Apple Health phone lines down Thursday, April 18
The Apple Health customer service phone lines will be down Thursday, April 18, from 11:30 a.m. to 2:30 p.m. We apologize for the inconvenience. View other ways to contact Apple Health.
The Apple Health customer service phone lines will be down Thursday, April 18, from 11:30 a.m. to 2:30 p.m. We apologize for the inconvenience. View other ways to contact Apple Health.
Find information about Apple Health managed care.
Want to know what plans are offered in your Apple Health managed care region?
Most Apple Health clients have managed care. This means Apple Health pays a managed care plan a monthly premium for your coverage, which includes preventive, primary, specialty, and other health services. If you are in managed care, then you must see providers who are in your plan's provider network, unless prior authorized or to treat urgent or emergent care.
Newly eligible and renewing Apple Health clients choose or are auto assigned into a plan (MCO) the day they become eligible. Your managed care enrollment is backdated to the beginning of the current month. You can change your managed care plan at any time. Changes usually take effect the month following when the change was made, unless the request was made in the last seven business days of the current month.
Apple Health offers Behavioral Health Services Only (BHSO) plans in all regions. These plans cover Behavioral Health services for clients who are eligible for Apple Health, but not eligible for managed care enrollment. This includes Apple Health clients who are:
Medically Needy BHSO plans are offered by the same health plans as managed care. Clients who are found eligible for Apple Health coverage without a managed care plan (also known as fee-for-service) can select a Behavioral Health Services Only plan. HCA will automatically enroll clients into a BHSO plan if they do not select one. View the BHSO fact sheet to learn more.
Behavioral Health – Administrative Services Organizations (BH-ASO) are funded through state and federal block grant funding.
When you visit a BH-ASO, they can help you navigate through mental health or substance use disorder (SUD) services when needed. Some of these services include:
The BH-ASO can choose when to provide outpatient behavioral health services or voluntary psychiatric inpatient hospitalizations for individuals who are not Apple Health clients. Read the BH-ASO fact sheet to learn more.
The Apple Health Foster Care (AHFC) program provides statewide physical and behavioral health coverage (mental health and substance use disorder treatment services).
This program may be for you if you are:
Apple Health Core Connections: Care coordination for all Washington State foster care enrollees is provided through a single, statewide managed care plan called Apple Health Core Connections administered by Coordinated Care of Washington (CCW).
Apple Health Core Connections can be reached at 1-844-354-9876.
You can choose any one of the five available plans that serve your area when you enroll in Apple Health. Not all plans are available in all areas.
View the health plans available in your area:
All Apple Health plans cover the same basic services, but they have some differences in the way they provide services. Each health plan has its own network of providers, hospitals, and pharmacies. Verify with the health plan that the providers you prefer are in the plan's network.
View the Washington Apple Health Plan Report Card for plan comparisons of each managed care plan under Apple Health.
Before you can be in a managed care program, you must apply for coverage.
Each managed care plan also provides Value-Added Benefits for their members. These are benefits that are not part of the standard Medicaid benefit package and are administered by the MCO not HCA.
To choose or change your health plan, most clients may visit Washington Healthplanfinder. See more information about how to change your health plan.
Contact your plan to:
Plan | Phone number |
---|---|
Community Health Plan of Washington (CHPW) | 1-800-440-1561 |
Coordinated Care (CC) | 1-877-644-4613 |
Molina Healthcare of Washington (MHW) | 1-800-869-7165 |
UnitedHealthcare Community Plan (UHC) | 1-877-542-8997 |
Wellpoint Washington (previously Amerigroup) (WLP) | 1-833-731-2167 |
All Apple Health plans offer the same basic services. As an Apple Health client, you also have access to value-added benefits offered through your managed care plan.
Some services are paid for by Apple Health without a managed care plan, also called fee-for-service (FFS). That's what we call it when Apple Health pays providers directly for each service they do, using your ProviderOne services card.
Most Apple Health clients receive their regular health care coverage through a managed care plan. Apple Health coverage without a managed care plan is sometimes necessary due to the way other coverage works with Apple Health — for instance, when clients have Medicare as their primary coverage.
The following services are always covered by directly by Apple Health using your ProviderOne services card:
Your primary care provider or health plan will help you find these benefits and coordinate your care, when necessary.
Phone: 988 (1-800-273-8255)
Online: 988 Suicide & Crisis Lifeline
Email: hcamcprograms@hca.wa.gov