Who can apply?
In order to receive insurance through the temporary high risk pool program, an individual must meet the following criteria established by law. Eligible individuals must:
- Be a citizen – an enrollee must be a resident of Washington, a citizen or national of the United States or lawfully present in the United States;
- Be uninsured - an enrollee must have not been covered under creditable coverage for the previous 6 months before applying for coverage; and
- Have a pre-existing condition - an individual must have a qualifying pre-existing condition or a denial letter from an insurance carrier or a letter of acceptance with a reduction or exclusion of coverage for the pre-existing condition.
(see list below)
Eligible pre-existing conditions
- Acute respiratory distress syndrome
- AIDS / HIV positive, IDS, ARC and other Immune deficiencies
- Amyotrophic Lateral Sclerosis (ALS)
- Anemia, chronic fatiguesyndrome
- Aneurysm
- Bilateral leg amputation
- Biliary atresia
- Bipolar disorder, schizophrenia
- Brain injury resulting in a deep or prolonged coma
- Brain or spinal cord abscess
- Cancer including lymphoma and leukemia
- Cerebral palsy
- Cirrhosis of the liver,
Hepatitis C
- Conditions treated by chemotherapy or radiation
- Congenital brain or spinal cord malformation (e.g. hydrocephalus, spina bifida)
- Coronary artery disease
- Crohns Disease or ulcerative colitis
- Cystic fibrosis
- Degenerative brain disorder
- Dermatomyositis
- Diabetes, sugar in urine
- Emphysema, chronic lung disease
- Endocrine system, gland or hormone disorder
- Endometriosis
- Epilepsy
- Fetal damage resulting from medication use or substance abuse (e.g. fetal alcohol syndrome)
- Fragile X syndrome
- Friedreich's Disease
- Fungal pneumonia
- Hemophilia
- Huntington's Disease
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- Chronic kidney disease
- Lupus
- Mental retardation
- MRSA (methicillin resistant staph) infection
- Mucopolysaccharidoses (e.g. Hunter's or Hurler's syndrome)
- Multiple Sclerosis
- Muscular dystrophies
- Myelodysplastic syndromes (e.g. pancytopenia, aplastic anemia)
- Necrotizing fasciitis (flesh eating bacterial infection)
- Nephrotic syndrome
- Opioid dependency
- Organ transplants
- Osteoarthritis
- Pancreatitis
- Parkinson's
- Peritonitis
- Phlebitis, blood clot of brain or veins
- Pregnant (currently)
- Pulmonary heart disease
- Rheumatic heart disease
- Rheumatoid arthritis, ankylosing spondylitis
- Severe autism
- Severe burns
- Spinal trauma with paralysis, surgery completed or recommended (e.g. fracture of lumbar vertebrae, closed fracture of dorsal vertebra)
- Stroke, paralysis
- Subdural hematoma with complications (loss of speech, sight or memory or paralysis
- Tuberculosis
- Tumors of the brain or spinal cord
- Wegener's granulomatosis
- Other (one or more conditions, with a request to describe)
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Updated
08/17/2011
