In Washington, as in many other states, your health insurance options are somewhat dependent on your health status.  Even if you are sick, however, the laws protect you in the following ways.

• Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more, because of your health status. This is called nondiscrimination.
• All health plans in Washington must limit exclusion of pre-existing conditions. There are rules about when a pre-existing condition exclusion period can be applied and how long you must wait before a new health plan will begin to pay for care for that condition. Generally, if you join a new plan your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage.
• Your health insurance cannot be canceled because you get sick. All health insurance is guaranteed renewable.
• If you leave your job, you may be able to remain in your old group health plan for a certain length of time. This is called COBRA continuation coverage or state continuation coverage. It can help when you are between jobs or waiting for a new health plan to cover your pre-existing condition. There are limits on what you can be charged for this coverage.
• If you lose your group health insurance and meet other qualifications, you can buy a conversion policy. This is an individual health insurance policy from the company that insured your employer’s group plan. You cannot be denied coverage because of your health status, and you will not face a new pre-existing condition exclusion period. There are rules about what conversion policies must cover and limits on what you can be charged.
• If you meet certain qualifications, you can buy individual health insurance without regard to health status. This is called guaranteed issue.
• If you are turned down for individual health insurance you may qualify for coverage from the Washington State Health Insurance Pool (WSHIP).
• If you lose your group health plan and meet other qualifications, you will be HIPAA eligible. If so, you will have the chance to purchase individual coverage, either from a private insurer or from WSHIP, that will not impose a pre-existing condition exclusion period.
• If you are buying an individual health insurance policy, you cannot be charged more for your health insurance due to your health status. Premiums may vary based on age. This is called modified community rating.
• If you are a small employer buying a group health plan, you cannot be turned down because of the health status, age, or any other factor that might predict the use of health services of those in your group. All health plans for small employers must be sold on a guaranteed issue basis. In addition, you cannot be charged more due to the health status of those in your group.
• If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The Washington Medicaid program offers free health coverage for pregnant women, families with children, elderly and disabled individuals with moderate to low incomes.
• If your child is 18 years old or younger, not eligible for Medicaid and not covered by other creditable insurance, he or she may be eligible to enroll in the Children’s Health Insurance Program (SCHIP).
• If you believe you may be at risk for breast or cervical cancer, you may be eligible for free screening and treatment. The Washington Breast and Cervical Health Program provides qualified women with free breast and cervical screening. In addition, women diagnosed with cancer may be eligible for treatment through Medicaid.
• If you have low or moderate household income and meet other qualifications, you may be eligible for subsidized health coverage through the Basic Health Program (BHP). If eligible, you will have access to comprehensive health insurance with low cost sharing at a below market monthly premium.
• If you have lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program then you may be eligible for a federal income tax credit to help pay for new health coverage. This credit is called the Health Coverage Tax Credit (HCTC), and it is equal to 65% of the cost of qualified health coverage, including COBRA.
• If you are a retiree aged 55-65 and receiving pension benefits from Pension Benefit Guarantee Corporation (PBGC), then you may also be eligible for the HCTC.