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Make my first appointment

Find information about making your first health care appointment with Apple Health (Medicaid) coverage.

Get a primary care provider

Once you're enrolled in a health plan, you'll need to choose a primary care provider (sometimes called a PCP). Your primary care provider might be a doctor, a nurse practitioner, a physician assistant, or a naturopath. Sometimes it’s not just one person— it can be a clinic with several kinds of providers.

Your primary care provider is the main health care professional you see, whether you are sick or getting preventive care. If you need special care that your primary care provider can’t give, they'll refer you to a specialist.

Even if you aren’t sick now, it’s important to choose a primary care provider and to schedule your first appointment. Your primary care provider will help you prevent future health problems and do routine screenings for certain diseases.

If you don’t choose a primary care provider, your health plan will choose one for you.

You can ask for a male or female primary care provider. You can also ask for a provider who speaks your language, specializes in your disability, or understands your culture.

You can ask for a specific provider, as long as they're in your health plan’s network.

If the provider you want is not in your health plan’s network, ask the provider which health plan they work with. If the other health plan is available where you live, you can change to that health plan.

Your primary care provider should be someone you feel comfortable with. If you aren’t happy with them for any reason, you can choose another provider.

To choose a different primary care provider, follow the directions sent to you by your health plan, call your health plan’s customer service phone number, or visit your health plan’s website.

Note: If you are not covered under an Apple Health managed care plan (i.e. fee-for-service), you must find a provider who is contracted with Washington Apple Health using your ProviderOne services card. Find a contracted provider.

Make an appointment

You must have an appointment to see a provider. Once you have selected a primary care provider, call their office to make an appointment.

Check the information your health plan sent you to see how to make your first appointment. You should be able to find the provider’s office contact information through your health plan’s website. Or call your health plan’s customer service line and ask for the phone number to make an appointment.

If you have immediate health concerns or needs, you should be able to see your primary care provider within a few days.

Even if you don’t have immediate health concerns, make an appointment for a general check-up (also called a wellness check). It takes longer to get an appointment for a general check-up, so don’t put it off.

If you don’t speak English, professional interpreters are available in many languages, including sign language, at no cost to you. When you make an appointment, let the receptionist know if you need an interpreter. The interpreter can go to the provider’s office or be on the phone during your appointment.

It’s better to use a professional interpreter than to bring a family member or friend to interpret for you. Professional interpreters are trained to understand health care terms and will help you and your provider understand each other.

If you have a speech or hearing disability, difficulty communicating, or a mobility impairment, be sure to tell the receptionist about it when you make the appointment. The receptionist will help you make any necessary arrangements.

If you have no way to get to your health care appointment, you may be eligible for help with transportation. The appointment must be for services allowed by your current health plan. A regional broker contracted by the Health Care Authority will arrange the most appropriate transportation for you.

For information on how to request nonemergency medical transportation, visit transportation services (nonemergency).

If you need to change or cancel an appointment, please call the primary care provider as soon as possible.

If you don’t go to your appointment and don’t call, valuable appointment time is wasted that could be used by another patient.

Get ready for your appointment

Make a list of the things you want to talk about with your primary care provider. Your provider can go over the most important things at your first visit. There’s a checklist you can use at the end of this guide.

Take a list of all your prescription medications with you, including vitamins, herbal supplements, and other over- the-counter medications, even aspirin.

Write down any allergies you have to medications, foods, or environmental allergens, such as pollen.

Bring previous medical records, including vaccination or immunization records, if you have them.

Go to your appointment

Feel free to take along a family member or friend. That person can help you find your way around or just help you feel more comfortable. Sometimes it’s good to have someone else to listen to what your primary care provider tells you.

Parents are allowed to stay with their children during the exam. Preteen and teenage kids may see their primary care provider without a parent present. Discuss this with your kids and their primary care provider.

For details about benefits and services for children covered by Apple Health, please see the Welcome to Washington Apple Health booklet.

Plan to arrive at the provider’s office 15 minutes before your appointment. Check in with the receptionist and fill out any forms given to you. You will need to show your Services Card (also called a ProviderOne card) and your health plan ID card. You will be asked to show a photo ID, such as a drivers license.

Your primary care provider will check out your overall health and talk to you about any health-related problems.

Ask your provider for written instructions on any health topics discussed during your visit. It’s okay to ask your provider to repeat anything you don’t understand.

Ask if your current medications are covered by your health plan. If they aren’t, your provider may be able to select a medication that is covered.

Tell your primary care provider about any problems you may have with your medications.

If you have any questions about your medications, ask your provider before you leave the office.

Your primary care provider might order tests. It usually takes a few days to get the results. Ask how long it will take and make sure your provider knows how to contact you.

To get tests done, you might need to go to a different room or a different building. Your primary care provider or an assistant should tell you what you need to know. If you’re not sure, ask for directions.

If you need your primary care provider to fill out and sign special forms for you, please allow extra time for that. It is helpful to fill out the form with information that you know about, such as name and address, before you give it to the provider. This helps the provider fill out the form more quickly.

Ask the receptionist or the assistant about the best way to get your forms filled out and how long it will take.

Emergencies, urgent care, or after-hours care

Call your primary care provider to see if they offer after- hours care.

You can also call your health plan’s 24-hour nurse helpline and ask a nurse what to do.

You may have an injury or illness that is not an emergency but needs urgent care. Contact your plan to find urgent care facilities in your plan’s network. You can also call your health plan’s 24-hour nurse helpline for advice.

If you have a sudden or severe health problem that you think is an emergency, call 911 or go to the nearest emergency room.

As soon as possible afterward, call your health plan and let them know that you had an emergency and where you received care.

Only go to the hospital emergency room if it’s an emergency

Do not go to the emergency room for routine care. The emergency room is only for serious emergencies

Other useful information

You don’t have to pay for prescriptions that are covered by your health plan.

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

Be sure to follow your primary care provider’s instructions when taking medications. It’s important to take the right amount, at the right time, and in the right way. Medications don’t work as well—and may be harmful to you—if you don’t take them correctly.

If you don’t understand the instructions, ask your primary care provider to explain them to you.

Be sure to go over your prescriptions with the pharmacist when you pick up your medications.

Do not make an appointment with a specialist until you talk to your primary care provider or your health plan.

To see a specialist you need to get “prior approval,” also called a “referral,” from your primary care provider.

It’s important to follow your health plan’s procedure.

If you see a specialist on your own, without prior approval, you will have to pay for the appointment out of your own pocket.

You don’t need to get prior approval from your primary care provider to see an obstetrician or gynecologist (OB/ GYN), as long as they are in your health plan’s network.

Routine women’s health check-ups are covered, as well as any follow-up care that might be needed. For pregnant individuals, regular care during pregnancy is covered.

Treatment for mental health problems such as depression, anxiety, and posttraumatic stress disorder (PTSD) is covered by your health plan.

Your primary care provider will help coordinate any mental health care you need with a mental health provider. The mental health network provider will decide where you should receive ongoing services. For an outpatient visit to a mental health provider, call your health plan. You may need to be treated at a community mental health agency if you have a serious mental health condition.

You do not need prior approval or a referral from your health plan. If you're enrolled in Apple Health, contact a treatment agency directly. You may find a treatment agency near you to get an assessment for treatment approval.

Call 1-800-273-TALK (8255) to be connected to a skilled, trained counselor at a crisis center in your area, any time, day or night.