American Indian/Alaska Native

Find information about Apple Health (Medicaid) coverage for American Indian and Alaska Native populations.

Apple Health options

Under the Affordable Care Act, American Indians and Alaska Natives have a range of options for health care and health care coverage. Learn more about these options.

As an American Indian or Alaska Native on Apple Health, you can:

  • Enroll in an Apple Health managed care plan, or
  • Receive Apple Health coverage without a managed care plan.

There are advantages and disadvantages to each, depending on your individual circumstances. Tribal health clinic and urban Indian clinic staff are very familiar with these options and can help you make this choice.

You can also:

Changes to behavioral health coverage

As of July 1, 2017, if you identify as American Indian or Alaska Native and are on Apple Health you may choose your coverage for behavioral health services, just like for physical health services.

Note: If you are eligible to receive care at an Indian Health Service (IHS) facility, Tribal health program, or urban Indian health program, this change will not affect your ability to receive care at those programs but they may be able to help you make your choice.

Behavioral health services coverage choices 

  What choices do I have for behavioral health services coverage?

Some mental health services (for example depression or autism)

When you choose your Apple Health coverage, this is your coverage for any mental health services that are not covered by the Behavioral Health Organization (BHO) (see below), either:

  • Apple Health Managed Care through either Amerigroup, Community Health Plan of Washington, Coordinated Care, Molina, or United HealthCare;
  • Apple Health coverage without a managed care plan.

Specialized mental health services

You may choose either:

  • Your local Behavioral Health Organization (BHO); or
  • Apple Health coverage without a managed care plan.

What do I need to do?

You will need to decide if you want your Apple Health coverage for behavioral health services from:

  1. Your local Behavioral Health Organization  (BHO), or
  2. Apple Health fee-for-service.
If you choose: Then:
Your local Behavioral Health Organization (BHO)

Your mental health and substance use disorder treatment services will be managed by the BHO.

  • If you are currently receiving specialized mental health services, your treatment will not be affected.
  • If you are currently in substance use disorder treatment, you may want to check first with your provider to confirm that you can continue treatment without interruption.
Apple Health fee-for-service (“Apple Health coverage without a managed care plan”)

You will be able to seek specialized mental health services and substance use disorder treatment services directly from a provider. You will want to make sure that the provider is participating in Apple Health fee-for-service.

  • If you are currently receiving specialized mental health services, you may want to check first with your provider to confirm that you can continue treatment without interruption.
  • If you are currently receiving substance use disorder treatment, your treatment will not be affected.

Note: If you do not make a choice, you will be automatically enrolled in the Apple Health fee-for-service program.

  What choices do I have for coverage for specialized mental health services and substance use disorder treatment services?

Specialized Mental Health services and Substance Use Disorder Treatment Services

  • Apple Health Managed Care through either Community Health Plan of Washington or Molina;
  • Apple Health coverage without a managed care plan (also known as “ProviderOne” or “Apple Health fee-for-service”).
  • If your Apple Health program does not give you the option of choosing an Apple Health Managed Care plan (e.g., Apple Health for Foster Care, Apple Health for Medicare enrollees) and you are enrolled in Apple Health coverage without a managed care plan, you will be given the option of choosing an Apple Health Managed Care Plan for your behavioral health coverage, either Community Health Plan of Washington or Molina.

What do I need to do?

You will need to decide if you want your Apple Health coverage for physical health, specialized mental health services, and substance use disorder treatment services from:

  1. One of the Apple Health integrated managed care plans, or
  2. Apple Health fee-for-service.

If you choose:

Then:

One of the Apple Health integrated managed care plans

Your physical health, specialized mental health services, and substance use disorder treatment services will be managed by the managed care plan.

 

Apple Health fee-for-service (also known as “ProviderOne” or “Apple Health coverage without a managed care plan”)

You will be able to seek physical health, specialized mental health services, and substance use disorder treatment services directly from a provider. You will want to make sure that the provider is participating in Apple Health fee-for-service

 

Note: If you are not given the option to choose one of the Apple Health integrated managed care plans (e.g., you are enrolled in Apple Health for Foster Care or Apple Health for Medicare enrollees) and you choose one of the Apple Health managed care plans for your behavioral health, then:

  • You will be able to get physical health care services directly from a provider. You will want to make sure that your physical health care provider is participating in Apple Health fee-for-service; and
  • Your specialized mental health services and substance use disorder treatment services will be managed by the managed care plan.

Can I change my behavioral health coverage?

Yes, you can change your selection at any time, but the change will not take effect until the first day of the following month. If you are connected or partnered with a Tribal Assister through a Tribal or UIHP, please contact them for assistance.

The Health Care Authority can answer your questions by calling 1-800-562-3022.

Indian health care providers

You can always go to tribal and urban Indian clinics, whether you have Apple Health or not, and you won't have to pay any out-of-pocket costs. You can sign up with the clinic as your primary care provider, whether you're enrolled in an Apple Health managed care plan or you receive Apple Health coverage without a managed care plan. If a tribal or urban Indian clinic can't provide the services you need, they will refer you to a specialist.

Find a tribal clinic or urban Indian clinic near you.