Washington Apple Health Integrated Managed Care (IMC)

Medicaid

Our plan offers a range of physical and behavioral health 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) Integrated Managed Care. We serve pregnant women, children and young adults to age 21, families and adults.

Island, King, Pierce, San Juan, Skagit, Snohomish, and Whatcom.

Dagiti Benepisyo ken Paset ti Plano

Taripato para ti Nakaradkad ken Agsakit

Get the assistance you and your family needs to stay healthy, to get better if you are injured or sick or — simply achieve your potential. 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.

Ti Salun-at ti Tig-tignay ket napateg kas iti salun-at a pisikal. Isu a sakupenmi dagitoy nga agpada. You have access to mental health and substance use disorder treatment services, known together as behavioral 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.

Talk to your PCP today about any health or behavioral health problems you have. Your PCP will refer you to a behavioral health provider with UnitedHealthcare Community Plan. They can refer you to specialists, and other facilities, such as hospitals and substance abuse and treatment services.

You don't need a referral from your PCP to see behavioral health specialists in your plan or to access drug and treatment services.

There are some treatments and services that need preapproval before you can get them. To learn more, talk to your doctor.

Search for a Mental Health Clinician or Facility

Required care is 100% covered. If you need behavioral health care, your PCP and UnitedHealthcare Community Plan can help coordinate your care.

Sakupen mi:

  • Evaluation and assessment
  • Medication management and monitoring
  • Individual and group counseling
  • Peer support
  • Family counseling
  • Education about mental health, treatments and medications
  • Rehab case management
  • Withdrawal management (detox)
  • Opiate replacement treatment
  • Panagimaton ti kaso

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

You may also be eligible for additional grant funded services such as care coordination, family hardship services and recovery support services. These provide comprehensive community-based services that supplement your current benefits.

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.

Member Handbook (English)
Member Handbook (Español)
Member Handbook (Russian)
Member Handbook (Chinese)
Member Handbook (Vietnamese)

What if I have a behavioral health crisis?

You are always covered for a behavioral health emergency. An emergency means a behavioral health condition that comes on suddenly, is life threatening, is painful, or other severe symptoms that cannot wait to be treated. You may have a mental health, drug, or alcohol use emergency.

Emergency services are covered anywhere in the United States. If you think you have a life threatening emergency, call 911 or go to the nearest hospital location where emergency providers can help you.

As soon as possible, call us to arrange for follow-up behavioral health care after an emergency.
A mental health crisis is a moment when someone's behavior can put themselves or others in danger, especially if they do not get help, such as:

  • Threatens to or talks about hurting or killing themselves
  • Feels hopeless
  • Feels rage or uncontrolled anger
  • Feels trapped, like there is no way out
  • Engages in reckless behaviors
  • Feels anxious, agitated, or unable to sleep
  • Increases alcohol or drug use
  • Withdraws from friends and family
  • Encounters dramatic mood changes
  • Sees no reason for living

Crisis Services:
If you think you have an emergency, no matter where you are, call 911 or go to the nearest hospital location where emergency providers can help you. As soon as possible, call your doctor or behavioral health provider to arrange for follow-up care after the emergency is over.

If you are experiencing a mental health crisis, your ID card has a phone number to access crisis services in your area. Our list of crisis services phone numbers are available in English and Español

Here are additional Behavioral Health Services and Crisis Intervention Contacts:

For a State Crisis Lines directory, visit: https://www.dshs.wa.gov/state-mental-health-crisis-lines

Washington Recovery Help Line: 1-866-789-1511
Online: http://www.waRecoveryHelpLine.org

Teen Link: 1-866-833-6546
Online: http://www.866teenlink.org

Suicide Prevention: 1-800-273-8255
TTY Users: 1-800-799-4TTY (4889)
Online: http://www.suicidepreventionlifeline.org

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

Member Handbook (English)
Member Handbok (Español)
Member Handbook (Russian)
Member Handbook (Chinese)
Member Handbook (Vietnamese)

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.
  • Baby Blocks™. Reminds and rewards pregnant women and new mothers. 9 rewards in all.

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:

  • Help manage your physical and mental health care needs.
  • Work with your physician, behavioral health specialists and outside agencies.
  • 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:

  • Make sure you have support at home.
  • Connect you to the social services you may need.

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.

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.

Choose a Birth Center

Nu sadino ti paganakam ket napateg a pangngeddeng. That's why you can pick from 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 will have a primary care physician (PCP) who will be your main doctor. Your PCP is the person you should see for most of your care. This includes checkups, treatments, vaccinations, minor injuries and health concerns. Talk to your PCP about any behavioral health concerns you may have. Your PCP can help you decide the right options for 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.

Usaren ti Panagbirok iti Doktor a tool tapno makitam no ti doktormo ket adda iti networkmi. Nu awanan ka iti doktor wenno nu iti doktormo ket di kabilang iti network, matunlungandaka nga agsapol iti baro nga asideg kenyam.

Diabetes Support

If you have diabetes, we'll help make life a little easier for you. Makaalakanto iti agas, suplay ken edukasion a tumulong tapno maragpat ken agtalinaedka iti kasayaatan a kasasaad. 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. Mabalin a mairaman ditoy dagiti suplay kas koma iti:

  • Katre ti ospital.
  • Tangke ti oxygen.
  • Wheelchair wenno walker.

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. This program will support you through your pregnancy. 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 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. Mabalin pay a masapulmo ti medikal a panagbisita iti uneg ti pagtaengan tapno ammuen no umim-imbagka met laeng. No maaprubaran, sakupen ti planomi ti:

  • Medikal a panagbisita iti uneg ti pagtaengan.
  • Medikal a ramit kas koma dagiti katre ti ospital, walker wenno wheelchair.
  • Dagiti disposable a medikal a suplay.
  • Tulong iti personal a pannakataripato wenno panagtagibalay.

Pannakaospital

This plan pays for all expenses related to a hospital stay, so you 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.

Dagiti mangipatarus ti pagsasao

Masapul nga agkinnaawatankayo iti doktormo. Narigat daytoy no saanka a makasao ti Ingles a nalaing. Mabalinmi nga urnosen ti medikal a mangipatarus ti pagsasao a kaduam kadagiti appointmentmo.

Adda pay empleadomi kadagiti serbisio para iti miembro a makasao iti nasurok ngem maysa a lengguahe. Chances are, we have someone who speaks your language or they can connect you with our interpreter service which covers more than 170 languages.

Pannakataripato ti Sakit iti Kidney

Ti sakit iti kidney ket serioso a medikal a kondision. 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.
  • Ag-agas.
  • Edukasion iti salun-at ken suporta.
  • Pannakai-transplant ti organ no kasapulan.

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.

We'll help you get the information needed to improve your health or be at your best.

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.

Dagiti Serbisyo para ti Kameng

No dadduma mabalin a masapulmo ti bassit a tulong tapno maawatam dagiti pagpilian para iti pannakataripato ti salun-atmo. Babaen kadakami, adda namnamaem a matawagam. We’ll answer your questions simply and completely.

Mabalin mi pay sika a tulongan a mangsapul:

  • Mangipapaay pannaripato iti pagtaengan.
  • Dentists and vision providers.
  • Adult Day Health Centers.

Dagiti Agas

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.

Mental Health Services for Children and Youth

Problems such as depression and anxiety can also be challenging for children and teens.

There are no costs for covered services. We have therapists and doctors for youth and teens that can address their specific behavioral health or substance use. Help get them extra support to live a heathier life.

Look for behavioral health providers or call 1-877-542-8997, TTY 711.

Additional Resources

Teens can connect with teens during specific hours: 866-833-6546, teenlink@crisisclinic.org, www.866teenlink.org

No Cost for Covered Services

Get the quality health care you deserve at no cost for covered services. Makaalaka:

  • Care from highly skilled and compassionate doctors.
  • 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).

Dagiti narsmi ket:

  • Listen to symptoms.
  • Tumulong iti panangtaripato iti bukod a bagi.
  • 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.

Dagiti Panagbisita ti Nars

No dadduma masapul ti agtultuloy a pannakataripato kalpasan iruruar iti ospital wenno lugar ti maganat a pannakataripato. Kas pangarigan, kalpasan ti panagsakit iti nakaro, operasion wenno pannakadangran. Kadagitoy a kaso, bumisita ti nars iti pagtaengan tapno:

  • Mangipaay ti medikal a pannakataripato.
  • Sungbatan ti aniaman a saludsod wenno pakaseknan.

Personal a Pannakataripato

No maminsan narigat nga aramiden dagiti kangrunaan para iti bukodmo a bagi kalpasan ti panagsakit wenno pannakadangran.

No kasapulam, mangipaay kami iti maysa a tao a tumulong iti:

  • Panagsukat ti bago.
  • Panagdigos.
  • Pannangan.

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:

  • Help manage your physical and mental health care needs.
  • Work with your physician, behavioral health specialists and outside agencies.
  • 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:

  • Make sure you have support at home.
  • Connect you to the social services you may need.

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.

Amin dagiti nairekomendar a klinikal a panagbisita ti masikog ken eksamen ket sakupen ti planomi.

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

Kalpasan ti panagsakit iti nakaro, operasion wenno pannakadangran, mabalin a masapulmo ti ekstra a pannaripato ken terapi.  No kasapulan, sakupen ti planomi dagiti apagbiit a panagtalinaed iti sentro ti rehabilitasion no sadino a makapaimbagka.  Mairaman dagiti sumaganad:

  • Serbisio a pannaripato iti pagtaengan.
  • 24-nga-oras a pannaripato ti nars.
  • Tulong kadagiti aktibidad ti inaldaw a panagbiag.
  • Speech, physical ken occupational therapy.

Panangisardeng ti Panagsigarilyo

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.

Indieksion ken Bakuna

Tumulong dagiti kadawyan nga indieksion tapno maprotektaranka manipud iti sakit.

Isu a sakupen ti planomi:

  • Dagiti mairekrekomendar nga indieksion ken bakuna.
  • Dagiti bakuna iti trangkaso.

Dagiti Serbisio a Terapiya

Makatulong ti physical, occupational ken speech therapy tapno umimbagka manipud iti nakaro a pannakadangran wenno panagsakit, wenno tapno magun-odmo ti pagpatinggaan ti kabaelam.

Ipaay ti planomi ti:

  • 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. Makatulong dagitoy a panagbisita tapno matakuatan a nasapa dagiti problema iti salun-at, tapno maagasan dagitoy. Dagiti serbisyo ti panagsakbay ket kairamanan ti:

  • Checkups children.
  • Screenings for adults.
  • Pannakataripato ti nasalun-at a maladaga.
  • Pannaripato para kadagiti babbai a masikog.
  • Kadawyan a bakuna ken pannakaeksamen.
  • Dagiti Mammogram.

Awan ti copayment para iti pannaripato tapno maliklikan ti sakit.

Dagiti Pamuspusan ti Kameng

Dagiti Pamuspusan ti Kameng

Ammoen ti Ad-adu pay

Washington Apple Health Integrated Managed Care (IMC)

Kitaen ti Pannakaikari

Panagpalista

Call to enroll today.

Monday through Friday, 8 am to 5 pm PT

1-877-542-8997
TTY: 711

Learn about the steps to enroll.

Dagiti Saludsod

Maysakan a kameng?

Makastrekka iti website a para laeng ti kameng. Print ID cards and more. View our handbook below.

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