How do I use my coverage?

Learning about your coverage

Understanding your coverage and how to use it can be confusing. The following pages have information and tips to help you along the way.

• American Indian/Alaska Native
• Apple Health managed care
• Apple Health coverage without managed care
• Apple Health client booklets
• Enrollment next steps
• Make my first appointment
• Access my 1095-B tax form

Questions you may have

Which pharmacy or drug store do I use?

If you don’t know how to fill prescriptions, such as which pharmacies to use, contact your health plan for more information.

What if I need care after hours?

Your health plan has a toll-free number you can call to speak to a nurse 24 hours a day, seven days a week. The phone number is also listed in your health plan booklet.

What if I have an emergency?

If you have a sudden or severe health problem that you think is an emergency, call 911 or go to the nearest location where emergency providers can help you. As soon as possible afterward, call your health plan and let them know that you had an emergency and where you received care.

If you need urgent care, but your life is not in danger, call your primary care provider, your health plan, or the 24-hour nurse’s line.

How do I get dental care?

You get dental care from a provider who accepts Apple Health coverage without a managed care plan (also known as fee-for-service). Visit DentistLink.org to find a dentist that accepts Apple Health. See an overview of the services covered under Apple Health at Dental services.

How do I get eye exams and eye glasses?

Fitting services and eye exams, including tests for refraction and visual fields, may be provided through your health plan.

• For children 20 years of age and younger - eyeglass frames, lenses, and contact lenses are covered by Apple Health fee-for-service.
• For adults - eyeglass frames and lenses are not covered. You can purchase eyeglass frames and lenses through participating optical providers at a discounted prices. Find a list of participating providers.

What if I have a secondary insurance?

If you have other insurance through an employer, you may still be eligible for Apple Health coverage. You can use Apple Health as secondary insurance, meaning it could cover out-of-pocket expenses that are not covered by your primary insurance. See if you qualify.