About Evergreen

The Evergreen Health Insurance Program can pay health insurance premiums for eligible Washington residents. To be eligible for Evergreen assistance, you must qualify for the Early Intervention Program (EIP) or EIP's Pre-Exposure Prophylaxis Drug Assistance Program (PrEP DAP). You must maintain your eligibility with EIP in order for Evergreen to continue paying your insurance premiums.

Why is insurance important?

Insurance can provide access to comprehensive care, not just support for your HIV-related prescriptions and medical needs. For example, insurance may provide coverage for specialists, hospitalization and emergency care, and mental health and chemical dependency treatment. In addition, insurance may cover a broad range of prescription medications, more than are on the EIP formulary.

Who is Eligible for EIP?

EIP serves people with low to moderate incomes who are living with HIV or AIDS or at risk of contracting HIV in Washington State. EIP maintains a current list of eligibility criteria:

  • Living with HIV or AIDS.
  • Living in Washington State.
  • Have a gross monthly income up to $3,960 (in 2016) or less for a single person, or 400% of the Federal Poverty Level.
  • The previous limit on assets has been eliminated.

Who is Eligible for PrEP DAP?

PrEP DAP is a drug assistance program for HIV-negative people who have risk factors that expose them to HIV. To be eligible for PrEP DAP you must:

  • Be HIV-negative.
  • Living in Washington State.
  • Meet one of the following risk factors:
    • Have a partner or partners known to be HIV-1 infected
      OR
    • Be a gay/bisexual/other man, or transgender person, who has sex with men in a high HIV prevalence area or social network and has one or more of the following conditions:
      • A diagnosis of a bacterial sexually transmitted infection (STI) in the last year
      • Exposure to an STI through a sexual network in the last year
      • Ten or more sexual partners in the last year
      • Used methamphetamine in the last year
      • Had unprotected anal intercourse with a partner of unknown HIV-1 status with any of the factors listed above.

What can Evergreen Health Insurance Program pay for?

We can pay for your current insurance, or help you find insurance if you are not currently insured. Evergreen can pay for medical insurance premiums for:

If you have Medicaid, Evergreen can only pay for Medicare Part D or Healthcare for Workers with Disabilities (HWD) policies. The Early Intervention Program may be able to assist you in meeting your spenddown.

The insurance Evergreen pays for must meet these cost-effective criteria:

  • The policy must have at least 50% prescription coverage.
  • There can be no yearly cap on prescriptions.
  • Payments must be made to a company, not to an individual.
  • Only Qualified Health Plans purchsed on the Washington Health Benefit Exchange have an annual deductible limit of $2,000.
  • The plan we are paying must be your primary insurance plan.
  • We can only pay for our clients; we cannot pay for dependents unless they are also enrolled in Evergreen.

What will Evergreen not pay for?

  • Stand-alone dental or vision insurance.
  • Medicare Part B premiums or Medicare Advantage Drug Plans (MA-PDs) that do not meet specific criteria.
  • Health Savings Accounts.
  • Bronze-level Qualified Health Plans in the Health Benefit Exchange.

How do I Apply?

See our how to apply page for more information and to download a form.

More information about this program is available by calling 206-323-2834 or 1-800-945-4256. You can also e-mail us at ehip@ehip.org.