The Evergreen Health Insurance Program can pay health insurance premiums for eligible Washington residents. To be eligible for Evergreen, you must be eligible for Washington State's Early Intervention Program (EIP). You must maintain your eligibility with EIP in order for Evergreen to continue paying your insurance premiums.
Why is insurance important?
Insurance can provide access to comprehensive care, not just support for your HIV-related prescriptions and medical needs. For example, insurance may provide coverage for specialists, hospitalization and emergency care, and mental health and chemical dependency treatment. In addition, insurance may cover a broad range of prescription medications, more than are on the EIP formulary.
Who is Eligible for EIP?
EIP serves people with low to moderate incomes who are living with HIV/AIDS in Washington State. EIP maintains a current list of eligibility criteria:
- Living with HIV
- Living in Washington State
- Have a gross monthly income up to $2600 (in 2008) or less for a single person, or 300% of the Federal Poverty Level
- Have liquid assets of $10,000 or less
What can Evergreen Health Insurance Program pay for?
We can pay for your current insurance, or help you find insurance if you are not currently insured. Evergreen can pay for medical insurance premiums for:
- Basic Health Plan
- COBRA and other employer-sponsored coverage
- Group policies
- Healthcare for Workers with Disabilities (HWD)
- Individual insurance
- Medicare Part B premiums if you receive a bill for Part B premiums
- Medicare Drug Plans offered through Medicare Part D, including Prescription Drug Plans (PDPs) and Medicare Advantage policies with prescription drug coverage (MA-PDs)
- Washington State Health Insurance Pool (WSHIP)
If you have Medicaid, Evergreen can only pay for Medicare Part D or Healthcare for Workers with Disabilities (HWD) policies. The Early Intervention Program may be able to assist you in meeting your spenddown.
- The policy must have at least 50% prescription coverage
- There can be no yearly cap on prescriptions
- Payments must be made to a company, not to an individual
- The policy can have an annual deductible up to $1000, and the monthly premium cannot exceed $900. Some exceptions to these limits may be made on a case-by-case basis.
- The plan we are paying must be your primary insurance plan
- We can only pay for our clients; we cannot pay for dependants unless they are also enrolled in Evergreen
What will Evergreen not pay for?
- Evergreen cannot pay for stand-alone dental or vision insurance.
- Evergreen cannot pay for Medicare Part B premiums if you have the Part B premium deducted from your SSI or SSDI check. Please note that if you have Medicare Part B and SSI/SSDI, the Part B is legally required to be deducted from your check.
How do I Apply?
See our how to apply page for more information and to download a form.
More information about this program is available by calling 206-323-2834 or 1-800-945-4256. You can also e-mail us at ehip@ehip.org.