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Washington Health Program includes a six-month maternity delivery services window, or waiting period for coverage, if your baby is born within six months of your enrollment or re-enrollment in Washington Health Program. If you deliver your baby within the maternity window, your delivery care is subject to a $5,000 deductible and to coinsurance.
The $5,000 maternity delivery services window deductible applies only to deliveries during the six months after your initial enrollment or re-enrollment. If you deliver your baby after the six-month maternity window (waiting period), you pay regular coinsurance and deductible without the $5,000 maternity window deductible.
Regardless of when you deliver, the $5,000 maternity window deductible does not apply to other maternity-related services, such as full prenatal care, postpartum care, care for pregnancy complications, well-child newborn care, and termination of pregnancy
About Washington Health Program
The Washington State Health Care Authority offers Washington Health Program through Community Health Plan of Washington. If you qualify, you and your family can get comprehensive, high quality care for low premiums and cost sharing. For Community Health Center provider visits and generic prescriptions, your copay is $10. All other participating provider services have a low $500 annual deductible. You can choose a plan with an annual benefit maximum of either $75,000 or $100,000.
In general, Washington Health Program covered benefits include:
- Routine office visits and immunizations
- Prescription drugs
- 24-hour nurse advice line
- Preventive screenings such as mammograms and Pap smears
- Diagnostic imaging and lab work
- Emergency room and hospital care
- Maternity (separate $5,000 deductible if delivery occurs in the first six months of enrollment)
For more detailed information about coverage and costs, see the
Washington Health Program Benefit Grid.
Community Health Plan of Washington members get services from more than 2,365 primary care providers and 13,571 specialists at more than 540 primary care clinics and more than 100 hospitals. It is a statewide, comprehensive delivery system of primary care providers who are dedicated to your health and who focus on treating the entire person.
Washington Health is available to anyone who lives in Washington and:
- Is not eligible for free or purchased Medicare.
- At the time of enrollment, is not confined to an institution.
- Is ineligible for coverage under the Washington State Health Insurance Pool (WSHIP) or qualifies to bypass the
standard health questionnaire under state law.
- Is not receiving Washington Department of Social and Health Services (DSHS) medical assistance (Medicaid) or
subsidized Basic Health benefit.
You can find more information and enroll in the Washington Health Program
HERE.
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