Getting Health Insurance 

 

Getting Health Insurance:

The Foundation for Health Coverage Education produces the Health Care Options Matrix pamphlet, which helps you identify key elements in finding health insurance coverage including determining your Federal Poverty Level (FPL)* position and health plans for which you may be eligible. The Foundation for Health Coverage Education site offers the above pamphlet as well as their online "Eligibility Tool" to help you identify healthcare resource options.

Benefits Checkup is offered through The Washington State Office of the Insurance Commissioner and State Health Insurance Benefits Advisors (SHIBA). SHIBA’s online tool is comprehensive and delivers results that include resources for prescription drug coverage. The Benefits Checkup online questionnaire is thorough and requires you to enter specific information on your income. The results are produced in a printable format for easy reference.

SHIBA also offers telephone assistance at 1/800/562-6900 or email assistance to all Washington State residents. Be sure to provide your name, contact information and concerns you would like to discuss with a helpline volunteer when emailing. An appointment will be set up for you for a face-to-face meeting or telephone consultation. Be aware that SHIBA places a focus on Medicare, Medicaid and Social Security recipients and senior, disabled and low-income residents. If you do not fall into one of these categories you will still get assistance with finding services, getting answers or resolving grievances.

Basic Health is a state-sponsored program that provides affordable health care coverage through private health plans for eligible residents of Washington State. Basic Health has a mandated enrollment capacity and currently (April 2009) is accepting applications. See if you are eligible and apply online now!

Medicaid is available to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers. You may also be asked to pay a small part of the cost (co-payment) for some medical services.

Medicare is a health insurance program administered by the United States government, covering people who are either age 65 and over, or who meet other special criteria. If you are 65 or older you are likely to qualify for Medicare coverage.

Evergreen Health Insurance Program can pay medical insurance premiums for eligible Washington State residents living with HIV-AIDS enabling them to maintain access to vital health care. To be eligible you must first enroll in Washington State Department of Health's HIV Client Services. 

Washington State Health Insurance Pool (WSHIP) may provide you coverage if you have been denied private individual coverage due to a chronic condition(s) or because you have had a serious illness such as cancer, stroke or heart disease in the past ten years. You are guaranteed acceptance to a WSHIP plan, but it is more expensive than individual plans. To apply to WSHIP, you must have the letter stating that you were denied a private plan.

The Washington State Office of the Insurance Commissioner's website is an excellent resource for Washington State residents. This site offers information and downloadable informational pamphlets. Here is a sample of the pamphlets available through this site:

As well as providing information on obtaining healthcare benefits, the site also offers information for those that may have health insurance and need assistance with a grievance or want to know about their rights as consumers or patients.

Actor's Fund of America offers Access to Health Insurance/Resources for Care. This site offers a comprehensive database of health and social service resources for Washington State residents.

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