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.

Mga Pakinabang at Feature

Pangangalaga Habang Walang Sakit at Kapag May Sakit

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:

  • 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.

Ang kalusugan ng pag-iisip na apektado ng pag-uugali ay kasinghalaga ng kalusugan ng pangangatawan. 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 physical health benefits are from another medical carrier. If you already have a Primary Care Provider (PCP), talk to them today about any health or behavioral health problems you have. We will coordinate your mental health and drug and alcohol treatment with your physical health treatment provider, if necessary.

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

There are some treatments and services that need preapproval before you can get them.

Search for a Mental Health Clinician or Facility

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

Sinasaklaw namin ang:

  • 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
  • Pamamahala sa sitwasyon

Additional mental 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.

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

Member Handbook (English)
Member Handbok (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)

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.
  • 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. 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.

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:

  • 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.
  • 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.

Choose a Birth Center

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

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. 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.

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 expenses related to a hospital stay, so you can rest and heal.

  • 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.

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

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.

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.

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. Magkakaroon ka ng:

  • 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.

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.
  • Answer any 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:

  • 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.

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.
  • Answer your questions

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. These visits can catch health problems early, so they can be treated. Kabilang sa mga serbisyong pang-iwas sa sakit ang:

  • Checkups children.
  • Screenings for adults.
  • 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

Mga Mapagkukunan ng Miyembro

Matuto Nang Higit Pa

Washington Apple Health Integrated Managed Care (IMC)

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

Learn about the steps to enroll.

Mga Tanong

Miyembro na?

Mayroon kang access sa aming website na para lang sa miyembro. Print ID cards and more. View our handbook below.

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