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Sea Mar CHC - Clients
 
AFFORDABLE INSURANCE
 

Customer Service Representatives

Sea Mar Community Health Centers has customer service representatives in each of its medical facilities to help patients find out if they are eligible for certain public benefits programs. These include Medicaid, State Children’s Health Insurance Program (SCHIP), Basic Health Plan, General Assistance – Unemployable, Medicare, and Basic Food. If you would like to find out if you are eligible for any of these programs, visit any Sea Mar medical clinic and ask to speak with a customer service representative.

 

  >> What is Medicaid?
  >> What is the State Children's Health Insurance Program (SCHIP)?
  >> What is the Basic Health Plan?
  >> What is General Assistance - Unemployable?
  >> What is Medicare?
  >> What is the Basic Food Program?

What is Medicaid?
 

Medicaid is a program funded by the federal and state governments that pays for medical care for people with low incomes who do not have adequate health-insurance coverage through other programs. The federal government establishes general guidelines for the program, and the State of Washington sets specific eligibility requirements and benefits within those guidelines. Benefits vary depending on the Medicaid program, and might include coverage for doctor visits, hospital care, prescriptions, behavioral health services, preventive health care and well-child exams, immunizations, dental care, and/or eye exams. Eligibility for Medicaid also varies depending on the program, and is based on:

  • Age
  • Income
  • Personal resources, such as bank accounts, real estate, and other possessions that can be sold for cash
  • Residency status
  • Disability status
  • Pregnancy status

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What is the State Children's Health Insurance Program (SCHIP)?
 

Washington’s State Children’s Health Insurance Program (SCHIP) is funded by the federal and state governments. Benefits are the same as those for full-scope Medicaid, including doctor visits, hospital care, prescriptions, mental health services, well-child exams, immunizations, dental care, and eye exams, among other services. SCHIP families pay a small monthly premium, currently $15 a month per child for up to 3 children, with no additional cost for more children. To be eligible for SCHIP, you must:

  • Be under age 19
  • Be a resident of Washington State
  • Live in a “middle-income” family, which is a family with an income between 201% and 300% of the federal poverty level (FP

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What is the Basic Health Plan?
 

The Basic Health Plan (BHP) is a state-funded program providing low-cost health care coverage through private health plans. To be eligible for BHP, you must:

  • Be a resident of Washington State.
  • Have a household income below 200% of FPL.
  • Not be eligible for free or purchased Medicare.
  • Not be receiving Medicaid.
  • Not be institutionalized.
  • Not be attending school full-time in the United States on a student visa.


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What is General Assistance - Unemployable?
 

General Assistance – Unemployable (GAU) is a state-funded program that provides cash and benefits to people who are physically and/or mentally unable to work for at least 90 days from the date of application. To be eligible for GAU, you must:

  • Be unable to work.
  • Be at least 18 years old, unless married or an emancipated minor.
  • Be a US citizen or permanent legal resident.
  • Be a resident of Washington State.
  • Agree to have one’s needs for medical and behavioral health treatment assessed.
  • Meet income requirements and have less than $1,000 in financial resources.

Note: Certain items, such as a home you live in, or a vehicle worth no more than $5,000 are not counted.


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What is Medicare?
 

Medicare is a federal health insurance program that covers elderly and disabled people. For those with low incomes and resources, there are supplemental programs to help pay for Medicare coverage and/or prescription drug costs. To be eligible for Medicare, you must:

  • Be either 65 and older, under age 65 and have one of a specific list of disabilities, or any age and have permanent kidney failure
  • Have entered the US lawfully.
  • Have lived in the US for at least 5 years.


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What is the Basic Food Program?
 

The Basic Food Program helps low-income individuals and families obtain a more nutritious diet by supplementing their income with Basic Food benefits. The amount of benefits depends on family size. To be eligible for the Basic Food Program, you must:

  • Be a resident of Washington State
  • Meet income and resource requirements, which are not necessarily the same as requirements for Medicaid or GAU. For example, a family of three must have a gross income of less than $3,052 per month to be eligible
  • Be a U.S. citizen or permanent legal resident. Legal immigrants who are no longer eligible for federally funded food assistance due to new requirements for that program may be eligible for the Basic Food Program.

 

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