Partial federal government shutdown
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
Compact of Free Association (COFA) Islander Health Care is a state-funded sponsorship program offered by the Health Care Authority (HCA). HCA pays the monthly premiums and out-of-pocket expenses under a silver level Qualified Health Plan for eligible COFA islanders. The program serves COFA islanders which includes people from the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau.
COFA islanders are only eligible for federally funded Washington Apple Health (Medicaid) if they are under age 19 or pregnant. They may also be eligible for limited medical coverage if the Department of Social and Health Services (DSHS) determines them to be incapacitated or under the Alien Emergency Medical (AEM) program.
Effective June 17, 2019
This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.
Effective June 17, 2019
This section defines terms used in this chapter. See chapter 182-500 WAC for additional definitions.
"Advance premium tax credit (APTC)" - A tax credit taken in advance to lower a monthly health insurance payment (or premium).
"COFA islander" – A person who is a citizen of the Federated States of Micronesia, the Republic of the Marshall Islands, or the Republic of Palau.
"COFA islander health care" – An agency-administered program that pays the premium and out-of-pocket costs for a silver level qualified health plan for eligible COFA islanders.
"Compact of Free Association (COFA)" – A legal agreement between the government of the United States and the governments of the Federated States of Micronesia (U.S. Pub. L. 108-188); the Republic of the Marshall Islands (U.S. Pub. L. 108-188); and the Republic of Palau (U.S. Pub. L. 99-658).
"Cost-sharing funds" – Agency-provided funds for out-of-pocket costs.
"Out-of-pocket costs" – Copayments, coinsurance, deductibles, and other cost-sharing requirements imposed under a qualified health plan for services, pharmaceuticals, devices, and other health benefits covered by the plan and rendered as in-network. Excludes premiums, balance billing amounts for out-of-network providers, and spending for noncovered services.
"Premium cost" – A person's premium for a qualified health plan, minus the amount of the person's advanced premium tax credit.
"Silver level qualified health plan (QHP)" – Silver level indicates the category of a qualified health plan (QHP) offered by the Washington health benefit exchange (HBE). For a definition of QHP, see WAC 182-500-0090.
This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.
Effective June 10, 2019
This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.
Effective June 17, 2019
In order to be eligible for state-funded COFA islander health care, you must enroll in a silver level qualified health plan (QHP) through the Washington health benefit exchange (HBE) during open enrollment or when you qualify for a special enrollment period as described in 45 C.F.R. 155.410 and 45 C.F.R. 155.420.
This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.
Revised June 17, 2019
This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.
Revised June 17, 2019
This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.
Revised June 17, 2019
This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.
You may be eligible for COFA Islander Health Care if you:
To qualify for COFA Islander Health Care, you must first qualify for a silver level qualified health plan with tax credits through the Healthplanfinder. If you are not eligible for a qualified health plan with tax credits and you want to appeal that decision, do one of the following:
If you are eligible for and enrolled in a qualified health plan with tax credits but are not eligible for COFA Islander Health Care, you can appeal this decision to us by doing one of the following: