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Basic Health
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Background and Description
The Washington State Health Care Authority offers comprehensive health care coverage
through Basic Health. This program offers one main program called the Subsidized
program. Individuals with a low monthly income may be eligible for reduced premiums
through the Basic Health Subsidized program. New enrollment in the Subsidized program
may be restricted due to budget limitations at the Health Care Authority. Effective
for 2003, the Health Care Authority is no longer offering the Basic Health Non-Subsidized
program.
Basic Health coverage is administered through private managed care health plans
in Washington State. Basic Health is available to Washington State residents who
are not eligible for free or purchased Medicare, not institutionalized at the time
of enrollment, and who are within Basic Health’s income guidelines. Those who are
eligible may enroll in Basic Health as individuals or through a participating employer,
home care agency or financial sponsor group, although the Health Care Authority
may institute a reservation list or freeze on new enrollment.
Basic Health benefits include comprehensive medical care with copayments, coinsurance,
and/or deductibles for most services. Benefits are subject to waiting periods for
pre-existing conditions.
Maternity services are limited to 30 days following diagnosis. Pregnant members
must apply for the Maternity Benefits Program for additional maternity benefits.
The Maternity Benefits Program is a Medicaid program for pregnant women who are
Basic Health members and meet the eligibility guidelines for Medicaid. Members should
contact Basic Health at (800) 660-9840 for an application. The Dept. of Social and
Health Services (DSHS) determines eligibility. Contact the DSHS Medical Assistance
Administraction HelpLine at (800) 562-3022 for information about the benefits of
the Maternity Benefits Program.
Plan Information
For information or to enroll in the Basic Health program, please contact
Basic Health toll free at (800) 660-9840 or (800) 842-7712, or contact the Basic
Health WebSite at www.basichealth.hca.wa.gov.
For questions related to benefits or coverage, please contact the CUP Member Services
Department at (360) 891-1520 or toll free at (800) 315-7862.
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