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Pierce Health Insurance

Facts and Figures

  • Insurance
    Carriers
    7
  • Number of
    General Doctors
    4700
  • Number of
    Hospitals
    12

State Government Insurance Programs Offered

Medicaid


hrsa.dshs.wa.gov Coverage: Physician services, Checkups (medical and dental), Family planning, Maternity, Prenatal, and newborn care, Prescriptions, Mental health, Hospital services, Comfort care, Hospice, Dental services, Drug and alcohol treatment, Eye glasses, Hearing aids. Must be Washington residents and U.S. citizens or legal aliens. Income limits: Pregnant women: 185% FPL. Aged, blind and disabled: Singles with incomes of up to 75% FPL and asset limit of $2,000 , and couples with incomes up to 83% FPL and asset limit of $3,000. Parents/caretakers living with children ages 0–18: 74% FPL. Children ages 0–18: 200% FPL.

Washington Basic Health


Basic Health is a program for residents who meet certain income eligibility requirements and provides an affordable health insurance plan. Although the plan has a waitlist, some groups may be able to get coverage fast. www.basichealth.hca.wa.gov (Basic Health is no longer processing applications. There is now a waiting list for applicants, with some exceptions.)

Washington Apple Health for Kids


hrsa.dshs.wa.gov/ applehealth - Washington Apple Health for Kids provides health coverage for uninsured children. - Ambulance, urgent or emergent care, Eye exams, Well-child checkups, Home health care, Hospital care, Immunizations (shots), Lab services, Maternity care, Medical supplies & equipment, Office visits, Respiratory therapy, Prescription drugs, Physical therapy, Occupational therapy, Speech therapy, Surgery, Specialty care, X-ray, Dental"

Washington Medicare


Seniors looking for Washington health insurance can get coverage through Medicare Advantage, Supplement and Original Medicare.

Medicaid


Physician services, Checkups (medical and dental), Family planning, Maternity, Prenatal, and newborn care, Prescriptions, Mental health, Hospital services, Comfort care, Hospice, Dental services, Drug and alcohol treatment, Eye glasses, Hearing aids

Washington State Health Insurance Pool (WSHIP)


No maximum lifetime benefits. Choose from Medicare and non-Medicare plans. There is a 6- month pre-existing condition exclusion period. Exceptions apply (if applicant signs up through a portability policy)

Heath Care Reform

Immediate Benefits for Washington

Small business tax credits. 106,000 small businesses in Washington could be helped by a new small business tax credit that makes it easier for businesses to provide coverage to their workers and makes premiums more affordable.1 Small businesses pay, on average, 18 percent more than large businesses for the same coverage, and health insurance premiums have gone up three times faster than wages in the past 10 years. This tax credit is just the first step towards bringing those costs down and making coverage affordable for small businesses.
Closing the Medicare Part D donut hole. Last year, roughly 76,600 Medicare beneficiaries in Washington hit the donut hole, or gap in Medicare Part D drug coverage, and received no extra help to defray the cost of their prescription drugs.2 Medicare beneficiaries in Washington who hit the gap this year will automatically be mailed a one-time $250 rebate check. These checks will begin to be mailed to beneficiaries in mid-June and will be mailed monthly throughout the year as new beneficiaries hit the donut hole. The new law continues to provide additional discounts for seniors on Medicare in the years ahead and completely closes the donut hole by 2020.
Support for health coverage for early retirees. An estimated 94,200 people from Washington retired before they were eligible for Medicare and have health coverage through their former employers. Unfortunately, the number of firms that provide health coverage to their retirees has decreased over time.3 Beginning June 1, 2010, a $5 billion temporary early retiree reinsurance program will help stabilize early retiree coverage and help ensure that firms continue to provide health coverage to their early retirees. Companies, unions, and state and local governments are eligible for these benefits.
New consumer protections in the insurance market beginning on or after September 23, 2010.
Insurance companies will no longer be able to place lifetime limits on the coverage they provide, ensuring that the 3.7 million Washington residents with private insurance coverage never have to worry about their coverage running out and facing catastrophic out-of-pocket costs.
Insurance companies will be banned from dropping people from coverage when they get sick, protecting the 359,000 individuals who purchase insurance in the individual market from dishonest insurance practices.
Insurance companies will not be able to exclude children from coverage because of a pre-existing condition, giving parents across Washington peace of mind.
Insurance plans’ use of annual limits will be tightly regulated to ensure access to needed care. This will protect the 3.4 million residents of Washington with health insurance from their employer, along with anyone who signs up with a new insurance plan in Washington.
Health insurers offering new plans will have to develop an appeals process to make it easy for enrollees to dispute the denial of a medical claim.
Patients’ choice of doctors will be protected by allowing plan members in new plans to pick any participating primary care provider, prohibiting insurers from requiring prior authorization before a woman sees an ob-gyn, and ensuring access to emergency care.
Extending coverage to young adults. Beginning on or after September 23, 2010, plans and issuers that offer coverage to children on their parents’ policy must allow children to remain on their parents’ policy until they turn 26, unless the adult child has another offer of job-based coverage in some cases. This provision will bring relief to roughly 20,500 individuals in Washington who could now have quality affordable coverage through their parents.4 Some employers and the vast majority of insurers have agreed to cover adult children immediately.
Affordable insurance for uninsured with pre-existing conditions. $102 million federal dollars are available to Washington starting July 1 to provide coverage for uninsured residents with pre-existing medical conditions through a new transitional high-risk pool program, funded entirely by the Federal government. The program is a bridge to 2014 when Americans will have access to affordable coverage options in the new health insurance exchanges and insurance companies will be prohibited from denying coverage to Americans with pre-existing conditions. If states choose not to run the program, the Federal government will administer the program for those residents.
Strengthening community health centers. Beginning October 1, 2010, increased funding for Community Health Centers will help nearly double the number of patients seen by the centers over the next five years. The funding could not only help the 232 Community Health Centers in Washington but also support the construction of new centers.
More doctors where people need them. Beginning October 1, 2010, the Act will provide funding for the National Health Service Corps ($1.5 billion over five years) for scholarships and loan repayments for doctors, nurses and other health care providers who work in areas with a shortage of health professionals. This will help the 10% of Washington’s population who live in an underserved area.
New Medicaid options for states. For the first time, Washington has the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status.

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