The Washington Hospital Health Insurance Information Service is a free and confidential service that can provide you with all the information you need to make an informed decision about your health insurance. You may reach this service by calling (800) 770-9447 anytime from 8 a.m. to 5 p.m., Monday through Friday. You may either have your questions answered over the phone or set up an appointment for a personal consultation. For a current list of health plans accepted by Washington Hospital Healthcare System, click here.
The Washington Hospital Health Insurance Information Service will help you:
- Understand the difference in the choices you have for open enrollment from your employer
- Understand health insurance policies and terminology
- Determine what to look for in a plan
- Maximize your benefits when both you and your spouse are enrolled in separate plans
- Find any available insurance programs which cover specialized needs
- Explore health insurance options
- Use a resource list of licensed brokers to find a policy that best meets your needs
- Access government-sponsored programs
- Determine which plans allow you to use Washington Hospital and its facilities
There are certain lifestyle issues that might affect your choice of health insurance plans, such as:
- Have you recently married?
- Does your spouse have health insurance benefits through his or her employer?
- Are you expecting any major life changes in the next year? For example, moving to a new area, retirement, job change or relocation, divorce, child attending college, birth or adoption of a child, or a dependent grandchild.
- Have you been declined coverage for insurance before?
- Are you currently taking any medications to control a medical condition? Do you have any chronic conditions such as asthma or diabetes?
- Are you eligible for Medicare benefits?
- Are your children uninsured due to parents' employment issues and changes?
Are the services you need covered?
The following services are not always covered by insurance plans or may have some annual limits:
- Emergency services
- Mental health services
- Laboratory tests
- Medical equipment/prosthetics
- Optical/vision care
- Pregnancy and pediatric care
- Preventive services/annual examinations
- Home health care
- Prescription drugs
Types of Insurance Plans
Preferred Provider Organizations (PPO)
You choose providers in the insurer's network to receive maximum benefits. You may see a provider outside the network, but you pay a higher share of the cost. You may be expected to make payment at the time of service for applicable co-insurance and deductible amounts.
Health Maintenance Organizations (HMO)
You choose a primary care physician or medical group to manage your health care. You must obtain a referral to access specialists. Preventative care is emphasized. No benefits are provided if you receive care from providers not included in the network.
- Medi-Cal is a medical assistance program for individuals in the State of California who are medically indigent and meet certain criteria. It is financed by state and National funding.
- Medicare is the U.S. Government's health insurance program for senior's age 65 and older and individuals with qualified disabilities.
- The Access for Infants Mothers Program (AIM) provides low cost health insurance to pregnant women and infants who are not eligible for Medi-Cal or do not have health insurance. Other plans are also available.
- Other plans are also available.