American Indians and Alaska Natives (AI/AN)

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.

Do you need immediate assistance?

Behavioral health services coverage choices

Note: If you are eligible to receive care at an Indian Health Service (IHS) facility, Tribal health program, or urban Indian health program, you can receive care at those programs but they may be able to help you make your choice.
  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 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 BHO, or
  2. Apple Health fee-for-service.
If you choose: Then:
Your local 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.
  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 Amerigroup, Coordinated Care, or Molina Healthcare;
  • 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 Amerigroup, Coordinated Care, or Molina Healthcare.

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.