This page describes the health insurance options that are available for people who are not eligible for one of the University's health insurance programs such as visitors, family members not eligible for a UW insurance program etc.
UW employees and their dependents who lose eligibility to participate in a UW medical plan should first consider exercising their right to insurance continuation through COBRA before exploring the options described on this page.
Be sure to understand the differences between comprehensive and catastrophic health insurance planes. The distinction is important relative to a policy holder’s ability to change health insurance plans and not be penalized for a pre-existing condition such as cancer or serious injury.
Comprehensive insurance usually has higher premiums than catastrophic insurance, and:
Catastrophic insurance usually has lower premiums than comprehensive insurance, and:
Consider which out-of-pocket expenses you are willing to pay. In addition to a monthly premium, you may be responsible for deductibles, co-insurance and/or co-payments (called "out-of-pocket expenses" or "cost sharing"). Health maintenance organizations (HMOs), preferred provider organizations (PPOs) and traditional fee-for-service insurance plans all administer cost sharing differently.
Some companies may allow you to stay enrolled, up through age 23 or 24, even if you are no longer a full-time student provided that your parent is your primary means of support. Check with your parent’s insurance company for specific provisions.
This type of non-renewable and relatively inexpensive plan provides coverage ranging from 30 days to six months. This can be useful if you are in a job transition, you do not have access to COBRA rights or you are visiting the UW from another state or country.
The following companies offer short-term health insurance in Washington State:
Students who lose their dependent status and/or become ineligible for coverage under their parents' health insurance upon graduation may be eligible for COBRA. Many plans provide for a period of continued eligibility on the parents’ plan (typically three months beyond graduation) as long as the dependent age limit has not yet been reached. After this limit has been reached, COBRA applies. There are other categories that may make individuals eligible for 18 to 36 months of COBRA. Special rules may allow extended coverage for an individual who is disabled within the meaning of the Social Security Act. See the U.S. Department of Labor's FAQs.
An employee, spouse and dependent child are eligible for COBRA under the following conditions:
COBRA law applies only to employers that have 20 or more employees. The coverage is identical to whatever the current employees receive. You must pay the COBRA premium to obtain this coverage. See the COBRA web pages.
Many professional and fraternal associations offer health insurance to their members. Association plans vary widely in the way that benefits are administered. Be sure to educate yourself about the provisions of coverage. Some association plans have a very limited and restricted payment schedule. You are responsible for all costs above the scheduled amount.
The availability of individual health insurance plans vary by county in Washington State. See Shopping for Individual Health Care Coverageand A Consumer's Guide to Health Care Coverage. The cost of premiums depend upon your age and level of cost-sharing for the plan. Legislation passed in March 2000 requires most individuals to pass a health screening questionnaire to qualify for individual coverage. The health plan you choose will send you an application packet with the health screening questionnaire.
If you qualify for private insurance, there may be a pre-existing condition waiting period of up to a nine-months for any health condition you had in the previous six months. This depends on whether and for how long you have been covered by a comprehensive insurance plan immediately prior to beginning an individual health insurance plan. Remember, catastrophic coverage is not deemed comprehensive coverage see Health Care Plan Considerations above.
If you do not “pass” the health screening, you will automatically become eligible for health insurance through the Washington State Health Insurance Pool (WSHIP), however you may still have a pre-existing condition waiting period.
Basic Health is for Washington State residents who are:
The income guidelines are based on the number of persons in your family. Be sure to count all of your family members, even those you don’t intend to cover, because family size is used to determine your monthly premium. Family members include you, your spouse, children, and/or legal dependents including those who are disabled or full-time students under the age of 23. You currently have to register for Basic Health and may be placed on a waiting list.
Medicaid provides health insurance to some people with low incomes who meet certain criteria. In Washington State, these criteria are: pregnant women, children, disabled individuals, persons over the age of 65, refugees and aliens. Medicaid eligibility is complex. If you think you may be eligible for Medicaid coverage you should meet with a representative of the Department of Social and Health Services at a local Community Service Office (Cso ). If you and/or family members have very high medical expenses, speak with a Cso representative to determine if you qualify for Medicaid through a spend-down process.
CHIP is for children up to 19 years of age who qualify by income (up to 250% of the federal poverty level). Income levels are based on family (household) size. A young person living alone qualifies as a household of one. Parents can enroll their child on CHIP even if they have other or no health insurance.
This state-instituted health insurance program is designed to provide health insurance for a small percentage of the population who otherwise are medically uninsurable because of pre-existing health problems. Before you can apply for WSHIP, you must have a letter of denial from a private health insurance company.
Community Clinics offer health care on a sliding fee schedule. Contact a SHIBA HelpLine representative for a list of Community Clinics in your area at:
SHIBA HelpLine
(800) 397-4422
TDD: (360) 664-3154
This is a statewide network of volunteers trained by the Washington State Office of the Insurance Commissioner to assist, educate and advocate for consumers about health insurance and health care access issues. The service is free.
The Insurance Commissioner's Office has responsibility for regulating all insurance business in Washington under the authority granted by the insurance laws of this state. Learn more at www.insurance.wa.gov.
The U.S. Department of Labor provides answers to frequently asked questions about COBRA.
