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If you are displaced or affected by wildfire, all Washington Apple Health and PEBB/SEBB medical plans are allowing prescription refills before the refill date.
Due to COVID-19, HCA’s lobby is closed. Learn more about your customer service options.

COFA Islander Health Care

Compact of Free Association (COFA) Islander Health Care provides health coverage for eligible COFA islanders.

COFA Islander Health Care logo

Interested in COFA outreach materials? 

View the COFA outreach toolkit

About the program

Health Care Authority (HCA) pays the monthly premiums and out-of-pocket expenses for silver level qualified health plans for eligible COFA islanders.

COFA islanders include people from the Republic of the Marshall Islands, the Federated State of Micronesia, and the Republic of Palau.

COFA islanders and Governor Inslee at health care signing ceremony

Program requirements

You may be eligible for COFA Islander Health Care if you:

  • Are a COFA islander.
  • Have income less than 133 percent of the federal poverty level (FPL).*
  • Live in Washington.
  • Enroll into a silver level qualified health plan.
  • Agree to file federal taxes (even if you do not meet tax filing requirements).
  • Not receiving other federal or state medical coverage.
Household Size 

Single person

2-person household

3-person household

4-person household

5-person household

Monthly Income  $1,384 $1,874




Household Size  6-person household

7-person household

8-person household 

9-person household

10-person household

Monthly Income 






*The income standards listed in these examples are subject to change annually at open enrollment. 

When to apply for coverage​

Submit applications for coverage during open enrollment or apply for a special enrollment period throughout the year.

How to apply for coverage

When you’re ready to apply

You’ll need this information:

  • Your household monthly income.
  • The Social Security numbers and dates of birth for each member of your household.
  • Your immigration information.

How to use your COFA Islander Health Care

To learn how to use your health care, download the Welcome to COFA Islander Health Care booklet.

For information on how to register online with Navia Benefit Solutions and have the ability to monitor your cost sharing funds transactions, view the Navia online registration instructions

How can I get involved?

To help others apply for coverage in your community or get more information about the program,  email us at cofaquestions@hca.wa.gov or call 1-800-547-3109.

You may view our promotional COFA Islander Health Care video in English or view other languages on the COFA outreach toolkit webpage.