All Washington State residents qualify for state-funded prescription drug program discounts.
Washington State's Health Care Authority (HCA) oversees several health insurance programs for eligible residents. Basic Health, Washington Health, Community Health Services, Washington State Health Insurance Pool and the Prescription Drug Program offer residents unable to procure private coverage a way to get the medical care they need. Eligibility and other state health insurance regulations vary depending on the program.
Basic Health Regulations
Washington's Basic Health is a state-funded health insurance program that experienced severe budget cuts prior to 2011. Designed to provide affordable coverage for Washingtonians on the lower end of the income scale, Basic Health requires eligible applicants to be in the 0 to 200 percentile of federal income guidelines -- a cap of $2428 per month for a couple and $3675 per month for a family of four. Applicants must not eligible for Medicare, and they cannot be covered by Medicaid or other state-funded insurance. Institutionalized individuals and full-time students may not enroll. As of January 2011, applicants were placed on a waiting list for this under-funded health insurance program, with exceptions including tribal-sponsored accounts and Washington National Guard members who fought in the Iraqi war.
Washington Health Program Regulations
In response to Basic Health's funding crisis, the HCA created the Washington Health Program (WHP) to fill the gaps. Washington residents not covered through Medicare or Medicaid are eligible for WHP benefits. Applicants cannot be covered through the Washington State Insurance Pool or reside in an institution at the time of enrollment. This insurance program does not specify income regulations. WHP partners with the Community Health Plan of Washington, a program that administers grants to 36 nonprofit clinics in the state for uninsured patients who earn below 200 percent of federal income guidelines. Together, the health insurance programs cover care in more than 90 hospitals, with over 1,600 primary care physicians throughout the state.
Washington State Health Insurance Pool Regulations
The Washington State Health Insurance Pool (WSHIP) provides coverage for individuals with pre-existing, severe or chronic conditions for which private health insurance denies coverage. The lifetime cap on benefits is $2 million. Eligibility regulations include Washington residency and a period of being uninsured for a minimum of six months prior to WSHIP coverage. WSHIP also has a six-month waiting period for coverage of pre-existing conditions.
Washington Prescription Drug Program Regulations
The Washington Prescription Drug Program (WPDP) is free to all residents. The program has no income or age restrictions, and all prescriptions are eligible for discounts up to 60 percent when an individual uses the WPDP card. Not all pharmacies accept the card, although more than 500 throughout Washington are participating as of January 2011. Washingtonians who purchase prescriptions with other health insurance discounts cannot benefit from using the WPDP card.
Tags: Washington State, Basic Health, health insurance, Washington State Health, Insurance Pool, State Health Insurance, Health Insurance Pool
