Washington Apple Health Medicaid

Medicaid

Our plan offers a range of benefits. View the benefits below to see all that it offers. It's for people who meet income requirements and are eligible for Washington Apple Health (Medicaid), including pregnant women, children and young adults to age 21, families and adults.

To find out if you qualify, visit wahealthplanfinder.org or call 1-855-WAFINDER (1-855-923-4633) TTY/TTD 1-855-627-9604.

We can also assist with interpreter services, including American Sign Language. To ask for help, please call 1-877-542-8997, TTY 711, Monday through Friday, 8:00 a.m. to 5:00 p.m.

Clallam, Cowlitz, Grays Harbor, Jefferson, Kitsap, Lewis, Mason, Pacific, Thurston, and Wahkiakum.

Dagiti Benepisyo ken Paset ti Plano

Umno a kababalin

Ti Salun-at ti Tig-tignay ket napateg kas iti salun-at a pisikal. That's why we have coverage for both. You are eligible for behavioral health services, also called mental health services. Behavioral health services can help you with personal problems that may affect you and your family. These problems may be stress, depression, anxiety or using drugs or alcohol.

Your PCP might think your behavioral needs are better served through services covered by a Behavioral Health Organization at a Community Mental Health or Substance Use Disorder Services agency. If so, your PCP will send you there for an evaluation. If the evaluation results determine you need this level of service, you may continue to get your behavioral health care from the Agency.

Search for a Mental Health Clinician or Facility

Required care is 100% covered with no copay.  If you need behavioral health care, your PCP and UnitedHealthcare Community Plan can help coordinate your care.

We:

  • Cover assessment for mental health services and treatment such as counseling, testing, and medications for addressing mental health symptoms.
  • Cover lower and mid-level intensity treatment.
  • Provide screening for substance use disorder and may make a referral to either a plan covered service or a community provider for further assessment.

For more information on services available, please refer to your Member Handbook

Additional health resources can be found here. Find the balance, support and care you need to live the healthiest life possible.

You can also contact the Washington Recovery Help Line at 1-866-789-1511 or visit https://www.warecoveryhelpline.org. 24-Hour Help for Substance Abuse, Problem Gambling & Mental Health.

If you need help finding mental health services or if you feel that your rights have been violated, please call your Regional Behavioral Health Ombuds. An Ombuds is someone who is hired to assist you with any difficulties with your services or with getting services. Services are free and all information is kept confidential.

Get the care you need to stay healthy – or to get better if you are injured or sick. That includes:

  • Pannakaospital. Awan pulos ti bayadam para ti taripato ti ospital.
  • Lab ken X-rays. Dagiti eksamen ti lab, x-rays ken diagnostic imaging ket masakupan.
  • Therapy Services. Therapy visits to help you recover or achieve your potential.
  • NurseLineSM. Speak with a registered nurse 24/7.
  • Dagiti Panagbisita ti Nakaradkad. Annual checkups and screenings (for those under 21) to help keep you or your family healthy.
  • Taripato ti Saka. More covered visits to keep your feet healthy.
  • Shots and Vaccines. Routine shots to help protect against illness.
  • No Copays. You pay nothing for doctor visits or prescriptions.

Awan ti napatpateg ngem nu di ti salun-at ken karadkadyo nga agina. That's why our plan benefits include:

  • Panagpili ti Paganakan. Pick from a large network of hospitals across Washington.
  • Panagpili ti Doktor. Find a doctor or OB/GYN you trust in our network.
  • Dagiti Umuna a Nasalun-at nga Addang®. Ti kanayonan a suporta para kenka ken ti maladagam tapno agtalinaed kayo a nasalun-at. Free breast pumps available for eligible members.
  • Panagbisita sakbay nga aganak. Taripato para kenka sakbay nga aganak ka.
  • Healthy Rewards Gift cards for prenatal and postpartum doctor visits.

If you have asthma, diabetes or another health condition, you can depend on us. Our plan makes sure you get the care and services you need. Dagiti benepisyo ket kairamanan ti:

  • Asthma and COPD Care. Exams, testing and supplies are covered.
  • Diabetes Support. Medicine, needles and more for managing diabetes.
  • Kidney Disease Care. Dialysis, medicine and treatments are covered.
  • Salun-at ti Panunot. Testing, medication and treatments are covered.
  • Personal Care Manager If you qualify, get personal help managing health conditions.
  • Residential Care. Brief stay at a care facility while you recover from sickness or injury.

Siguradoen nga iti panagkitam ken panagdengngeg mo ket nasayaat da. Dagiti benepisyo ket kairamanan ti:

  • Hearing. Exams and testing are covered, as well as hearing aids for enrollees.
  • Vision. Eye exams every twenty-four months for adults and once every twelve months for children and age 21. Eyeglasses, contact lenses, and hardware fittings are covered separately under the Apple Health fee-for-service program.

Get the medical care and equipment you or a family member needs to recover or live at home. Dagiti benepisyo ket kairamanan ti:

  • Personal Care. Someone to help with dressing, bathing and dining.
  • Makinarya ken dagiti Suplay. In-home medical and safety equipment is covered.
  • Home Health Care. Medical and personal care at home, if needed.

Do you or a family member have a serious health problem? If your health needs qualify then our care managers are in your corner. They will:

  • Explain medical terms in plain language.
  • Coordinate your doctor appointments.
  • Provide your care team with your medical records.

Your care manager will stay with you throughout the medical journey. He or she will:

  • Think beyond your medical needs.
  • Make sure you have support at home.

View Advance Directives in English | Español.

Get extra benefits and support. You can rely on:

  • Healthy Rewards. Earn rewards for completing important preventive services.
  • Panagadal maipanggep ti Salun-at. Free coaching to help improve your health.
  • Tulong para ti Lenggwahe. Connect to a translator through Member Services.
  • Interpreters. Have an interpreter with you at your child’s doctor visits.
  • Programs for Kids and Teens. Free Boys & Girls Club memberships.
  • Panangisardeng ti Panagsigarilyo. Coaches and supplies to help you quit using tobacco.
  • Dagiti Serbisyo para ti Kameng. Your benefit questions are answered 24/7.
  • Dental. Services and annual exams are covered separately under the Apple Health fee-for-service program.

Asthma and COPD Support

Individual care to help control your child's asthma.

Does your child have trouble managing asthma or COPD symptoms? A nurse who specializes in breathing issues can really help. Your child will get a customized treatment plan and medicine to:

  • Manage flare-ups.
  • Reduce symptoms.
  • Let your child stay active.

Umno a kababalin

Ti Salun-at ti Tig-tignay ket napateg kas iti salun-at a pisikal. That's why we have coverage for both.

Required care is 100% covered with no copay. This includes:

  • Testing and diagnosis.
  • Therapy ti Tig-tignay.
  • Medication.

Choose a Birth Center

Nu sadino ti paganakam ket napateg a pangngeddeng. That's why you can pick from a large network of hospitals all across Washington.

We also encourage you to tour the hospital's birthing center. Ta iti kastoy ket masanay ka iti dayta. And you'll be more relaxed when you have your baby.

Ti Panagpili ti Doktor

You get a primary care physician (PCP), who is your main doctor. Use the Doctor Lookup tool to see if your doctor is in our network.

If you don't have a doctor or if your doctor is not in our network, we can help you find a new one close to you.

Iti PCPim ket iti kangrunaam nga doktor para:

  • Managlapped a taripato.
  • Panagagas nu sika ket agsakit wenno nadunor.
  • Kadagiti reperal kadagiti espesyalista para ti maipadung nga kondisyon.

Diabetes Support

If you have diabetes, we'll help make life a little easier for you. You'll get medicine, supplies and education to help you reach and stay your best. You are also rewarded with gift cards for taking simple steps to manage your diabetes.

Our diabetes program also includes self-care training and classes focused on:

  • Planning healthy meals.
  • Managing stress.
  • Living a healthy lifestyle.

Equipment and Medical Supplies

Ti salun-at mo ken kinatalged mo iti pagtaengan ket napateg.

Our plan covers medical equipment ordered by your doctor or case manager. This can include supplies like:

  • Katre ti ospital.
  • Oxygen tanks.
  • Wheelchairs or walkers.

Taripato ti Saka

If you have diabetes or a circulatory condition, good foot care can help prevent much more serious problems. We provide the needed exams to help keep your feet in great shape.

Iti masakupan ti podiary a serbisyo iramanna iti:

  • Routine foot exams.
  • Singasing panggep iti panagtaripato ti saka ken panagpili iti umno a sapatos.
  • Impormasyon panggep kadagiti patigmaan nga senyales ti panagdadael iti urat.

Panagadal maipanggep iti salun-at

Free coaching to help improve your health or to address a condition. Our plan includes coaching on diabetes, nutrition and more. You can even get a ride, if needed, to and from the class at no cost to you.

Umuna nga Addang wenno Healthy First Steps®

When you're pregnant, you receive help and advice from your mom, aunts, sisters and girlfriends. Nupay kasta, tunggal panagsikog ket sabali. Daytoy a programa ket suportarannaka bayat ti panagsikog mo. Get pregnancy and parenting support by calling (toll-free) 1-800-599-5985 (TTY 711).

We can help you:

  • Find a doctor for both mother and baby.
  • Learn about resources for nutrition, fitness and safety.
  • Get supplies, including breast pumps for nursing moms.

Taripato ti Panagdengngeg

Ti parikut ti panagdengngeg ket apektaran na ti inaldaw a biag mo iti nadum-duma a wagas. Ti plano mi ket kairamanan dagiti serbisyo ken suporta a makatulong a mangprotekta ti panagdengngeg. We cover exams and testing, as well as hearing aids for enrollees.

Home Health Care

After surgery or a serious illness—or if you have a disability—you may need extra help with day-to-day tasks. You may even need an in-home medical visit to check on how well you are healing. With approval, our plan covers:

  • An in-home medical visit.
  • Medical equipment like hospital beds, walkers or wheelchairs.
  • Disposable medical supplies.
  • Help with personal care or housekeeping.

Pannakaospital

This plan pays for all medically necessary expenses related to a hospital stayall can rest and heal.

Ti plano mi ket sakupen na:

  • Ti Nursing care.
  • Ti kwarto ken makan.
  • Dagiti suplay ken makinarya.
  • Panagagas ken dagiti therapy.
  • Dagiti eksamen a diagnostic.

Ken kalpasan a rumwar ka ti ospital, saan ka nga agmaymaysa. Siguradoen mi nga adda ti follow-up a taripato tapno agtultuloy ka nga agimbag iti pagtaengam.

Interpreters

Your doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to be at your appointments.

We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language or they can connect you with our interpreter service which covers more than 170 languages.

Kidney Disease Care

Kidney disease is a serious medical condition. After the kidneys stop working, regular treatments, called renal dialysis or an organ transplant are needed to live. Dialysis uses a machine to clean the blood just like healthy kidneys do.

Ti planomi iramanna dagiti:

  • Dialysis.
  • Medications.
  • Health education and support.
  • Organ transplant if needed.

Lab ken X-rays

Ti panagammmo nu ania iti parikut ken panagduktal iti daytoy ti nasapa ket nalabit a makaaramid ti dakkel a pagdumaan. Ti plano mi ket sakupen na:

  • Dagiti Lab ken eksamen.
  • Dagiti X-rays, scans ken dadduma nga imaging.

Tulungandaka nga mangala iti impormasyon a kasapulam tapno maparang-ay ti salun-at wenno tapno addaka ti nasayaat a kasasaad.

Tulong ti Lenggwahe

You can receive information in your preferred language. Agdamag ka laeng. We also have people at our customer service centers who speak more than one language. Chances are, we have someone who speaks your language or they can connect you with our interpreter service which covers more than 170 languages.

Medicines

Our plan includes prescription drugs and refills with no copays. Masakupan mi pay dagiti agas a magatang nga awan reseta na ngem addaan nakasurat nga ballakad ti doktor mo.

And we make getting your medicine easy. You can fill your prescriptions at:

  • Local pharmacies.
  • Services that deliver routinely right to your door.

Dagiti Serbisyo para ti Kameng

Sometimes you might need a little help understanding your health care options. With us, you have someone you can call. We’ll answer your questions simply and completely.

Mabalin mi pay sika a tulongan a mangsapul:

  • Home care providers.
  • Dentists and vision providers.
  • Adult Day Health Centers.

No Copays for Doctor Visits or Prescriptions

While your health care is low-cost or free, the care quality is high. Makaalaka:

  • Care from highly skilled and compassionate behavioral health providers.
  • Treatments at respected hospitals and clinics.
  • Home medical equipment and supplies to help you be at your best.

NurseLine℠

Medical questions and situations sometimes happen at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week: 1-877-543-3409 (TTY 711).

Our nurses will:

  • Listen to symptoms.
  • Help with self-care.
  • Balakadan naka maipapan ti panangalam ti taripato iti panagbisitam iti doktor mo wenno iti urgent care center.
  • Tulongan naka a mang-ammo nu kaano ka a mapan ti emergency room.

Nurse Visits

Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:

  • Provide medical care for you.
  • Answer your questions and concerns.

Personal Care

Sometimes the basics are hard to do yourself after an illness or injury.

If needed, we provide someone to help with:

  • Dressing.
  • Bathing.
  • Feeding.

Personal Care Manager

Do you or a family member have a serious health problem? If your health needs qualify then our care managers are in your corner. They will:

  • Explain medical terms in plain language.
  • Coordinate your doctor appointments.
  • Provide your care team with your medical records.

Your care manager will stay with you throughout the medical journey. He or she will:

  • Think beyond your medical needs.
  • Make sure you have support at home.

Programs for Kids and Teens

Kids with positive role models make more healthy choices. That's why we provide free memberships to the Boys & Girls Clubs in your area.

Along with fun and games, these clubs offer help with:

  • Homework.
  • Mentoring.
  • Coaching.

Panagbisita Sakbay ti Panaganak.

Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN. With our plan, you will also be rewarded with gift cards for prenatal and postpartum doctor visits.

All recommended prenatal clinical visits and tests are covered by our plan.

Kadagitoy a panagbisita, ti klinika ket:

  • Make sure both you and your baby are healthy.
  • Ipalawag nu ania ti namnamaem kada lebel ti panagsikog mo.
  • Sungbatan dagiti saludsod mo.

Residential Care

After a serious illness, surgery or injury, you may need extra nursing and therapy.

If needed, our plan covers short stays in a rehabilitation center where you can heal. Included are:

  • Nursing home services.
  • 24-hour nursing care.
  • Help with activities of daily living.
  • Physical, occupational and speech therapy.

Quitting Tobacco

You know the bad health effects of smoking. You know you need to quit. We support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture. Call 1.866.QUIT.4.LIFE (1.866.784.8454) Or visit www.quitnow.net.

Shots and Vaccines

Routine shots help protect you from illness.

So, our plan covers:

  • Recommended shots and vaccines.
  • Influenza shots.

Therapy Services

Physical, occupational and speech therapy can help you recover from a serious injury or illness, or simply reach your full potential.

Our plan provides:

  • Okupasyonal a therapy.
  • Pisikal a therapy.
  • Therapy ti panagbalikas.
  • Therapy ti pagnaedan.

Pagluganan

Get a ride – at no cost to you - to and from health care locations. That includes trips to:

  • Doctor or therapy visits.
  • Vision clinics.
  • Dagiti sentro iti naganat a taripato.

Apple Health pays for transportation services to and from needed non-emergency health care appointments. If you have a current ProviderOne Services Card, you may be eligible for transportation. Call the transportation provider (broker) in your area to learn about services and limitations. Your regional broker will arrange the most appropriate, least costly transportation for you. See the list of brokers

Taripato ti Panagkita

You'll get the care and treatment that let you see life more clearly. Iraman ti masakupan iti:

  • Eye exams every twenty-four months for adults and once every twelve months for children and age 21. Eyeglasses, contact lenses, and hardware fittings are covered separately under the Apple Health fee-for-service program.
  • Annual eye exams for members to age 21.

Dagiti Panagbisita ti Nakaradkad

Well visits with your doctor can help you stay healthy. Dagitoy a panagbisita iti doktor mo ket mabalin a makatulong tapno agtalinaed ka a nasalun-at. Dagiti serbisyo ti panagsakbay ket kairamanan ti:

  • Checkups for adults and children.
  • Well-baby care.
  • Care for women expecting a baby.
  • Routine shots and tests.
  • Dagiti Mammogram.

There are no copayments for preventive care.

Dagiti Pamuspusan ti Kameng

Kitaen dagiti Mabalin a Mausar a Pamuspusan
Kitaen ti Pannakaikari

Panagpalista

Call to enroll today.

Monday through Friday 8 am to 5 pm PT

1-877-542-8997
TTY: 711

Dagiti Saludsod

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