Who Is Eligible For Apple Health
People of all ages may be eligible for coverage under Apple Health, including yourself, your parents, and your children. The Washington State Health Care Authoritys website details all the ways you may be eligible for Apple Health. Click the link below that best describes you and/or your family to learn more.
How Is Washington Healthplanfinder Related To Healthsherpa
HealthSherpa is a privately-run alternative to HealthCare.gov that has all the same plans, prices, and subsidies as you would find on the government version. HealthSherpa provides a quick and easy approach that saves you time and puts the power of finding the right plan for you and your family in your hands. In addition, HealthSherpa can help Washington residents enroll in the same plans found on Washington Healthplanfinder at the same prices and with the same subsidies. To get HealthSherpas free assistance, just call the customer advocate team at 772-2663.
Do You Need Extra Support
If you are feeling like you need extra support with managing daily stress, chronic health conditions -including stopping smoking or speaking with a nurse about your medications, struggles with alcohol or drug use and would like to connect with a behavioral health counselor or substance use disorder professional, we are here to help. Click to find support and resources.
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Is Washington Apple Health State Insurance
OLYMPIA Since the COVID-19 pandemic began, more than 100,000 Washington residents have enrolled in Apple Health , our states insurance program for individuals with lower incomes. Apple Health is meant to be there when people need health care the most, said HCA State Medicaid Director MaryAnne Lindeblad.
Qualified Health Plans And Other Individual Insurance
Children and adults can buy Qualified Health Plans if they are US citizens or have an eligible immigration status, are state residents, and are not in jail/prison.
Children and adults can get subsidies to help with the costs of buying a Qualified Health Plan if they meet other requirements, including: having household income below 400% of the Federal Poverty Level not qualifying for public programs like Apple Health or Medicare and not having an affordable offer of coverage through a parent’s employer.
You can shop and apply for coverage at Washington Healthplanfinder. Other individual health insurance plans are available outside the QHP marketplace at full price. Learn more here.
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What Is Managed Care
Apple Health offers managed care plans in all regions statewide. Your plan coordinates physical health, mental health, and substance use disorder treatment services to provide whole-person care under one health plan.
Most Apple Health clients have managed care, which means Apple Health pays a health plan a monthly premium for your coverage, which include preventive, primary, specialty, and other health services. Clients enrolled in managed care must see providers who are in their plan’s provider network, unless prior authorized or to treat urgent or emergent care.
Newly eligible and renewing Apple Health clients choose or are auto-assigned into a managed care organization the day they become eligible. Their managed care enrollment is backdated to the beginning of the current month. Clients can change their managed care plan at any time. Changes usually take effect the following month that the change was made, depending on when you request the change.
Apple Health Services Covered Without A Managed Care Plan
Some services are paid for by Apple Health without a managed care plan, also called fee-for-service . That’s what we call it when Apple Health pays providers directly for each service they do, using your ProviderOne services card.
Most Apple Health clients receive their regular health care coverage through a managed care plan. Apple Health coverage without a managed care plan is sometimes necessary due to the way other coverage works with Apple Health for instance, when clients have Medicare as their primary coverage.
The following services are always covered by Apple Health without a managed care plan.
- Inpatient psychiatric care for physician services
Your primary care provider or health plan will help you find these benefits and coordinate your care, when necessary.
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Unitedhealthcare Dual Complete Plans
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call TTY 711, or use your preferred relay service for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.
Dental Services For Children
Apple Health pays for covered dental services for eligible children, age 20 and younger. The Academy of Pediatric Dentistry recommends all children see a dentist by 12 months of age. Be sure to check the Health Care Authoritys website for the most up to date and accurate list of what is covered services.
Some covered dental services include but are not limited to:
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Washington State Medicaid Drug Benefits
Medicaid covers most prescription drugs but requires prior approval for some. It is up to your doctor to prescribe generic drugs whenever possible and to use the Washington Medicaid preferred drug list. If your doctor wants to prescribe you a non-generic or non-preferred drug, he or she will have to seek approval from the Medicaid program first.
How Does Apple Health Work
The Health app gathers health data from your iPhone, Apple Watch, and apps that you already use, so you can view all your progress in one convenient place. Health automatically counts your steps, walking, and running distances. And, if you have an Apple Watch, it automatically tracks your Activity data.
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Washington Apple Health Dental
Washington Medicaid pays for dental services for eligible members, but children and adults get different coverage. Kids can get:
- Cleanings and exams
- Orthodontic care when necessary
Adults can get coverage for all of those services plus front teeth root canals, dentures, oral surgery, gum disease treatment, and nitrous oxide . Adults do not have coverage for crowns, implants, bridges, or orthodontics.
What Is The Difference In The Plans
All Apple Health plans cover the same basic services, but they have some differences in the way they provide services. Each health plan has its own network of providers, hospitals, and pharmacies. Please verify with the health plan that the providers you prefer are in the plan’s network.
View the Washington Apple Health Plan Report Card for plan comparisons of each managed care plan under Apple Health.
Before you can be in a managed care program, you must apply for coverage.
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How Can I Qualify For Medicaid
Medicaid beneficiaries generally must be residents of the state in which they are receiving Medicaid. They must be either citizens of the United States or certain qualified non-citizens, such as lawful permanent residents. In addition, some eligibility groups are limited by age, or by pregnancy or parenting status.
Does Washington State Have Good Healthcare
Hawaii is the top state for health care. Its followed by Massachusetts, Connecticut, New Jersey and California to round out the top five. Learn more about the Best States for health care below.Health Care Rankings. Rank 8 State Washington Washington Health Care Access 12 Health Care Quality 13 Public Health 9.
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How Do You Enroll In Health Insurance In Washington State
To enroll in ACA plans in Washington, you can choose one of the following options:
All of these options will make sure your eligibility for financial assistance is assessed. That is, whether you qualify for any ACA subsidies or for Washington Apple Health. If you qualify for WA Apple Health, theyll direct you to the right place to apply. For those who need language assistance, help is available in 175 languages if you call Washington Healthplanfinder customer service at 923-4633. Their website also provides resources in 20 languages. The one exception is if youre age 65 or older, blind, or disabled and are applying for Washington Apple Health to get coverage or to help pay for Medicare premiums and expenses. In that case, you can apply via Washington Connection.
Washington State Medicaid Eligibility For Seniors And Disabled Citizens
The aged, blind, and disabled WA Medicaid program has slightly different income requirements than the adult Medicaid program. In 2019, anyone who is blind, disabled, or over 65 can qualify for Medicaid with an income of $771 per month or less . If you are disabled and employed, you can qualify at $2,290 per month as long as you pay a monthly premium. Your premium would not exceed 7.5% of your income.
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What You Need To Know
The Affordable Care Act is a program that allows many Washington residents to access health insurance coverage at an affordable rate and, in some instances, at no cost. The ACA was created to ensure most can get the healthcare they need. You cannot be denied health insurance coverage due to an illness or prior health issue.
The Exchange plans offer more options for insurance coverage through the Washington Healthplanfinder. Beyond the nonstandard plan selection, the Exchange has Cascade Care Plans. Cascade Care launches Washington State on the path to achievable universal care. By 2025, only Cascade Standard and Public Option plans will be offered on the Exchange. Saving opportunities are available to reduce your premium cost and/or cost sharing .
There are three types of Qualified Health Plans plans to choose on the Washington Exchange:
What Is Washington Healthplanfinder
Washington Healthplanfinder is the online Marketplace operated by the Washington Health Benefit Exchange, the Affordable Care Act health insurance exchange in the state of Washington. The website launched to the public on October 1, 2013, and it is used by individuals and families to enroll in private health insurance and dental plans. It is also where residents can qualify for and apply ACA subsidies like premium tax credits and cost-sharing reductions to lower their health insurance premiums and healthcare costs. Washington Healthplanfinder used to also offer small business health insurance, but that ended with the 2017 coverage year. There is also a complementary mobile app called the WAPlanfinder Mobile App where you can view your health and dental coverage from a mobile device.
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How Much Does Apple Health Cost
Apple Health premiums are either free or low-cost depending on income level. Even if you are working, you and your family might still be eligible for Apple Health. The Health Care Authoritys website lets you know how much your premiums will be based on your eligibility.
Washington Health Insurance Plans Fit For Your Needs And Budget
Your healthcare needs and budget are as unique as you are. Thats why we offer Washington plans across a range of price levels. We can help you find a plan thats right for you, whether youre an individual who only needs emergency coverage or part of a large family with more extensive healthcare needs. Plus, financial assistance to help cover health insurance costs is available for those who qualify, so its easier to stay on budget and on top of your health.
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What Is Washington Apple Health
Washington Apple Health is the states Medicaid program. It is run by the Washington State Health Care Authority and offers free or low-cost coverage for eligible residents. Washington Apple Health covers preventative care and immunizations as well as dental services, pregnancy services, transgender health benefits, and more.
Because Washington expanded Medicaid under the ACA, Washington Apple Health eligibility is assessed by income and qualifying characteristics. Adults and children typically qualify if they are U.S. citizens, have annual household incomes lower than the Medicaid standard, and do not qualify for Medicare certain non-citizens can also qualify. Explore these eligibility requirements for the income limits and see if you qualify.
Services Covered By Apple Health
Apple Health offers complete major medical coverage for individuals who meet the eligibility requirements. Apple Health services are available through managed care or coverage without a managed care plan .
Services covered by Apple Health:
- Appointments with a doctor or health care professional for necessary care
- Medical care in an emergency
- Maternity and newborn care
- Treatment for chemical or alcohol dependence
- Pediatric services, including dental and vision care
- Limited dental and vision care for adults
- Prescription medications
- Transportation to and from medical appointments, when necessary
- An interpreter for your appointment, if you do not speak English
Note: This list is for general information only and does not guarantee Apple Health will cover the service. Check your health plan’s member handbook for additional covered benefits and services. If a service you need is not listed, check with your health care provider or your health plan.
To view additional services that may be provided under specific Apple Health programs , visit the program benefit packages and scope of service page.
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Unitedhealthcare Connected General Benefit Disclaimer
This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.
You can get this document for free in other formats, such as large print, braille, or audio. Call Member Services, 8 a.m. – 8 p.m., local time, Monday – Friday . The call is free.
You can call Member Services and ask us to make a note in our system that you would like materials in Spanish, large print, braille, or audio now and in the future.
Language Line is available for all in-network providers.
Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al Servicios para los miembros, de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.
Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro.
Apple Health Covers Dental Care
In Washington state, Medicaid insurance is called Apple Health. Apple Health covers dental care for both children and adults! DentistLink can help anyone in Washington state get connected to dentists who accept Apple Health at no cost to you. Call or text our DentistLink referral specialist team at .
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Unitedhealthcare Connected For Mycare Ohio
UnitedHealthcare Connected® for MyCare Ohio is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio information, please contact our Member Services at from 7 a.m. to 8 p.m. Monday through Friday for help at no cost to you.
Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio , comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al de lunes a viernes de 7 a.m. a 8 p.m. .
This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays, and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.
What Is Apple Health
Apple Health is the name for Medicaid in Washington. Apple Health is free or low-cost health insurance coverage for those who qualify. Covered services include primary care, emergency visits, maternity services, pediatric care, dental services, vision care, prescription medications and more.
Apple Health is available year-round. You can apply for Apple Health at any time.
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What Is The Penalty For Not Having Health Insurance In Washington State
Washington D.C. individual mandate Individuals who go without qualifying health coverage for a full year and dont file for an exemption may owe a tax penalty. The penalty amount is either 2.5% of the gross family household income or $695 per individual and $347.50 per child youll pay whichever amount is greater.
