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        • Voices of Apple Health
          • Apple Health for Kids provides relief for new parents
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          • Children’s Health Insurance Program (CHIP) keeps health care affordable for families
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          • 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
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        • Apple Health eligibility manual
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    • Uniform Medical Plan (UMP)
      • Plan: Uniform Medical Plan Classic
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          • How UMP and Medicare work together
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      • Plan: UMP Consumer-Directed Health Plan (UMP CDHP)
        • Find providers
        • Your cost for care
          • Annual deductible
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          • Knee and hip replacement
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        • 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
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        • Your cost for care
          • Annual deductible
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    • Employee and retiree benefits
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          • Waiving medical coverage
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        • Dental plans & benefits
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        • Additional benefits
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          • Paying for benefits
        • Surcharges
          • Tobacco use surcharge
          • Spousal coverage surcharge
            • Spousal plan questionnaire 2018
            • 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
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        • Contact the plans
      • School employees
        • Eligibility and enrollment
        • Medical plans and benefits
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        • Additional benefits
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      • Retirees
        • Eligibility & enrollment
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            • Retiring from a DRS retirement plan
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            • COBRA
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            • 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
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          • Medical plans available by county
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        • Dental plans & benefits
          • Compare dental plans
        • Additional benefits
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          • Non-Medicare plan premiums
          • Medicare plan premiums
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          • Paying for benefits
        • Surcharges
          • Tobacco use surcharge
          • Spousal coverage surcharge
            • Spousal plan questionnaire 2018
        • Medicare & PEBB Program benefits
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      • Continuation coverage
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          • How to determine eligibility
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          • Health plans with health savings accounts (HSAs) (non-Medicare)
        • Dental plans & benefits
          • Compare dental plans
        • Additional benefits
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          • Long-term disability insurance (unpaid leave only)
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        • Plan costs
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          • Long-term disability insurance premiums (unpaid leave only)
          • Paying for benefits
        • Surcharges
          • Tobacco use surcharge
          • Spousal coverage surcharge
            • Spousal plan questionnaire 2018
        • Change your coverage
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        • Cancel your coverage
        • Frequently asked questions (FAQs)
        • Contact the plans
      • For groups joining the PEBB Program
        • How to join the PEBB Program
          • Employer groups
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        • Plan costs
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      • Wellness programs
        • Diabetes prevention
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        • SmartHealth
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      • Help with My Account
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    • Billers, providers, and partners
      • Washington Apple Health (Medicaid) providers
        • Enroll as a provider
          • Eligible provider types and requirements
          • Enroll as a billing provider
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          • Next steps for new Medicaid providers
        • Existing Apple Health (Medicaid) providers
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      • Prior authorization, claims, and billing
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          • Document submission cover sheets
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          • Provider billing guides and fee schedules
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          • ICD-10 billing codes and implementation
            • Approved diagnosis codes by program
        • HIPAA Electronic Data Interchange (EDI)
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      • ProviderOne resources
        • ProviderOne Billing and Resource Guide
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      • 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
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        • First Steps (maternity and infant care)
        • Foster Care
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        • Ground emergency medical transportation (GEMT)
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          • Interpreter services reports
        • 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
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          • Washington State Federally Recognized Tribes
          • Correspondence
        • Pharmacy
          • Apple Health Preferred Drug List (PDL)
          • Become an endorsing practitioner
          • Apple Health (Medicaid) drug coverage criteria
          • Opioids
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        • School-based health care services (SBHS)
        • Transgender Health Services Program
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            • State Youth Treatment - Implementation (SYT-I) Project
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            • Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project
            • Washington State Hub and Spoke Project
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      • Work with us
        • Voices of HCA
          • 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
          • HCA gives employees a healthy foundation to do great work
          • 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
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Program administration

Find information about the Apple Health Eligibility Manual, coordination of benefits, patient review and coordination, and fraud prevention.

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  • Share your Apple Health story
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In this section

  • Apple Health eligibility manual
  • Apple Health (Medicaid) manual WAC index
  • Coordination of benefits
  • Patient review and coordination
  • Premium payment program

How do I...

  • View Washington Apple Health eligibility WACs
  • Report if I have other health insurance

Related links

Apple Health (Medicaid) reports

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