Children's
Health
care
Program
The Children's Healthcare program provides free medical coverage to non-citizen children under the age of 19 with family income at or below 200% Federal Poverty Level (FPL), who are not eligible for Medicaid because of their immigration status. The income amounts below are effective April 1, 2008.
|
Number of people in family |
Countable Income per Month |
|
1 |
1,734 |
|
2 |
2,334 |
|
3 |
2,934 |
|
4 |
3,534 |
|
5 |
4,134 |
|
More |
Add $600 or each additional family member |
The Children’s Healthcare program also offers premium based
medical coverage to non-citizen children under the age of 19
with family income over 200% FPL, but not over
250% of FPL.
The premium is $15/mo per child, but no more than $45/mo per
family.
|
Number of people in family |
Countable Income per Month |
|
1 |
2,167 |
|
2 |
2,917 |
|
3 |
3,667 |
|
4 |
4,417 |
|
5 |
5,167 |
|
More |
Add $750 or each additional family member |
How do I apply?
Complete, print, sign and return the following Children's Health Application.
English Application (PDF); Spanish Application (PDF); Russian Application (PDF); Cambodian Application (PDF); Chinese Application (PDF); Korean Application (PDF); Laotian Application (PDF); Somali Application (PDF); Ukrainian Application (PDF); Vietnamese Application (PDF) - If you don't have Adobe Acrobat Reader to view this file, download it free.
Please include proof of your income with your application. Mail your application to:
MEDS
PO BOX 45531
Olympia, WA 98599-5531
How
to order applications.
English, Spanish and Russian applications are now available
to order in bulk from the DSHS fulfillment center.
For questions or to order on line go to: http://fortress.wa.gov/dshs/maa/CustomerPublications/.
To the left are selections so you can learn more about our
program and the services offered. Call
1-877-KIDS-NOW
(toll-free
1-877-543-7669)
for more information.
For comments or questions regarding (your program
here), email
contact us.