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.

Mga Pakinabang at Feature

Kalusugan sa Pag-uugali

Ang kalusugan ng pag-iisip na apektado ng pag-uugali ay kasinghalaga ng kalusugan ng pangangatawan. 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:

  • Pagkakaospital. Wala kang babayaran para sa pangangalaga sa isang ospital.
  • Laboratoryo at mga X-ray. Ang mga pagsusuri sa laboratoryo, x-ray at diagnostic imaging ay sinasaklaw.
  • Therapy Services. Therapy visits to help you recover or achieve your potential.
  • NurseLineSM. Speak with a registered nurse 24/7.
  • Mga Pagpapatingin Habang Walang Sakit. Annual checkups and screenings (for those under 21) to help keep you or your family healthy.
  • Pangangalaga sa Paa. 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.

Wala nang mas mahalaga pa sa kalusugan at kapakanan mo at ng iyong sanggol. That's why our plan benefits include:

  • Pagpili ng Birth Center. Pick from a large network of hospitals across Washington.
  • Pagpili ng Doktor. Find a doctor or OB/GYN you trust in our network.
  • Healthy First Steps®. Karagdagang suporta upang tulungan kayo ng iyong sanggol na manatiling malusog. Free breast pumps available for eligible members.
  • Mga Pagpapatingin Habang Nagbubuntis. Pangangalaga para sa iyo bago ipanganak ang iyong sanggol.
  • 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. Kabilang sa mga benepisyo ang:

  • 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.
  • Kalusugan ng pag-iisip. 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.

Tiyaking nasa pinakamagandang kundisyon ang iyong paningin at pandinig. Kabilang sa mga benepisyo ang:

  • 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. Kabilang sa mga benepisyo ang:

  • Personal Care. Someone to help with dressing, bathing and dining.
  • Kagamitan at Mga Supply. 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.
  • Edukasyon sa Kalusugan. Free coaching to help improve your health.
  • Tulong sa Wika. 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.
  • Paghinto sa Paninigarilyo. Coaches and supplies to help you quit using tobacco.
  • Mga Serbisyo sa Miyembro. 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.

Kalusugan sa Pag-uugali

Ang kalusugan ng pag-iisip na apektado ng pag-uugali ay kasinghalaga ng kalusugan ng pangangatawan. That's why we have coverage for both.

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

  • Testing and diagnosis.
  • Therapy para sa kalusugan ng pag-iisip na apektado ng pag-uugali.
  • Medication.

Choose a Birth Center

Mahalagang pumili ng ospital kung saan ka manganganak. 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. Nang sa gayon ay maging pamilyar ka rito. And you'll be more relaxed when you have your baby.

Pagpili ng 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.

Ang iyong PCP ay ang iyong pangunahing doktor para sa:

  • Pampigil na pangangalaga.
  • Panggagamot kung mayroon kang sakit o pinsala.
  • Mga referral sa mga espesyalista para sa ilang partikular na kundisyon.

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

Ang iyong kalusugan at kaligtasan sa tahanan ay mahalaga.

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

  • Mga kama sa ospital.
  • Oxygen tanks.
  • Wheelchairs or walkers.

Pangangalaga sa Paa

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.

Kasama ng aming saklaw sa podiatry ang:

  • Routine foot exams.
  • Mga tip tungkol sa pangangalaga sa paa at pagpili ng mga tamang sapatos.
  • Impormasyon tungkol sa mga senyales ng babala sa pinsala sa nerve.

Edukasyong pangkalusugan

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.

Healthy First Steps®

When you're pregnant, you receive help and advice from your mom, aunts, sisters and girlfriends. Gayunpaman, magkakaiba ang bawat pagbubuntis. Susuportahan ka ng programang ito sa kabuuan ng iyong pagbubuntis. 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.

Pangangalaga sa Pandinig

Ang problema sa pandinig ay maaaring makaapekto sa iyong pang-araw-araw na pamumuhay sa maraming paraan. Kabilang sa aming plano ang mga serbisyo at suporta upang matulungang protektahan ang iyong pandinig. 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.

Pagkakaospital

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

Sinasaklaw ng aming plano ang:

  • Pangangalaga ng isang nurse.
  • Kwarto at matutuluyan.
  • Mga supply at kagamitan.
  • Panggagamot at mga therapy.
  • Mga diagnostic na pagsusuri at eksaminasyon.

At pagkalabas mo sa ospital, hindi ka mag-iisa. Titiyakin naming makakakuha ka ng follow-up na pangangalaga upang maipagpatuloy ang pagpapagaling sa tahanan.

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.

Kasama ng aming plano ang:

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

Laboratoryo at mga X-ray

Napakainam na malaman nang maaga pa lang kung ano ang problema. Sinasaklaw ng aming plano ang:

  • Mga laboratoryo at pagsusuri.
  • Mga x-ray, scan at iba pang imaging.

Tutulungan ka naming makuha ang impormasyong kailangan upang makatulong na mapabuti ang iyong kalusugan at maibalik ka sa pinakamalusog na kundisyon.

Tulong sa Wika

You can receive information in your preferred language. Magtanong lang. 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. Sinasaklaw din namin ang mga over-the-counter na gamot na may nakasulat na tagubilin mula sa iyong doktor.

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

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

Mga Serbisyo para sa Miyembro

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.

Maaari ka rin naming tulungang humanap ng:

  • 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. Magkakaroon ka ng:

  • 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.
  • Papayuhan ka tungkol sa pagkuha ng pangangalaga sa pagpapatingin sa isang doktor o sa isang center ng agarang pangangalaga.
  • Tutulungan kang malaman kung kailan dapat pumunta sa 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.

Mga Pagpapatingin Habang Nagbubuntis

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.

Sa mga pagpapatinging ito, ang klinika ay:

  • Make sure both you and your baby are healthy.
  • Ipapaliwanag kung ano ang dapat asahan sa bawat yugto ng iyong pagbubuntis.
  • Sasagutin ang iyong mga tanong.

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:

  • Occupational therapy.
  • Physical therapy.
  • Speech therapy.
  • In-home therapy.

Transportasyon

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

  • Doctor or therapy visits.
  • Vision clinics.
  • Mga center ng agarang pangangalaga.

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

Pangangalaga sa Paningin

You'll get the care and treatment that let you see life more clearly. Kasama sa saklaw ang:

  • 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.

Mga Pagpapatingin Habang Walang Sakit

Well visits with your doctor can help you stay healthy. Maaaring matukoy kaagad ang mga problema sa kalusugan sa mga pagpapatinging ito upang magamot ang mga ito. Kabilang sa mga serbisyong pang-iwas sa sakit ang:

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

There are no copayments for preventive care.

Mga Mapagkukunan ng Miyembro

Tingnan ang Mga Available na Mapagkukunan

Matuto Nang Higit Pa

Washington Apple Health Medicaid

Suriin ang Pagiging Karapat-Dapat

Pag-enroll

Call to enroll today.

Monday through Friday 8 am to 5 pm PT

1-877-542-8997
TTY: 711

Mga Tanong

Miyembro na?

Mayroon kang access sa aming website na para lang sa miyembro. Mag-print ng mga ID card, makipag-chat sa isang nurse online at higit pa.

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