Premium payment program

Find information about the Premium Payment Program that may provide reimbursement for private health insurance coverage for those receiving Apple Health (Medicaid).

What is the Premium Payment Program?

  • Helps people on Washington Apple Health (Medicaid) take advantage of private health insurance in a way that saves the state money.
  • Lets government and businesses work together to:
    • Increase private health insurance coverage to families who otherwise couldn't pay their own premiums.
    • Reduce healthcare costs to the state.
  • Provides reimbursement for private health insurance coverage when:
    • An Apple Health (Medicaid) client has access to private health insurance coverage, such as through an employer.
    • It saves the state money.

How can the Premium Payment Program help?

  • Keep Apple Health (Medicaid) and have private health insurance too

Your private insurance is primary and Medicaid is second. Medicaid can pay for your co-pays and any out of pocket expenses.

Access to specialists under your private insurance that aren't covered under Medicaid like a naturopathic doctor or chiropractor.

  • Non-Medicaid family members may also be included in the premium payment if cost effective
  • Apple Health (Medicaid) coverage does not change by enrolling

Your medical continues when enrolled in your private health insurance.

Do I qualify for premium payment assistance?

If you answer yes to these two questions, you should apply:

  • Does at least one person in your family receive Apple Health (Medicaid)?

If no one in your family receives Apple Health medical assistance, go to www.wahealthplanfinder.org to see if you qualify.

Note: you must have Apple Health (Medicaid) coverage before applying for the Premium Payment Program.
  • Do you have access to health insurance? Such as:
    • Private health insurance you purchase yourself
    • Employer sponsored insurance made available through your job
    • COBRA continuing your job's health insurance if you become unemployed

How do I apply for premium payment assistance?

Complete, print out, and sign this application for premium assistance.

Mail to:
Health Care Authority
P.O. Box 45518
Olympia, WA 98504

Fax: 1-877-893-3810 (toll free)

A case manager will determine premium reimbursement* based on the following:

  • Cost and type of insurance.
  • Age and gender of family members with active Apple Health (Medicaid) coverage.
  • Type of Apple Health (Medicaid) program.

*It can take up to 30 days to process your application after we receive all necessary paperwork.

Contact

Phone: 1-800-562-3022 (toll free) ext. 15473
Business hours: Monday-Friday 10 a.m. - 1 p.m. Pacific Time

Melissa Bruce
Phone: 360-725-1572
Email: melissa.bruce@hca.wa.gov