Find the phone number of an Ombuds in your area. If you have managed care, you also receive a health plan / member ID card specifically for their coverage. Spenddown in this example would be $900.00 for a 3 month … Washington Apple Health is an umbrella term or “brand name” for all Washington State medical assistance programs, including Medicaid. You may also call 1-855-923-4633. If you've missed the deadline to renew, but you would like to continue coverage, please contact us as soon as possible. Find a provider. Learn more about your customer service options. ... Find resources and information about COVID-19 vaccines in the state of Washington. Find an Apple Health dental provider near you. Learn more about your customer service options. These include mental health services and drug or alcohol treatment. The Academy of Pediatric Dentistry (AAPD) recommends all children see a dentist by 12 months of age. Pregnant or applying for someone who is pregnant. 42 C.F.R. You'll be auto-enrolled into an Apple Health managed care plan. Free or low-cost coverage is available year round. Apple Health (Medicaid) pays for covered dental services for eligible children, age 20 and younger. Most Washington Medicaid members will be enrolled in an Apple Health Managed Care Plan. Furthermore, emphasis will be specifically on long-term care, whether that be provided in ones home, a nursing home, an adult f… See if you qualify for or renew your Apple Health managed care. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, 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, 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, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, How to apply for or renew MAGI Medicaid coverage, How to apply for or renew Classic Medicaid coverage, Application for health care coverage (18-001P), Application for aged, blind, disabled/long-term care coverage (HCA 18-005), Application for aged, blind, disabled/long-term care coverage, Application for Apple Health (Medicaid) health care coverage, Website feedback: Tell us how we’re doing. EXAMPLE : A client has $300.00 per month is excess income. In Washington State, Medicaid is called Apple Health. Usually, no. Evergreen Recovery offers CARF-accredited addiction and … Apple Health (Medicaid) coverage In Washington State, Medicaid is called Apple Health. Apply for Apple Health (Medicaid) coverage through Washington Connection. Coverage will begin on the first day of the month in which the application was submitted. Learn More About. If you are eligible, you can go to any dental providers who contract with Washington State Medicaid. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, 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, 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, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, Developmental Disabilities Administration (DDA), Find an Apple Health dental provider for children (InsureKidsNow), Find a dental provider for children (InsureKidsNow), Website feedback: Tell us how we’re doing. Molina Healthcare Apple Health (Medicaid) provides quality free or low-cost health care for your family. In the State of Washington, Medicaid is called Apple Health. Due to COVID-19, HCA’s lobby is closed. If you are a biller, provider, or partner: visit our Billers, providers, and partners webpage. If you or someone you know is experiencing a mental health, substance use or problem gambling crisis please call (866) 789-1511 or click here Coverage will begin on the first day of the month you submitted your application. Medicaid is a federal and state government health coverage program available to individuals who meet the income and resource limits. (The Department of Social and Health Services administers Apply for Apple Health (Medicaid) coverage through Washington Healthplanfinder. Anyone between ages 19 to 65, who meets income standards, is eligible. Orthodontic services are available for children with cleft palate or other serious dental problems (covers medically necessary services with prior authorization). As of publication, that's an annual income of $15,856 for a single individual, $21,404 for two people, $26,951 for a family of three and $32,499 for a family of four. You can apply for free or low-cost Apple Health coverage year-round. Medical providers taking part in Washington’s Medicaid program (Apple Health) must accept payment from the agency as payment in full. Apple Health (Medicaid) preferred drug lists (PDLs) Managed care plans and fee-for-service (FFS) plans. § 447.15; WAC 182-502-0160; WAC 182-502-0010(2) (g). Other limited dental services, including: Topical fluoride - an additional two times per year for adults, Sealants - additional coverage for premolar teeth, Stainless steel crowns - additional coverage for adults. They are provided through Correctional Industries Optical only. Managed care means that you have a set doctor network to choose from, which means that your doctors and specialists are more likely to have a line of communication with each other and you are more likely to get the best care possible. Apple Health provides preventative care, like cancer screenings, treatment for diabetes and high blood pressure, and many other health care services. They can help if you have a behavioral health grievance, appeal or fair hearing. You'll have the option to select a managed care plan online or you'll be auto-enrolled into a plan. Your Apple Health (Medicaid) coverage will cover the cost of your annual exam and chosen birth control method, including: Evergreen Recovery, Everett, Washington. Apple Health (Medicaid) pays for covered dental services for adults (21 years and older). How do members get care? Eyeglasses are covered for children under age 21 through your Washington State Medicaid Services Card. Apple Health provides preventative care, like cancer screenings, treatment for diabetes and high blood pressure, and many other health care services. View the benefits below to see all that it offers. All Washington residents can apply for Health Care Coverage including institutional Medicaid through the wahealthplanfinder.org For long-term care services you may apply online through the health plan finder. View services covered under Apple Health. Choosing a Washington Managed Care Plan. Overview The Medically Needy (MN) program provides Apple Health Medicaid health care coverage for aged, blind, or disabled persons, institutionalized individuals, hospice individuals, pregnant women, children, and refugees with income above Categorically Needy (CN) standards and countable resources below the applicable MN resource standard. The Ombuds is a person who has had behavioral health services, or a person whose family member has had behavioral health services. Washington Apple Health (Medicaid) Starting January 1, 2014 Client Handout The Washington Apple Health (Medicaid) resumed covering dental services for all adults with Medicaid (clients 21 years of age and older) Includes people who already have Medicaid AND people who are eligible for “Expanded Medicaid,” part of health care reform. The brand name may be shortened to “Apple Health.” The Health Care Authority (HCA) administers most Washington Apple Health programs. You are sent a ProviderOne Services Card after you are enrolled in Apple Health. The Academy of Pediatric Dentistry (AAPD) recommends all children see a dentist by 12 months of age. Find out more about your health plan, what’s covered and … While Medicaid covers individuals of all ages, the focus of this page will be on Medicaid eligibility for elderly Washington residents (65 years of age and older). Washington residents whose income falls below 138 percent of the Federal Poverty Level are eligible for coverage under Apple Health. Clients with the DDA designation are eligible to receive all Apple Health dental services as well as some additional services and/or increased frequency of services. Washington Apple Health (Medicaid) Washington Apple Health is the new name for Medicaid in Washington state. Your immigration information, if that applies to you. ProviderOne​ is the Apple Health (Medicaid) system in Washington. Your vision provider can orders the eyeglasses for you. Medicaid is a health insurance program for low-income, low-asset individuals, and is jointly funded by the state and the federal government. Health Care Authority - Apple Health (Medicaid) Manual Revised December 11, 2014 Due to implementation of the Affordable Care Act (ACA), medical WAC’s and clarifying information can now be found in the Apple Health (Medicaid) Manual . A parent or caretaker applying with children. Medicare. Apple Health (Medicaid) pays for covered dental services for eligible children, age 20 and younger. Why would I use ​ProviderOne? Washington Apple Health is an umbrella term or “brand name” for all Washington State medical assistance programs, including Medicaid. Find Medicaid Therapists, Psychologists and Medicaid Counseling in Washington, get help for Medicaid in Washington. (The Department of Social and Health Services administers Washington Apple Health is an umbrella term or “brand name” for all Washington State medical assistance programs, including Medicaid. Community Health Plan of Washington (CHPW) Apple Health plans are built around you. The fastest way to renew your lost coverage is to go online. Apply for Apple Health Classic Medicaid coverage online through Washington Connection if you are: You have several options to apply for or renew Classic Medicaid coverage: If you're found eligible for coverage, you'll receive a Services Card in about two weeks. Washington Apple Health Application for Long-term Care/Aged, Blind, Disabled Coverage Form (Form 18-005) Apply on-line. The brand name may be shortened to “Apple Health.” The Health Care Authority (HCA) administers most Washington Apple Health programs. We offer local care and extensive benefits for the whole family. All agency-contracted managed care organizations (MCOs) and the fee-for-service (FFS) program use the Apple Health PDL. Read here. Select Your State Select Your Language ... Molina Healthcare’s Apple Health (Medicaid) Programs offer free or low-cost medical coverage for children and adults who meet the eligibility requirements for Apple Health (Medicaid). For other questions, call Washington State Medicaid … The types of services that help an adult remain at home.. Finding other places to live and get care if the adult can no longer live at home.. Finding caregiver resources and information.. Ways to stay independent as long as possible.. Find in-depth information about the rules and laws that govern Washington State’s Medicaid program. Washington Apple Health (Medicaid) clients who receive the following coverage: Medical - Apple Health coverage without a managed care plan Dental - only if you are on … It tells you what you need to know about your Molina Healthcare Medicaid Health Plan. Apply for Apple Health (Medicaid) coverage through Washington Healthplanfinder Apply for or renew your Apple Health MAGI coverage online through Washington Healthplanfinder if you are: An adult age 18 to 64 years old. The Social Security numbers and dates of birth for each member of your household. Due to COVID-19, HCA’s lobby is closed. The Apple Health PDL can be found on the agency’s Apple Health PDL page. Learn more. Enroll Now Already a Member Benefits of Community Health Plan of Washington care Our three enhanced plans offer different services and benefits to fit your life. Apple Health provides preventative care, like cancer screenings, treatment for diabetes and high blood pressure, and many other health care services. Apple Health provides coverage to individual adults, families and children, pregnant individuals, and individuals with disabilities. Community Health Plan of Washington now offers Apple Health (Medicaid) plans in Chelan, Douglas, Grant, Okanogan, and Pierce counties. Apple Health eligibility manual - WAC 182-504-0020 Certification periods for the noninstitutional medically needy (MN) program. Apple Health coverage without a managed care plan (also known as fee-for-service) is when Apple Health pays your provider directly. Examples include but not limited to the following: Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, 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, 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, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), 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), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. You may choose any provider who participates in the Apple Health fee-for-service program and currently accepts patients. Renew or Enroll today. Apply for or renew your Apple Health MAGI coverage online through Washington Healthplanfinder if you are: You have several options to apply for or renew coverage: When you’re ready to apply, you’ll need this information: If you’re accepted, you'll receive a Services Card in about two weeks. Find information about dental services covered under Washington Apple Health (Medicaid). Washington Apple Health (Medicaid) Behavioral Health Services Only (BHSO) Our plan offers a range of behavioral health benefits. To be eligible you must: Be a Washington resident. What is Apple Health coverage without a managed care plan? Revised 12/22/2014 Family Planning Services for Apple Health (Medicaid) recipients provides birth control and family planning services for women and men. Now that you're enrolled in Apple Health (Medicaid) coverage, these two resources will explain what to expect next: Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, 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, 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, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), 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), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. How to apply for Medicaid.. The Ombuds is independent from Amerigroup Washington. If you’re not eligible for Apple Health, you may qualify for help with your health insurance or for other health services. In the state of Washington, Medicaid is called Washington Apple Health or simply Apple Health. New 2021 health plans are available, including Cascade Care plans. In Washington State, Medicaid is called Apple Health. Washington Recovery Help Line is a statewide 24-hour crisis intervention and referral line for those struggling with issues related to substance abuse, problem gambling and mental health. If we find you eligible within 90 days after the date you lost coverage, we will cover you for the period you were without coverage. The Washington Healthplanfinder website  or WAPlanfinder app will help you with that. 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