” page; or
  • your 2026 letter that has your plan name and premium breakdown from Providence or the Marketplace (HealthCare.gov)

Marketplace Enrollment

Open Enrollment

An open enrollment period is a window of time that happens once a year when you can sign up for health (medical) insurance or change your current plan. The Marketplace Open Enrollment is between November 1 and December 15 for coverage starting the following January 1. If you are enrolling in a Marketplace plan for the first time, you will likely need to wait until Open Enrollment to enroll. There are some special circumstances, called a qualifying life event, that may allow you to enroll outside of this period; see the FAQs for more information.

Note: Open Enrollment for 2026 coverage ended on January 15. Marketplace health insurance plans are renewed during Open Enrollment. If you have experienced a qualifying life event and want enrollment information, please see the 2026 Special Enrollment Period below.

2026 Special Enrollment Period

Special Enrollment Period (SEP)

A limited exception, called a qualifying life event, may allow you to enroll during a Special Enrollment Period (SEP) after Open Enrollment for the year is over. For example, if you lost your insurance coverage from a spouse’s plan or another employer, or you lost Medicaid coverage, you may be eligible to enroll through the Marketplace in a Carewell-approved 2026 plan. Special Enrollment Periods usually last 60 days before or after the date of the  qualifying life event, so if you believe you may be eligible for a SEP, call 1-844-503-7348 right away.

See FAQ for more information on Special Enrollment Periods.

To start the enrollment process, after finding the Carewell-approved plan for your area below, complete and submit the 2026 Annual Paperwork.

Access Form

Carewell-approved Plans for 2026

You can enroll in any medical insurance plan you would like on the Marketplace. However, if you are eligible for Healthcare Cost Assistance, you must select a Carewell-approved plan to request Healthcare Cost Assistance benefits. These benefits help pay for your health insurance premiums and eligible out-of-pocket medical costs.

Oregon

Download PDF of 2026 Oregon plans by county

Please note that the Moda health insurance plans are no longer available as approved plans in 2026. Care providers on Moda need to switch to an approved 2026 plan for their county to request Healthcare Cost Assistance benefits.

Washington

Download PDF of 2026 Washington plans by county

California

Anthem Silver 70 EPO
BlueShield of California Silver 70 PPO

Idaho​

PacificSource Navigator Silver 3600

You can see Summaries of Benefits and Coverage for approved plans here.

 

Find Your County, Find Your Plan:

Approved Plan for Multnomah County

Kaiser Permanente OR Silver 3000 Plan ID 71287OR0420011

Download Summary of Benefits and Coverage


Approved Plan for Asotin County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plan for Washington County

Kaiser Permanente OR Silver 3000 Plan ID 71287OR0420011

Download Summary of Benefits and Coverage


Approved Plan for Lane County (inside Kaiser service area)

Kaiser Permanente OR Silver 3000 Plan ID 71287OR0420011

Download Summary of Benefits and Coverage


Approved Plans for Lane County (outside Kaiser service area)

Providence Oregon Standard Silver Choice Network Plan ID 56707OR1330004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plans for Baker County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Benton County (inside Kaiser service area – OR)

Kaiser Permanente OR Silver 3000 Plan ID 71287OR0420011

Download Summary of Benefits and Coverage


Approved Plans for Benton County (outside Kaiser service area – OR)

Providence Oregon Standard Silver Choice Network Plan ID 56707OR1330004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Benton County (WA)

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plan for Clackamas County (inside Kaiser service area)

Kaiser Permanente OR Silver 3000 Plan ID 71287OR0420011

Download Summary of Benefits and Coverage


Approved Plans for Clackamas County (outside Kaiser service area)

PacificSource OR Standard Silver Plan Core Plan ID 10091OR0770006

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Clark County

Kaiser Permanente Cascade Silver Plan ID 233711940002-00

Download Summary of Benefits and Coverage


Kaiser Permanente Cascade Vital Gold Plan ID 23371WA1940004-01

Download Summary of Benefits and Coverage


Approved Plans for Clatsop County

Providence Oregon Standard Silver Choice Network Plan ID 56707OR1330004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Columbia County

Kaiser Permanente OR Silver 3000 Plan ID 71287OR0420011

Download Summary of Benefits and Coverage


Approved Plans for Coos County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Cowlitz County

Kaiser Permanente Cascade Silver Plan ID 233711940002-00

Download Summary of Benefits and Coverage


Kaiser Permanente Cascade Vital Gold Plan ID 23371WA1940004-01

Download Summary of Benefits and Coverage


Approved Plans for Crook County

PacificSource OR Standard Silver Plan Core Plan ID 10091OR0770006

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plans for Curry County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plans for Deschutes County

PacificSource OR Standard Silver Plan Core Plan ID 10091OR0770006

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plans for Douglas County

Providence Oregon Standard Silver Choice Network Plan ID 56707OR1330004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Franklin County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plans for Gilliam County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plans for Grant County (OR)

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Grant County (WA)

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plans for Harney County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Grays Harbor County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plan for Hood River County (inside Kaiser service area)

Kaiser Permanente OR Silver 3000 Plan ID 71287OR0420011

Download Summary of Benefits and Coverage


Approved Plans for Hood River County (outside Kaiser service area)

Providence Oregon Standard Silver Choice Network Plan ID 56707OR1330004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Island County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plans for Jackson County

Providence Oregon Standard Silver Choice Network Plan ID 56707OR1330004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plans for Jefferson County

PacificSource OR Standard Silver Plan Core Plan ID 10091OR0770006

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plans for Josephine County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for King County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plan for Kitsap County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plans for Klamath County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Klickitat County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plans for Lake County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Lewis County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plans for Lincoln County

Providence Oregon Standard Silver Choice Network Plan ID 56707OR1330004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Linn County (inside Kaiser service area)

Kaiser Permanente OR Silver 3000 Plan ID 71287OR0420011

Download Summary of Benefits and Coverage


Approved Plans for Linn County (outside Kaiser service area)

Providence Oregon Standard Silver Choice Network Plan ID 56707OR1330004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plans for Malheur County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Marion County (inside Kaiser service area)

Kaiser Permanente OR Silver 3000 Plan ID 71287OR0420011

Download Summary of Benefits and Coverage


Approved Plans for Marion County (outside Kaiser service area)

Providence Oregon Standard Silver Choice Network Plan ID 56707OR1330004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Morrow County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Pierce County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plan for Pacific County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plan for Polk County

Kaiser Permanente OR Silver 3000 Plan ID 71287OR0420011

Download Summary of Benefits and Coverage


Approved Plans for Sherman County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Skamania County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plan for Snohomish County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plan for Spokane County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plan for Thurston County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plans for Tillamook County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plans for Umatilla County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plans for Union County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Walla Walla County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plan for Wahkiakum County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plans for Wallowa County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plans for Wasco County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Whatcom County

Regence Cascade Silver Individual Connect Network Plan Plan ID 87718WA217

Download Summary of Benefits and Coverage


Regence Cascade Vital Gold Individual Connect Network Plan ID WW0126SCVGICE

Download Summary of Benefits and Coverage


Approved Plans for Wheeler County

Providence Oregon Standard Silver Signature Network Plan ID 56707OR1360004

Download Summary of Benefits and Coverage


Regence Standard Silver Individual Connect Plan ID 77969OR5290001

Download Summary of Benefits and Coverage


Approved Plan for Yamhill County

Kaiser Permanente OR Silver 3000 Plan ID 71287OR0420011

Download Summary of Benefits and Coverage


Healthcare Cost Assistance Benefit Details

Use This Benefit

Use your Benefit Convenience Card to pay for your covered:

  • Medical premiums
  • Out-of-pocket expenses (deductibles, copayments, coinsurance, and prescriptions)

You may be asked to show proof of your expenses, so keep the Explanation of Benefits (EOB) you receive from your insurance carrier and all receipts.

​​The BCC can’t be used for:

  • Premium or out-of-pocket expenses for dental, vision, and/or hearing services.
  • ATM withdrawals or to get cash back when making a purchase.
  • Expenses for your spouse or dependents.
  • Expenses for products or services that your health insurance plan doesn't cover.
  • Premium expenses to anyone other than your current medical carrier.
  • Expenses incurred while you were not eligible for Healthcare Cost Assistance benefits.
  • Covered medical expenses from a previous calendar year; for these expenses submit a reimbursement request by logging in to your Ameriflex account and completing the form. Please follow the instructions once you have logged in to the Ameriflex website.
  • Your individual premium payment if your family is on the same premium bill; for your individual premium payment, submit a reimbursement request through MyCarewellSEIU503.

You may be financially responsible for repaying funds to Carewell SEIU 503 if your card is used for expenses that are not covered medical expenses.

Set up automatic payments with your insurance carrier

Make sure your premium is paid on time every month! Contact your insurance carrier to set up automatic payments from your Benefit Convenience Card:

Make an appointment

Before you make an appointment with a medical provider, make sure that they are in your insurance carrier’s provider network. If you receive services from out-of-network providers, you will incur much higher out-of-pocket expenses.

Keep Your Benefit

To ensure you continue receiving Healthcare Cost Assistance, please remember to:

  • Turn in your timesheets and/or payroll vouchers every pay period.
  • Avoid recording 0 hours of work for 2 months in a row. Going 2 months in a row with no work could cause you to lose your Carewell SEIU 503 benefits, including Healthcare Cost Assistance. In this case, you would still have your Marketplace insurance plan, but you would have to start paying for premiums yourself or look for alternative coverage like the Oregon Health Plan. Eligibility rules are changing October 1, 2025. Learn more here.
  • Keep your personal information up to date with Carewell SEIU 503 and your employer.
  • Submit the Healthcare Cost Assistance Benefits Request Form every year you are eligible for this benefit.
  • Pay your monthly premium to your insurance carrier on time, and monitor your premium payments. Your carrier may terminate your insurance plan if payments are missed.
  • Report to the Marketplace any change in your information within 60 days. We’re here to help with this. Just call 1-844-503-7348 for assistance.
  • Stay current on your tax filing.
Reimbursements

The fastest way to get your reimbursement is by completing the following forms online!

Medical Premium Reimbursement Claim Form

Use the Medical Premium Reimbursement Claim Form for:

  • Premium reimbursements if you are enrolled with family members on your plan. You can only claim the portion of your premium equal to your individual coverage if you are enrolled in an approved plan on a Health Insurance Marketplace. If you need help calculating your individual premium amount, contact your insurance carrier or Valley Insurance Professionals (503-480-0499 ext. 7). Please submit this form and a copy of your premium bill each month.
  • You are eligible to receive a temporary Healthcare Cost Assistance benefit for a non-approved plan on a Health Insurance Marketplace.

Ameriflex Reimbursement Claim Form

Go to Ameriflex to request reimbursement

Log in to your Ameriflex account and complete the form. Please follow the instructions once you have logged in to the Ameriflex website.

Use the Ameriflex Reimbursement Claim Form to claim reimbursement for:

  • Covered Medical Out-of-Pocket expenses if you paid with your own funds. For instance, if you paid for a prescription medication out-of-pocket because you didn’t have your Benefit Convenience Card with you at the time.
  • Covered Medicare Out-of-Pocket expenses if you paid with your funds. For instance, if you paid for a prescription medication out-of-pocket because you didn’t have your Benefit Convenience Card with you at the time.
  • Medical Monthly Premium – net monthly premium for qualifying individual plans purchased through the Marketplace (not family plan, not average premium reimbursement).

Losing Eligibility

Losing Carewell SEIU 503 benefits does not mean you’re losing your health insurance coverage! But at the end of your waiting period month, your Benefit Convenience Card (BCC) will be turned off, and you will have to start paying your own premiums and out-of-pocket medical expenses.

Don’t throw away your BCC – if you become eligible for Healthcare Cost Assistance benefits again, you’ll be able to use your card again.

Reminder! If you set up automatic payment with your health insurance carrier, you’ll need to contact your carrier to update your payment information. See below for contact information for insurance carriers (like Kaiser Permanente, Regence, or Providence).

If you have coverage through a Marketplace plan:

  • Make your premium payments on time, or you may lose coverage for not making a payment. Losing eligibility for Healthcare Cost Assistance is not a qualifying life event, so you may need to wait until the next Open Enrollment to enroll in health insurance.
  • Update your Marketplace application if your income has changed.

If your income is lower because you lost work hours, you may become eligible for Medicaid coverage. You can apply any time of the year for:

  • Oregon Health Plan (OHP) in Oregon — click here to go to website.
  • Apple Health in Washington — click here to go to website.
What To Do When Regaining Trust Eligibility for Benefits After Losing Them

If you have a Marketplace plan

You’ll have to fill out the  Healthcare Cost Assistance Benefits Request Form to let us know about your plan and your premiums. We also recommend you call 1-844-503-7348 to ensure your Healthcare Cost Assistance (HCA) benefits start again without delays.

If you kept your Benefit Convenience Card (BCC)

You should still be able to use your card once you have submitted the Healthcare Cost Assistance Benefits Request form with supporting documents and it has been approved. However, you won’t be able to use your BCC if the expiration date on the front of your card has passed. Please note that Ameriflex, the BCC Administrator, issued new cards in July 2022. If you received your BCC before that date, it is no longer valid, regardless of its expiration date.

If you don’t have a valid BCC, call Ameriflex at 1-888-868-3539 or log in to the Ameriflex online portal to order a new card.

If you have no medical coverage

You may not be able to enroll in a medical insurance plan on the Health Insurance Marketplace until Open Enrollment, unless you qualify for a Special Enrollment Period. Open Enrollment usually begins on November 1 for coverage the following year. Until you enroll in a Carewell-approved plan on the Marketplace, you would not be able to receive Healthcare Cost Assistance benefits.

To make an appointment with Valley Insurance Professionals, please call 1-844-503-7348, or email CarewellSEIU503Benefits@RISEpartnership.com.

You can also call that number or email for the following reasons:

  • Assistance in determining a pathway to enroll in medical coverage
  • Basic assistance with Carewell SEIU 503 benefits
Valley Insurance Professionals

1-503-974-8471

hcwenroll@valleyinsurancepro.com

Reasons to contact Valley Insurance Professionals:

  • Questions about the enrollment platform or assistance over the phone
  • To make any of the following changes with the Marketplace:
    • Correct any personal information (name, date of birth, income, or address)
    • Add or remove dependents due to pregnancy, birth, adoption, marriage, divorce, or death
    • Change your status (disability, tax filing, citizenship, tribal, incarceration)
    • Change in health coverage (for example, if you were offered coverage through a job or you started on Medicaid)
  • For assistance with submitting documentation requested by the Marketplace

Note: Do not call Valley Insurance Professionals to make an appointment with them. Instead, please call 1-844-503-7348, or email CarewellSEIU503Benefits@RISEpartnership.com.

Federal Marketplace

1-800-318-2596

HealthCare.gov

Marketplace Enrollment Guide

Reasons to contact the federal Marketplace:

  • Find out the amounts of Advance Premium Tax Credits you may receive, as well as your gross and net health insurance premiums
  • Request copies of your annual 1095 form

Note: For enrollment and life changes, we recommend that you enroll in and report life changes through Valley Insurance Professionals to ensure your information is also reported to Carewell SEIU 503.

Insurance Carriers

Reasons to contact your insurance carrier:

  • Set up automatic payments
  • Obtain new coverage ID cards
  • Questions about billing
  • Verify if your doctor or a specific procedure is covered

Kaiser Permanente
Customer service: 1-800-813-2000
kp.org

PacificSource (Oregon)
Customer service: 1-888-977-9299
pacificsource.com

Providence
Customer service: 1-888-816-1300
providence.org

Regence
Customer service: 1-888-675-6570
regence.org

Ameriflex

1-888-868-3539

When calling, please identify yourself as a homecare worker, personal support worker, or personal care attendant receiving Carewell SEIU 503 benefits, and have your Benefit Convenience Card with you.

Ameriflex online portal

Click here to learn more about the Ameriflex mobile app

Reasons to contact Ameriflex:

  • Check the balance on your Benefit Convenience Card, review your payment history, order a replacement card, etc.
  • If your Benefit Convenience Card was declined and you were unable to make a payment
  • Reimbursement claims on health insurance premium or medical expenses that were submitted to Ameriflex

Frequently Asked Questions

Read common questions about the Carewell Healthcare Cost Assistance benefit for approved plans. See the FAQs page for more information.

What's a Special Enrollment Period and am I eligible for one?

A Special Enrollment Period (SEP) allows you to enroll in a health (medical) insurance plan outside of Open Enrollment period (generally between November 1 – December 15). You may qualify for a SEP if you’ve had a life change, such as losing job-based coverage, or a change in income that makes you no longer eligible for Medicaid.

If your SEP is approved by the Health Insurance Marketplace, you can enroll in a Marketplace plan. However, you have limited time to get enrolled, usually 60 days from the date of your qualifying life event. The Marketplace will also need proof that you qualify for a Special Enrollment Period, so you need to gather that information as soon as possible to complete your enrollment. For assistance, call 1-844-503-7348.

Do I qualify for temporary Healthcare Cost Assistance benefits?

Temporary Healthcare Cost Assistance may be available if you became eligible for Carewell SEIU 503 benefits outside of Open Enrollment and you’re enrolled in a non-approved plan on a Health Insurance Marketplace. In this case, you would receive a Benefit Convenience Card to pay covered out-of-pocket expenses. You may also be eligible for temporary reimbursement of your health insurance premiums.

More information can be found in this FAQ.

To continue receiving Healthcare Cost Assistance after the end of the year, you must enroll in a Carewell-approved Marketplace plan as soon as you can and no later than Open Enrollment (generally between November 1 and December 15). Otherwise, your Healthcare Cost Assistance will stop at the end of the calendar year.

To check if you qualify for temporary Healthcare Cost Assistance benefits, call 1-844-503-7348.

What is my net health insurance premium?

Your net premium is the monthly amount that you must pay to your insurance company to maintain your insurance. For example, if your gross premium (the full cost of the premium from your insurance carrier) is $500 per month and your Advance Premium Tax Credit or APTC (the financial assistance from the federal government) is $200 per month, your net premium would be $300 per month.

How do I use my Benefit Convenience Card?

Your Benefit Convenience Card works just like a regular credit card, with 2 important differences:

  1. Your card is limited in use, meaning you can only use it for the covered medical expenses listed under “What can I use the Benefit Convenience Card to pay for?”
  2. You cannot use your card at an ATM or to obtain cash back when making a purchase.
How much money is on the Benefit Convenience Card?

There are 2 accounts on your Benefit Convenience Card. One account is preloaded with the annual amount for paying medical and prescription copays, deductibles, and coinsurance expenses for covered services and prescriptions. In 2026, that amount is $8,000, but this may change from year to year. The other account is preloaded with the amount necessary to pay your net monthly premium: the portion of your individual health insurance premium that is not covered by your federal advance premium tax credit (APTC).

What can I use the Benefit Convenience Card to pay for?
  • Your net monthly premium bill for a Carewell-approved Marketplace plan.
  • The deductible applicable to your Marketplace plan. A deductible is the amount you must pay for the services that your insurance plan covers before your insurer begins to pay.
  • The copayments for medical services and prescriptions covered by your approved Marketplace plan. A copayment (or copay) is a fixed amount your insurance plan may require you to pay and is usually due at the time that you receive the service or prescription.
  • The coinsurance for medical services and prescriptions covered by your approved Marketplace plan. Coinsurance is a percentage of the costs you must pay for services your insurance plan covers. Cost sharing may range from 20% to 50% of a covered service, depending on your insurance plan. For example, if your insurance plan has an “80/20” coinsurance arrangement, this means that, after you pay any deductible, your insurance company will pay 80% of the cost of the covered medical expense and you must pay the remaining 20%.
What is the Advance Premium Tax Credit (APTC)?

The Advance Premium Tax Credit (APTC) is a tax credit issued by the federal government that you can use to lower your monthly insurance payment (called your “premium”) when you enroll in a plan through the Health Insurance Marketplace. Your tax credit is based on the income estimate and household information you put on your Marketplace application. If your estimated income falls between 100% and 400% of the federal poverty level, you qualify for a premium tax credit.

You must apply all tax credits you are eligible for to your premium.

Learn & Connect: Open Enrollment Questions Answered 

During these in-person events, the Carewell Benefits team and our insurance partners, Valley Insurance Professionals, review how Healthcare Cost Assistance benefits work when you choose a Carewell-approved plan on the Marketplace.

You can:

  • Learn about the approved health insurance plans for 2026
  • See how Advance Premium Tax Credits (APTC) work to reduce your premium
  • Get support in enrolling in a Carewell-approved health (medical) insurance plan on the Marketplace
  • Check your eligibility for Healthcare Cost Assistance benefits that cover your net monthly health (medical) insurance premiums and up to $8,000 in out-of-pocket medical costs in 2026.

Click here for more information!  

10 Essential Health Benefits Covered by All Marketplace Plans

All plans offered in the Marketplace cover these 10 essential health benefits:

  • Prescription drugs
  • Laboratory services
  • Outpatient care you get without being admitted to a hospital
  • Preventive and wellness services and chronic disease management
  • Emergency services
  • Hospitalization (like surgery and overnight stays)
  • Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)