High Risk Health Insurance offered by Washington State Health Insurance Pool
High Risk Health Insurance offered by Washington State Health Insurance Pool
Administers a state health insurance pool to provide supplemental health insurance to Medicare eligible residents of Washington state who have been denied supplement coverage. Because the Affordable Care Act does not apply to Medicare supplements, insurance companies can continue to reject or limit Medicare supplement coverage based on medical status. WSHIP non-Medicare enrollees already enrolled in a WSHIP plan may keep their coverage. This coverage is non-creditable coverage, which means it does not provide prescription drug coverage that is at least as good as the Part D Prescription Drug coverage.
Physical Address
Hours
M-F, 8am-5pm.
Voice
Website
https://www.wship.org
Application process
Call, access the website or write for information. Any agent licensed to sell health insurance in Washington state can also help with the application. After a completed application is submitted, applicants will be notified of their status generally within 30 days. When calling to discuss questions about coverage or claims, applicants must have their WSHIP Identification Card available.
Fee
State law requires WSHIP premiums to be based on the average of what the largest carriers in the state charge for their individual plans with benefits similar to WSHIP. Premiums vary depending on age, plan type and deductible. Premiums are based on attained age and type of plan selected. Pharmacy services may be subject to a separate annual deductible; they require a per prescription copayment or coinsurance. Low-income subsidies may be available to enrollees on Basic and Standard Plan.
Eligibility
Resident of Washington state Enrolled in Medicare Part A and Part B Do not have access to a reasonable choice of Medicare Advantage Plans (Part C) Rejected for coverage by a health carrier OR Offered substantially reduced coverage on a Medicare supplemental insurance policy OR Do not have comprehensive Medicare supplemental coverage available Reasonable choice of Medicare Advantage Plans means: - You have a choice of health maintenance organization (HMO) or preferred provider organization (PPO) Medicare Advantage Plans offered by at least three different carriers that have had provider networks in your county of residence for at least five years. - The benefit plan options include coverage at least as comprehensive as Plan F Medicare supplement plan combined with Medicare Parts A and B. - The benefit plan options also provide access to adequate and stable provider networks that make up-to-date provider directories easily accessible on the carrier website, and will provide a hard copy, if requested. - The health care provider with whom you have an established care relationship and from whom you have received treatment within the past twelve months is not a member of the available HMO or PPO Medicare Advantage Plan carrier networks.
Service area
WA
Agency info
Washington State Health Insurance Pool
Administers a state health insurance pool designed to provide health insurance to Washington non-Medicare residents who reside in a county where individual health plans are not offered.