What is the Basic Health Plan?
Basic Health is a state-subsidized program providing affordable health care coverage through private managed care plans. Basic Health contracts with five different health plans around the state. All health plans in Basic Health offer the same basic benefits, but monthly premiums, providers, and some details of coverage may vary, such as which prescription drugs or preventive services are covered. The amount a person or family pays depends on age, income, the number of people in the family, and the health plan chosen.
Am I eligible for Basic Health?
Your eligibility for Basic Health is primarily based on your income. You cannot make more than $1701.75 gross monthly income as a single adult to qualify for this insurance plan. For more information, check the Basic Health website.
Basic Health is for Washington State residents who are:
- Within Basic Health's income guidelines
- Not eligible for free or purchased Medicare
- Not institutionalized at the time of enrollment, and
- Not attending school full-time in the United States on a student visa
Can Evergreen pay for my Basic Health coverage?
Yes, as long you are currently enrolled in Basic Health, it is your only insurance, and you are eligible to be an Evergreen client. However, if you currently lack insurance, the Washington State Health Insurance Pool (WSHIP) may offer better coverage.
How do I apply for Basic Health?
- You can download an application online or request that one be mailed to you at the Basic Health website. You can also call Basic Health at 1-800-660-9840 and request an application.
- Fill out the Basic Health application. If you need help, please ask your case manager or an Evergreen Insurance Advocate to assist you with the paperwork.
- Complete a Basic Health application and submit it directly to Basic Health either online or via mail. Complete an application to Evergreen. You will also need to enroll in the Early Intervention Program (EIP) if you are not a current EIP client. Once you receive a bill from Basic Health, forward it to us and we will process your application.
Other important information about Basic Health
- Unlike most health plans in Washington State, you do not have to take the Standard Health Questionnaire to apply for Basic Health. This means that people with HIV/AIDS will not be "screened out" by the questionnaire, and will be eligible to enroll in the Basic Health Plan.
- Basic Health has a 9-month pre-existing wait period. During this time, you will not have coverage for anything that can be linked to your pre-existing health condition, such as HIV. However, you would not have a pre-existing wait period if you had prior insurance coverage within 63 days before enrolling in Basic Health.
- Basic Health has low premium payments and a low annual deductible of $150. However, its prescription coverage is limited. For generic drugs (ones that are on the preferred drug list, or formulary), there is a $10 co-pay for each medication. For brand-name drugs that are on the plan's formulary, there is a 50% co-insurance for each medication. This can be quite expensive for clients with high prescription drug needs, such as anti-retroviral treatment.
For more detailed information please visit the Basic Health website.