Eligibility Requirements
To be eligible, you must meet all of the following requirements:
- You must be a resident of Washington State and a U.S. citizen or national, or person lawfully present in the United States; and
- You must have been uninsured for at least six months prior to applying; and
- You must have a qualifying pre-existing medical condition (see list below) or a denial letter from an insurance carrier or a letter of acceptance with a reduction or exclusion of coverage for your pre-existing condition.
Eligible pre-existing conditions
If you have been diagnosed with one of the medical conditions listed below and you meet the other eligibility requirements, you automatically qualify for the Pre-existing Condition Insurance Plan–Washington State. A letter from your physician confirming your diagnosis with the physician’s name and address or a copy of a signed prescription form with your name and exact diagnosis must accompany your application. (A denial letter from an insurance carrier or letter of acceptance with a reduction or exclusion of coverage for your pre-existing condition will also satisfy the pre-existing condition eligibility requirement.)
Acute respiratory distress syndrome
AIDS / HIV positive, IDS, ARC and other
immune deficiencies
Amyotrophic Lateral Sclerosis (ALS)
Anemia, chronic fatigue syndrome
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
Crohn's 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 Disease
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 or paralysis
Subdural hematoma with complications (loss of speech, sight, memory or paralysis)
Tuberculosis
Tumors of the brain or spinal cord
Wegener's granulomatosis
Other (with a request to describe)
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