To be eligible for the Evergreen Health Insurance Program, you must first be eligible for the Early Intervention Program (EIP). If you need assistance, contact your HIV case manager, your Evergreen insurance advocate at the numbers listed below, or call EIP directly.
- If you are not yet enrolled in EIP, download and print the dual application for EIP and the Evergreen Health Insurance Program (PDF) and submit it directly to EIP only. (If you want Evergreen's assistance with medical insurance premiums, be sure to complete Section 3.)
- If you are currently enrolled in the EIP program, download and print the Evergreen New Enrollment/New Payable application and then submit it to Evergreen only. You can mail or fax the completed application. Evergreen's fax number is (206) 323-0158. Evergreen's mailing address is:
Evergreen Health Insurance Program
P.O. Box 80547
Seattle, WA 98108-0547
When you are filling out the Evergreen application, you must tell us what insurance you have or want. Please see the Insurance section for information on how to apply for insurance.
If you need help at any time during this process, we at Evergreen are here for you. Call us at 206-323-2834 (King County) or 1-800-945-4256 (toll-free, outside of King County).