Skip to main content
Toggle search
In crisis?
Toggle navigation
MENU
Home
About HCA
Contact HCA
Home
Home Sub-menu">
Health care services and supports
Apple Health (Medicaid) coverage
Eligibility
Individual adults
Parents/Caretakers
Pregnant women
Children
Noncitizens
Aged, blind or disabled
Aged 65 and older or Medicare eligible
Foster Care
Long-term services and supports (LTSS)/hospice
Medicare Savings Program
Benefits & services
Covered services
Autism & Applied Behavioral Analysis (ABA) therapy
Behavioral health and recovery
Dental services
Health Home
Immunizations
Interpreter services
Medically Intensive Children's Program (MICP)
Pharmacy services
Pregnancy services
First Steps (maternity and infant care)
First Steps provider directory
Chemical-Using Pregnant Women
Take Charge (Family Planning non-Medicaid)
Take Charge provider directory
Transgender Health Program
Transportation services (nonemergency)
Veterans and family members
Apply for or renew coverage
Use my coverage
American Indians and Alaska Natives (AI/AN)
Apple Health managed care
Apple Health client booklets
Enrollment next steps
Make my first appointment
Update my income or address (report a change)
Change my health plan
Replace my services card
Cancel my coverage
Voices of Apple Health
Access to housing, employment and health care gives Yakima resident a second chance
Cancer patient lives a quality life thanks to Apple Health
New mother and baby have healthy start thanks to Apple Health
Apple Health covers medically necessary surgery when other insurance wouldn’t
Apple Health leads the way to a better life for autism spectrum disorder (ASD) client
Apple Health for Kids provides relief for new parents
Access to health care allows student to pursue education stress-free
Children’s Health Insurance Program (CHIP) keeps health care affordable for families
Helping Apple Health (Medicaid) clients when they need it most
Apple Health gives life to those with chronic disease
Mother and daughter have a better life because of Apple Health
Apple Health provides otherwise unaffordable, life-saving medication for HIV patient
Apple Health outreach staff help spread the word about free and low-cost health insurance
Apple Health and community partners help improve the health of the Latino population in Washington
Apple Health brings stability to lives of young couple
I can’t begin to explain how much Apple Health has helped me
I wouldn’t be able to afford health insurance otherwise
We were not alone in this awful process
Getting the help I so desperately needed
Apple Health gives me a sense of security
Helping people navigate their way to Washington Apple Health
Apple Health has given her such peace of mind
Stakeholder training and education
Community-based training
Reference guides
Webinars, video and presentations
Outreach toolkit
COFA outreach toolkit
Hospital Presumptive Eligibility
Medicaid suspension
Contact Washington Apple Health (Medicaid)
Forms & publications
Behavioral health and recovery
American Indians and Alaska Natives (AI/AN)
Child and youth behavioral health services
Frequently asked questions (FAQs)
Signs of early psychosis
Wraparound with Intensive Services (WISe)
Client rights
Ombuds services
Behavioral health facility complaints
Mental health services
Acute mental health care (inpatient)
Frequently asked questions (FAQs)
Mental health advance directives
Mental health crisis lines
Peer support
Problem gambling
Recovery support
Substance use treatment
Alcohol use treatment
Opioid use treatment
Trainings and events
Prescription assistance
Programs
Alternate help with prescriptions
Program Administration
Apple Health eligibility manual
General eligibility requirements that apply to all Apple Health programs
Classic (non-MAGI) based programs manual
Modified Adjusted Gross Income (MAGI) based programs manual
Long-term services and supports (LTSS) manual
Apple Health (Medicaid) manual WAC index
Coordination of benefits
Patient review and coordination
Premium payment program
News
Uniform Medical Plan (UMP)
Plan: Uniform Medical Plan Classic
Find providers
Your cost for care
Annual deductible
Medical out-of-pocket limit
Coinsurance/copayments
Preferred vs. out-of-network providers
No-cost care
Medical benefits
Summary of benefits
Knee and hip replacement
Preventive care
Spine care
Exclusions
Services requiring preauthorization
Wellness programs
Prescription drugs
Find a network pharmacy
What you pay for drugs
Search the UMP Preferred Drug List
Filling your prescriptions
Limits on drug coverage
For Medicare retirees
How UMP and Medicare work together
Prescription drugs and Medicare
Seeing providers and Medicare
Plan: UMP Consumer-Directed Health Plan (UMP CDHP)
Find providers
Your cost for care
Annual deductible
Out-of-pocket limit
Coinsurance
Preferred vs. out-of-network providers
No-cost care
Medical benefits
Summary of benefits
Knee and hip replacement
Preventive care
Spine care
Exclusions
Services requiring preauthorization
Wellness programs
Prescription drugs
Find a network pharmacy
What you pay for drugs
Search the UMP Preferred Drug List
Filling your prescriptions
Limits on drug coverage
Health Savings Account
Plan: UMP Plus
Find providers
UMP Plus provider information
UMP Plus–UW Medicine Accountable Care Network
UMP Plus–Puget Sound High Value Network
Your cost for care
Annual deductible
Medical out-of-pocket limit
Coinsurance/copayments
Cost for providers by type
No-cost care
Medical benefits
Summary of benefits
Preventive care
Exclusions
Services requiring preauthorization
Wellness programs
Prescription drugs
Find a network pharmacy
What you pay for drugs
Search the UMP Preferred Drug List
Filling your prescriptions
Limits on drug coverage
UMP Plus FAQs
UMP administration
Claims history
Centers of Excellence (COE)
Medical policies
Complaints & appeals procedures
UMP notice of privacy practices
UMP provider portal
Submitting a claim
Cancel your coverage
Access coverage while traveling
Forms available online
If you have other coverage
Glossary
Find drugs
Compare medical plans
Forms & publications
News
Post-open enrollment
Contact UMP
Log in to your accounts
Employee and retiree benefits
Public employees
Eligibility & enrollment
How to determine eligibility
How to enroll
Dependent verification
Waiving medical coverage
Medical plans & benefits
Benefits & coverage by plan
Compare medical plans
Medical plans available by county
Kaiser Permanente NW plans
Kaiser Permanente WA plans
Uniform Medical Plan (UMP) plans
Health plans with health savings accounts (HSAs)
Dental plans & benefits
Compare dental plans
Additional benefits
Auto & home insurance
Dependent Care Assistance Program (DCAP)
Life insurance
Long-term disability insurance
Medical Flexible Spending Arrangement (FSA)
Plan discounts
Plan costs
Medical plan premiums
Life insurance premiums
Long-term disability insurance premiums
Paying for benefits
Surcharges
Tobacco use surcharge
Spousal coverage surcharge
Spousal plan questionnaire 2019
Spousal plan calculator
Help for question 1
Help for question 2
Help for question 3
Help for question 4
Help for question 5
Help for question 6
Help for question 7
Medicare & PEBB Program benefits
Change your coverage
Find a provider
Cancel your coverage
Frequently asked questions (FAQs)
Benefits after layoff or separation
Contact the plans
School employees
Eligibility and enrollment
How to determine eligibility
How to enroll
Waiving medical coverage
Medical plans and benefits
Dental plans and benefits
Vision plans and benefits
Additional benefits
Life insurance
Long-term disability insurance
Plan costs
Surcharges
Tobacco use surcharge
Spousal coverage surcharge
Retirees
Eligibility & enrollment
Preparing for retirement
Retiring from a DRS retirement plan
Employment ending without retirement
COBRA
Disability retirement
Separating employment: Plan 3 members
Higher-education retirement plan
Not participating in a Washington State-sponsored retirement plan
How to determine eligibility
How to enroll
Completing the retiree forms
Dependent verification
Deferring coverage
Medical plans & benefits
Benefits & coverage by plan
Compare medical plans
Medical plans available by county
Kaiser Permanente NW plans
Kaiser Permanente WA plans
Medicare Supplement Plan F
Uniform Medical Plan (UMP) plans
Health plans with health savings accounts (HSAs) (non-Medicare)
Dental plans & benefits
Compare dental plans
Additional benefits
Auto & home insurance
Life insurance
Plan discounts
Plan costs
Non-Medicare plan premiums
Medicare plan premiums
Life insurance premiums
Paying for benefits
Surcharges
Tobacco use surcharge
Spousal coverage surcharge
Spousal plan questionnaire 2019
Spousal plan calculator
Help for question 1
Help for question 2
Help for question 3
Help for question 4
Help for question 5
Help for question 6
Help for question 7
Medicare & PEBB Program benefits
Change your coverage
Find a provider
Cancel your coverage
Frequently asked questions (FAQs)
Contact the plans
Continuation coverage
Eligibility & enrollment
How to determine eligibility
How to enroll
Dependent verification
Medical plans & benefits
Benefits & coverage by plan
Compare medical plans
Medical plans available by county
Kaiser Permanente NW plans
Kaiser Permanente WA plans
Medicare Supplement Plan F
Uniform Medical Plan (UMP) plans
Health plans with health savings accounts (HSAs) (non-Medicare)
Dental plans & benefits
Compare dental plans
Additional benefits
Auto & home insurance
Life insurance (unpaid leave only)
Long-term disability insurance (unpaid leave only)
Medical Flexible Spending Arrangement
Plan discounts
Plan costs
PEBB Continuation Coverage premiums (non-Medicare)
PEBB Continuation Coverage premiums (Medicare)
Life insurance premiums (unpaid leave only)
Long-term disability insurance premiums (unpaid leave only)
Paying for benefits
Surcharges
Tobacco use surcharge
Spousal coverage surcharge
Spousal plan questionnaire 2019
Spousal plan calculator
Help for question 1
Help for question 2
Help for question 3
Help for question 4
Help for question 5
Help for question 6
Help for question 7
Change your coverage
Find a provider
Cancel your coverage
Frequently asked questions (FAQs)
Contact the plans
For groups joining the PEBB Program
How to join the PEBB Program
Employer groups
School districts
Plan costs
Employer group monthly premiums
School district monthly premiums
Rules & policies
PEBB rules and policies
SEBB rules and policies
Wellness programs
Diabetes prevention
Living tobacco free
SmartHealth
Public Employees Benefits Board (PEBB) Program
PEB Board
Schedules, agendas, & minutes
Archived agendas, minutes, & presentations
Enrollment reports
School Employees Benefits Board (SEBB) Program
File an appeal
Contact the PEBB Program
Help with My Account
Forms & publications
News
Newsletters
Billers, providers, and partners
Washington Apple Health (Medicaid) providers
Enroll as a provider
Eligible provider types and requirements
Enroll as a billing provider
Enroll as a health care professional practicing under a group or facility
Enroll as a nonbilling provider
Enroll as a billing agent/clearinghouse
Next steps for new Medicaid providers
Existing Apple Health (Medicaid) providers
Revalidation
Provider termination and exclusion list
Prior authorization, claims, and billing
Getting started
Document submission cover sheets
Prior authorization (PA)
Claims and billing (guides/fee schedules)
Provider billing guides and fee schedules
Hospital reimbursement
ICD-10 billing codes and implementation
Approved diagnosis codes by program
HIPAA Electronic Data Interchange (EDI)
Indian health programs
Audit and program integrity
ProviderOne resources
ProviderOne Billing and Resource Guide
ProviderOne user manuals
ProviderOne for social services
ProviderOne Security
Fact sheets
Webinars
ProviderOne maintenance
ProviderOne Discovery Log
Programs & services
Program benefit packages and scope of services
Patient review and coordination (PRC)
Autism and Applied Behavior Analysis (ABA) therapy
Behavioral health and recovery
American Indians and Alaska Natives (AI/AN)
Become a behavioral health provider
Child and youth behavioral health services
Early psychosis
Wraparound with Intensive Services (WISe)
Contractor and provider resources
Access to Care Standards (ACS) and ICD information
Medicaid documentation support
Service Encounter Reporting Instructions (SERI)
TARGET
GAIN-SS
Designated crisis responders (DCR)
Peer support
Preadmission screening and resident review (PASRR)
Program of Assertive Community Treatment (PACT)
Substance use treatment
Alcohol use treatment
Medication assisted treatment (MAT)
Opioid treatment programs (OTPs)
Screening, brief intervention, and referral to treatment (SBIRT)
Screening
Brief interventions
Motivational interviewing
Referrals to treatment
Resources
Dental services
Archives
Durable medical equipment (DME)
First Steps (maternity and infant care)
Foster Care
Health Home
Resources
Transportation services (nonemergency)
Ground emergency medical transportation (GEMT)
Interpreter services
Kidney Disease Program (KDP)
Managed care
Model managed care contracts
Resources
Medicaid Administrative Claiming (MAC)
King County Superior Court Juvenile Probation Services
Local Health Jurisdictions
Public school districts
Washington State Federally Recognized Tribes
Correspondence
Pharmacy
Apple Health Preferred Drug List (PDL)
Become an endorsing practitioner
Apple Health (Medicaid) drug coverage criteria
Opioids
Pharmacy prior authorization
School-based health care services (SBHS)
Transgender Health Services Program
Transportation services (nonemergency)
News
Provider Alerts
Provider Alerts 2018
Provider Alerts 2017
Provider Alerts 2016
Provider Alerts 2015
Provider Notices 2014
Provider Notices 2013
Provider Notices 2012
Contact us
Forms & publications
About HCA
Programs & initiatives
Apple Health (Medicaid)
What we're working on
Apple Health dental moving to managed care
COFA Islander Health Care
1095-B tax form
Medicaid suspension
Rate increase for pediatric primary care
Adult hearing benefit
Apple Health for You
News
How we work
Related laws and rules
Medicaid (Title XIX) State Plan
Medicaid Title XIX Advisory Committee
What is the State Plan?
Approved State Plan Amendments
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
Apple Health (Medicaid) reports
Contact Apple Health (Medicaid)
Behavioral health and recovery
What we're working on
Children's Mental Health Lawsuit and Agreement
Medicaid waivers
Ricky’s Law: Involuntary Treatment Act (ITA)
State Youth Treatment - Implementation (SYT-I) Project
Substance abuse prevention and mental health promotion
Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project
Washington State Hub and Spoke Project
Partners
Behavioral Health Advisory Council
Children’s Behavioral Health Data and Quality Team
Children's Behavioral Health Executive Leadership Team (CBH ELT)
Children's Long-term Inpatient Program Improvement Team (CLIP-IT)
Children's Mental Health Workgroup
Cross System Initiatives Team
Office of Consumer Partnerships
Family Youth System Partner Round Table (FYSPRT)
Parent-Initiated Treatment Stakeholder Advisory Group (PIT)
Reports
Evidence-based and research-based practices
Mental health reports
Wraparound with Intensive Services (WISe)
Clinical collaboration and initiatives
What we're working on
Bleeding Disorder Collaborative for Care
Bree Collaborative
Eliminating hepatitis C
ER is for emergencies
OB outcomes
Opioid crisis
Shared decision making
Washington prescription drug price and purchasing summit series
How we work
Partners
Contact us
Health Information Technology
What we're working on
How we work
News
Newsletters
Meetings & materials
Resources
Clinical Data Repository
Electronic Health Records
Operational plan
Contact us
Health Technology Assessment
What we're working on
Health technology reviews
Topic selection
Health Technology Clinical Committee
Clinical experts
Committee members
Recruitment
How we work
Technology selection
Key questions
Evidence report
Coverage decision and meeting
Decision complete
Tracking success
How to participate
Meetings and materials
Calendar
Contact us
Healthier Washington
Voices of a Healthier Washington
Voices
Insights
All stories
Share your story
What we're working on
Accountable Communities of Health (ACH)
Analytics, Research, and Measurement (ARM)
Data dashboards
Health workforce
Medicaid Transformation
Initiative 1: transformation through ACHs
Initiative 2: long-term services & supports
Initiative 3: supportive housing & supported employment
Medicaid Transformation resources
Medicaid Transformation metrics
ACH submitted documents
Paying for value
Integrated physical and behavioral health care
Regional resources
Rural transformation
Resources
Performance measures
Plan for improving population health
Prevention framework
Practice transformation support hub
Shared decision making
Patient Decision Aids (PDAs)
Certified aids
How we work
News
Partners
Health Innovation Leadership Network
How to participate
Healthier Washington Symposium
Medicaid Transformation Learning Symposium
Meetings & materials
Resources
Reports
Contact us
Making informed health care decisions
Program integrity
How we work
Partners
Operations
Related laws and rules
Resources
Contact us
Public Employees Benefits Board (PEBB) Program
What we're working on
1095-C tax form
How we work
News
Operations
How to participate
Meetings & materials
Related laws & rules
Reports
Contact us
School Employees Benefits Board (SEBB) Program
Operations
Meetings and materials
News
School Employees Benefits Board (SEBB) Program FAQs
SEBB fact sheets
FAQs for school administrators
Tribal Affairs
Consultations and meetings
Health care coverage
Resources
What we're working on
Medicaid Transformation
Governor's Indian Health Council
Contact us
Uniform Medical Plan (UMP)
Partners
How to participate
Resources
Washington Prescription Drug Program (WPDP)
How we work
Partners
Tracking success
Participants
How to participate
Become an Endorsing Practitioner
Meetings and materials
Related laws and rules
Resources
Reports
Contact us
Washington Wellness
What we're working on
Build a wellness program
SmartHealth
Diabetes prevention
Living tobacco free
Healthy Worksite Summit
How we work
Tracking success
Meetings & materials
Resources
Physical activity
Healthy eating
Community supported agriculture
Vending
Catering
Farmers market
Preventive care
Flu shot clinics
Family health history
Health fairs
Lunch & learn lectures
Employee Assistance Program (EAP)
Find a wellness coordinator
More resources
Reports
Contact us
Who we are
Our leadership
Our mission, vision, and values
Performance measures
Health care reform
Value-based purchasing
Work with us
Voices of HCA
HCA hosts Camo2Commerce Work Ex intern
Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple
Celebrating HCA’s nurses during National Nurses Week, May 6-12
Community based specialists help people with free or low-cost health care coverage
Introducing new HCA Director Sue Birch
Military experiences shape personal and professional values
Artist turned graphic designer helps HCA create and maintain hundreds of print and web products
Infants at the Workplace Program provides support and flexibility for new parents
Around the world at HCA
HCA goes ‘above and beyond’ for employees with disabilities
Black History Month celebration was a first at HCA
Ryder Andrake retires from HCA’s Infants at the Workplace Program
Careers at HCA
Bids and contracts
News, data, and reports for HCA
News releases
Press room
HCA Connect blog
Public notices
Data & reports
Apple Health (Medicaid) reports
Behavioral health and recovery
Budget information
Dental data
Legislative reports
Public Benefits Board (PEBB) Program enrollment
Reproductive health
Announcements
Connect with us
Rules
Rulemaking
New filings
General Health Care Authority rulemaking
Apple Health (Medicaid) rulemaking
Behavioral health and recovery rulemaking
Public Employees Benefits Board rulemaking
School Employees Benefits Board rulemaking
Upcoming public hearings
Rule notices
Rule notices 2018
Rule notices 2017
Appeals
File an appeal: Apple Health (Medicaid)
File an appeal: PEBB
Board of Appeals
Significant decisions
Policies
Accessibility
Language access
Nondiscrimination statement
Notice of privacy practices
HCA notice of privacy practices
UMP notice of privacy practices
Website privacy policy
Administrative
Disaster outreach
Fraud prevention
Legislative relations
Log in (HCA employees/vendors)
Public disclosure requests
Voter registration
Contact HCA
300 Series reason codes
Announcement Menu
Home
Apple Health Eligibility Manual
Home
Search
Close menu
Search form
Search all of HCA
Search Health care services and supports
Search Billers, providers, & partners
Search Employee & retiree benefits
Search UMP
Search About HCA
Search
Home
About HCA
Contact HCA
In crisis?
Health care services and supports
Forms & publications
News
Contact
Health care services and supports
Apple Health (Medicaid) coverage
Eligibility
Individual adults
Parents/Caretakers
Pregnant women
Children
Noncitizens
Aged, blind or disabled
Aged 65 and older or Medicare eligible
Foster Care
Long-term services and supports (LTSS)/hospice
Medicare Savings Program
Benefits & services
Covered services
Autism & Applied Behavioral Analysis (ABA) therapy
Behavioral health and recovery
Dental services
Health Home
Immunizations
Interpreter services
Medically Intensive Children's Program (MICP)
Pharmacy services
Pregnancy services
First Steps (maternity and infant care)
First Steps provider directory
Chemical-Using Pregnant Women
Take Charge (Family Planning non-Medicaid)
Take Charge provider directory
Transgender Health Program
Transportation services (nonemergency)
Veterans and family members
Apply for or renew coverage
Use my coverage
American Indians and Alaska Natives (AI/AN)
Apple Health managed care
Apple Health client booklets
Enrollment next steps
Make my first appointment
Update my income or address (report a change)
Change my health plan
Replace my services card
Cancel my coverage
Voices of Apple Health
Access to housing, employment and health care gives Yakima resident a second chance
Cancer patient lives a quality life thanks to Apple Health
New mother and baby have healthy start thanks to Apple Health
Apple Health covers medically necessary surgery when other insurance wouldn’t
Apple Health leads the way to a better life for autism spectrum disorder (ASD) client
Apple Health for Kids provides relief for new parents
Access to health care allows student to pursue education stress-free
Children’s Health Insurance Program (CHIP) keeps health care affordable for families
Helping Apple Health (Medicaid) clients when they need it most
Apple Health gives life to those with chronic disease
Mother and daughter have a better life because of Apple Health
Apple Health provides otherwise unaffordable, life-saving medication for HIV patient
Apple Health outreach staff help spread the word about free and low-cost health insurance
Apple Health and community partners help improve the health of the Latino population in Washington
Apple Health brings stability to lives of young couple
I can’t begin to explain how much Apple Health has helped me
I wouldn’t be able to afford health insurance otherwise
We were not alone in this awful process
Getting the help I so desperately needed
Apple Health gives me a sense of security
Helping people navigate their way to Washington Apple Health
Apple Health has given her such peace of mind
Stakeholder training and education
Community-based training
Reference guides
Webinars, video and presentations
Outreach toolkit
COFA outreach toolkit
Hospital Presumptive Eligibility
Medicaid suspension
Contact Washington Apple Health (Medicaid)
Forms & publications
Behavioral health and recovery
American Indians and Alaska Natives (AI/AN)
Child and youth behavioral health services
Frequently asked questions (FAQs)
Signs of early psychosis
Wraparound with Intensive Services (WISe)
Client rights
Ombuds services
Behavioral health facility complaints
Mental health services
Acute mental health care (inpatient)
Frequently asked questions (FAQs)
Mental health advance directives
Mental health crisis lines
Peer support
Problem gambling
Recovery support
Substance use treatment
Alcohol use treatment
Opioid use treatment
Trainings and events
Prescription assistance
Programs
Alternate help with prescriptions
Program Administration
Apple Health eligibility manual
General eligibility requirements that apply to all Apple Health programs
Classic (non-MAGI) based programs manual
Modified Adjusted Gross Income (MAGI) based programs manual
Long-term services and supports (LTSS) manual
Apple Health (Medicaid) manual WAC index
Coordination of benefits
Patient review and coordination
Premium payment program
News
News
Search
Apply
Jul
17
2018
Reasonable Opportunity Periods Medicaid State Plan Amendment 18-0031 Public Notice
Jul
16
2018
Treat and Refer Services Medicaid State Plan Amendment 18-0024 Public Notice
Jun
4
2018
New Medicare cards coming
Apr
30
2018
Welcome to Washington Apple Health booklets have moved online!
Aug
10
2017
Follow us on social media!
Dec
23
2016
Health Home program addition to King and Snohomish counties delayed
News release
Feb
9
2016
State notifies 91,000 Apple Health (Medicaid) clients of data breach by Health Care Authority employee
News release
In crisis?