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Benefits
Eastern Washington University
Cheney, WA 99004
phone: 509.359.2488
fax: 509.359.2874

What If I'm ineligible for EWU Sponsored Coverage?

Other Health Insurance Options When Ineligible for EWU Insurance Coverage

Who is This Page For?

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 an EWU insurance program etc.

Common Terms

Premium - The periodic payment required to keep a policy in effect.

Deductible - The portion you must pay before insurance coverage begins.

Co-insurance - The percentage you pay when your health plan pays less than 100% of covered costs. This is sometimes know as "percentage participation". This usually applies after a specified deductible is met.

Be sure to understand the differences between comprehensive and catastrophic health insurance plans. 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:

  • The deductible must be less than $1,500 (as required by Washington State Law); and,
  • Time spent under a comprehensive health insurance plan is credited towards the pre-existing condition waiting period (generally up to nine months). This is called "credible coverage."

Catastrophic insurance usually has lower premiums than comprehensive insurance, and:

  • The deductible per medical occurrence is $1,500 or more; and,
  • If you move to another health insurance plan that has a pre existing condition waiting period, you will be responsible for the entire cost of care for any pre-existing conditions during the pre-existing condition waiting period-generally up to nine months. This can have disastrous financial consequences.

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.

Private Health Insurance Options

Stay on your parent's insurance
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 parents' insurance company for specific provisions.

Short-term Health Insurance
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 EWU from another state or country.

The following companies offer short-term health insurance in Washington State:

COBRA for Employees and Dependents

An employee, spouse and dependent child are eligible for COBRA under the following conditions:

  • Voluntary or involuntary termination of employment of covered employee for reasons other than "gross misconduct"
  • Reduction in the number of hours worked by covered employee falling below the level for health insurance
  • Employee is enrolled in Medicare
  • Divorce or legal separation from covered employee
  • Death of covered employee
  • Loss of "dependent child" status

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 page.

Professional Associations
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 he scheduled amount.

Individual Health Insurance
The availability of individual health insurance plans vary by county in Washington State. See Shopping for Individual 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 nine months for any health condition you have 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.

Public Health Insurance Program Options                                                                                                                    
Washington Health Program
The state of Washington launched this new non-subsidized program July 1 to expand access to uninsured individuals and families, many of whom are among the 120,000 people on Basic Health's wait list. Because Washington Health is not subsidized by the state, there is no income requirement but enrollees must be Washington residents. 

You can learn more about Washington Health and apply online at http://www.washingtonhealth.hca.wa.gov/.   Washington Health customer service representatives are available to answer questions via an online chat or by telephone at 1-800-660-9840.

Children's Health Insurance Program (CHIP)
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.

Washington State Health Insurance Pool (WSHIP)
This state-instituted health insurance program is designed to provide health insurance for a small percentage of the populations 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.

Other Healthcare Options
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.

Washington State Office of the Insurance Commissioner
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.

 

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