Apple Health managed care changes
Health Care Authority implemented changes to the Apple Health managed care program. You may learn more about these changes below.
Changes in January 2017
If you have Apple Health (Medicaid) and other primary health insurance
If you or someone in your household has Apple Health (Medicaid) coverage in addition to primary private health insurance (such as Group Health or Blue Shield), changes are coming to how the Washington State Health Care Authority (HCA) provides your Apple Health coverage.
Beginning January 1, 2017, the agency will enroll most fee-for-service Apple Health clients who have other primary health insurance into an agency-contracted managed care organization (MCO). Learn what you need to do.
Changes in April 2016
Clients may choose from Community Health Plan of Washington (CHPW) or Molina Healthcare of Washington (MHW) in the SW WA region.
Behavioral Health – Administrative Service Organization (BH-ASO) or mental health crisis services and short-term substance use disorder (SUD) crisis services are provided by Beacon Health Options of Washington in SW WA.
Behavioral Health Services Only (BHSO) in the SW WA region are available to clients who are Medicaid eligible but not eligible for managed care. They will have a choice of CHPW or MHW for these behavioral health services. These clients include:
- Dual eligible – Medicare/Medicaid
- Foster care
- American Indian/Alaska Native (AI/AN)
- Medically needy
- Clients who have met their spenddown
- Non-citizen pregnant women
- Individuals in Institutions Mental Disease (IMD)
- Long-term care residents
- Clients with other carrier coverage
These clients include children and youth:
- Under the age of 21 who are in foster care
- Under the age of 21 who are receiving adoption support
- Age 18 to 26 years old who aged out of foster care on or after their 18th birthday
AHCC clients are auto-enrolled to CCW with the ability to opt out with a phone call to the foster care unit. American Indian/Alaska Native (AI/AN) children are not auto-enrolled.
Find support available to you, based on where you live:
24-hour crisis line
In Clark and Skamania counties only
For more information about changes to Apple Health managed care, please see the following resources: