American Indians and Alaska Natives (AI/AN)

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, and they may be able to help you find additional resources.
  What choices do I have for behavioral health services coverage?
Mental health services and substance use disorder treatment
  • Apple Health Managed Care  
  • Apple Health coverage without a managed care plan
  • If your Apple Health program does not give you the option of choosing an Apple Health Managed Care plan for your physical health, mental health, and substance use disorder treatment services (e.g., 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 (mental health and substance use disorder treatment services).

What do I need to do?

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

  1. One of the Apple Health managed care plans, or
  2. Apple Health coverage without a managed care plan (also referred to as fee-for-service).
If you choose: Then:
Apple Health managed care

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

Apple Health coverage without a managed care plan (also referred to as fee-for-service) You will be able to seek physical health, mental health, and substance use disorder treatment services directly from a provider. You will want to make sure that the provider accepts Apple Health.

Note: If you are not given the option to choose one of the Apple Health managed care plans (e.g., you are enrolled in 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 accepts Apple Health; and
  • Your mental health and substance use disorder treatment services will be managed by the managed care plan.
  • Great Rivers (Cowlitz, Grays Harbor, Lewis, Pacific, and Wahkiakum counties)
  • Salish (Clallam, Jefferson, and Kitsap counties)
  • Thurston-Mason (Mason and Thurston counties)
  What choices do I have for behavioral health services coverage?
Mental health services
  • You may choose either:

What do I need to do?

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

  1. Your local BHO, or
  2. Apple Health coverage without a managed care plan (also referred to as 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 coverage without a managed care plan (also referred to as fee-for-service)

You will be able to seek mental health services and substance use disorder treatment services directly from a provider. You will want to make sure the provider accepts Apple Health.

  • If you are currently receiving 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.

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 Urban Indian Health Program, please contact them for assistance. The Health Care Authority can answer your questions by calling 1-800-562-3022.