Part 1: After you enroll in Apple
Health
We will mail you a letter that includes the name of
your welcome booklet. Your booklet shares important
information about your coverage. View the booklet online
at hca.wa.gov/ah-client-booklets. Your health plan will
also send you information about your benets.
You will receive your ProviderOne services card about two
weeks after you enroll in Apple Health. Keep this card.
Your card is activated before it is mailed to you.
Each member in your household enrolled in Apple
Health receives their own card. Your card shows your
client number which stays with you for life. You need this
number to receive health services.
We won't mail you a new card if you had Apple Health
coverage in the past. Your old card is still valid and your
client number will stay the same.
If you don’t receive the card
You can request a replacement ProviderOne services
card if you don’t receive it two weeks after applying for
coverage or if you lose your card.
You can access a digital copy of your services card
through WAPlannder mobile app. Download the app:
wahbexchange.org/mobile/
There are several ways to request a replacement.
• Visit the ProviderOne client portal:
https://www.waproviderone.org/client
• Call the toll-free line at 1-800-562-3022
• Request a change online:
https://fortress.wa.gov/hca/p1contactus/home/
client
o Select the topic “Services Card”
The Health Care Authority administers
Washington Apple Health (Medicaid)
Enrolling in your health plan
If you applied for Apple Health online through
wahealthplannder.org, you probably enrolled in one
of the health plans available in your area. If you did not
enroll in a health plan at that time, we’ll choose one for
you.
Can I change my health plan?
You can change your health plan at any time. Changes
made usually take eect on the rst day of the next
month, depending when the change is made. There are
several ways to switch your plan:
• Online: wahealthplannder.org
• ProviderOne Client Portal:
https://www.waproviderone.org/client
• Request a change online:
https://fortress.wa.gov/hca/p1contactus/. Choose
“Client” and select the topic “Enroll/Change Health
Plans.”
• Call our Customer Service Center at 1-800-562-3022.
First-timers’ Guide to Washington Apple Health (Medicaid)
Part 1: After you enroll in Apple Health. Use this guide to learn about Apple Health
coverage and how to make your rst appointment.
Part 2: Information on making your rst health care appointment (View part 2 of this guide).
This is your ProviderOne services card
HCA 19-024 (12/23)
Your health plan card
Your health plan will send you an ID card
like one of those shown on this page. Keep
this card. Take both your ProviderOne
services card and your health plan card
with you when you go to a doctor,
pharmacy, or other health care provider.
You may also need a photo ID.
Name
Member #
Plan
Group
Clinic (PCP)
Clinic Phone
Copayment
RxBin
RxGroup
State ID#
JOHN M SAMPLE
12345678 01
Washington Apple Health
Apple Health - Family
Clinic XYZ
555-555-5555
OV $0 / ER $0 / RX $0
003858
CHWA
200000000WA
Please see back of card for
important information.
Health Plan (80840) 911-87726-04
Member ID: Group Number:
0501
Payer ID:
Rx Bin: 610494
Rx GRP: ACUWA
Rx PCN: 9999
Apple Health - Family Coverage
Administered by UnitedHealthcare of Washington, Inc.
000000000
WAHLOP
Member:
MEMBER NAME
PCP Name:
PROVIDER NAME
PCP Phone: (000)000-0000
PROVIDER ADDRESS
CITY, STATE, ZIP
87726
03115 9936462 0000 0000005 0000005 178 2 11303115 9936462 0000 0000005 0000005 178 2 113
RUN_DATE 20180627 13:01:01DATA_SEQ_NO 0000001CLIENT_NUMBER 003115UHG_TYPE DIG1SHRTDOC_ID DOC_SEQ_ID 0000005NAME ENGLISH ,REISSUEMAILSET_NUMBER 0000005CUSTCSP_KEY1 000200026000200026_KEY0 CARD1CUSTCSP_KEY2 WAHLOPCUSTCSP_KEY3 REISSUECUSTCSP_KEY4 HCAC/MedicalCUSTCSP_KEY5 00CUSTCSP_KEY6 00000000CUSTCSP_KEY7 000200026~00CARD1CUSTCSP_KEY8 000200026CUSTCSP_KEY9 000200026~00CARD1
In an emergency go to nearest emergency room or call 911. Printed: 06/27/18
This card does not guarantee coverage. To verify benefits or to find a provider, visit the
website myuhc.com/communityplan or call.
For Members:
877-542-8997 TTY 711
NurseLine: 877-543-3409 TTY 711
For Providers: www.uhccommunityplan.com
877-542-9231
Medical Claims: PO Box 31361, Salt Lake City, UT 84131-0361
Pharmacy Claims: OptumRX, PO Box 29044, Hot Springs, AR 71903
For Pharmacists: 877-305-8952
Shipper ID: 00000000 Insert #1 Insert #2
Shipping Method: DIRECT Insert #3 Insert #4
CARRIER: USPS Insert #5 Insert #6
Address: Insert #7 Insert #8
REISSUE ENGLISH
Insert #9 Insert #10
124 ANY STREET
Insert #11 Insert #12
ANYTOWN, WA 99999-9999
Cycle Date: 20180627
PDF Date: Wed Jun 27, 2018 @ 13:01:01
MaxMover: Y
Mailing/Meter Date: UHG JOB ID: 8903 GRP: WAHLOP PV: RC: MKT: 77777
MT: 00 SA: 00 OI: 97 FORM: K2H000 CPAY:
DALE BROWN: NO LETTER NM: LETTER2 DIVISION : CARD TYPE: BF
TEMPLATE: NEW FAMILY/IND : STD IND : STANDARD : STANDARD
Managed care health* Phone Nurse Helpline **
Community Health Plan of Washington (CHPW)
chpw.org
1-800-440-1561 1-866-418-2920
Coordinated Care of Washington, Inc (CC)
coordinatedcarehealth.com
1-877-644-4613 1-877-644-4613
Molina Healthcare of Washington (MHW)
molinahealthcare.com/members/wa
1-800-869-7165 1-888-275-8750
UnitedHealthcare Community Plan (UHC)
uhccommunityplan.com/wa/medicaid/imc
1-877-542-8997 1-877-543-3409
Wellpoint Washington (WLP)
wellpoint.com/wa/medicaid
1-833-731-2167 1-866-864-2544
* Not all plans are available in all areas of the state.
**Call your health plan’s toll free number to speak to a nurse 24 hours a day, seven days a week.
Questions you might have
What’s the dierence between Washington Apple
Health and Medicaid?
Washington Apple Health is the name for Medicaid in
Washington State. Your provider or the receptionist may
call it Medicaid.
What is managed care?
Most Apple Health clients have “managed care” which
means Apple Health pays a health plan a monthly fee for
your coverage.
What is Apple Health without a managed care
plan?
Apple Health coverage without a managed care plan
(also known as fee-for-service) is when Apple Health
pays your provider directly. Most Apple Health clients are
enrolled in managed care.
Apple Health pays your provider directly for some
benets, even if you are enrolled in managed care. This is
known as fee-for-service.
Clients enrolled in Apple Health without a managed
care plan can find a provider online at https://fortress.
wa.gov/hca/p1findaprovider or call 1-800-562-3022.
Can I access services before I have my ProviderOne
services card?
You can see a doctor or ll prescriptions before your cards
arrive by:
• Visiting the ProviderOne client portal at
https://www.waproviderone.org/client to get
your ProviderOne ID number. Give that to the
provider or pharmacist.
• Tell a provider or pharmacist your name, date of
birth, and Social Security number. They can look you
up in their systems.
What if I lose my health plan card?
• Call your health plan and request a new card.
How do I check my Apple Health enrollment?
Check your Apple Health enrollment:
• Online: https://www.waproviderone.org/client
• Phone: 1-800-562-3022
Do I have to be enrolled in a health plan?
Yes, with few exceptions. For more details see your
Welcome to Washington Apple Health booklet
available online at hca.wa.gov/ah-client-booklets. If
you’re not sure which booklet to read, call the Apple
Health Customer Service Center at 1-800-562-3022 for
assistance.
Can I see any provider?
No, you must see providers in your health plan’s network,
unless your plan gives you written permission to see a
specialist. If you want to use a specic provider, ask what
health plans they network with.
Does everyone in my household need to have the
same health plan?
Yes, everyone in your household has the same health
plan, unless they are American Indian or Alaska Native.
What is the dierence in the plans?
All plans cover the same basic services, but have
dierences in how they deliver services and their
provider networks.
• Learn more about the basic covered services:
hca.wa.gov/apple-health-services.
How do I renew my coverage?
Your Apple Health coverage usually lasts for one year.
We will send you a letter to remind you to renew your
coverage, so it’s important to keep your mailing address
updated. Learn more about renewing your coverage
online at hca.wa.gov/apply-or-renew-coverage.
What do I do if I have private health care coverage?
If you have other medical or dental coverage available
to you through an employer, spouse/domestic partner,
or parent, Apple Health can pay for deductibles, co-pays,
and any out-of-pocket cost for qualied covered services.
Report your other health care coverage one of the
following ways:
• Report insurance or a change online at https://
fortress.wa.gov/hca/p1contactus/
.
• Call Apple Health customer service at
1-800-562-3022.
If you are enrolled with a managed care plan, also
report your other insurance to your plan.
To nd a dental provider:
• DentistLink
o Online: DentistLink.org
o Call 1-844-888-5465
• Find a Provider search tool:
o Online: https://fortress.wa.gov/hca/
p1ndaprovider
See an overview of dental services covered by Apple
Health at hca.wa.gov/dental-services.
How do I get eye exams and eyeglasses?
Fitting services and eye exams, including tests for
refraction and visual elds, may be provided for children
and adults through your health plan.
• For children 20 years of age and younger — eyeglass
frames, lenses, and contact lenses are covered by
Apple Health fee-for-service. Your primary care
provider will help you nd these benets and
coordinate your care when necessary.
• For adults — eyeglass frames, lenses, and contact
lenses are not covered by Apple Health. You can
purchase eyeglass frames and lenses at a discounted
price by contacting a participating provider at
hca.wa.gov/assets/free-or-low-cost/optical_
providers_adult_medicaid.pdf.
What else do I need to know?
More information is included in your Welcome to
Washington Apple Health booklet available online at
hca.wa.gov/ah-client-booklets and in the materials you
receive from your health plan.
Which pharmacy or drug store do I use?
Use pharmacies or drug stores in your health plan’s
network.
What if I have an emergency?
Call 911 or go to the nearest emergency room if you have
sudden or severe health problems that you think is an
emergency. Call your health plan as soon as possible to
let them know you had an emergency and where you
received care.
If you need urgent care, but your life is not in danger, call
your primary care provider, your health plan, or the 24-
hour nurse’s line. See page 2 for phone numbers.
Do I have to pay to see a provider or get
prescriptions lled?
No, you do not have to pay for covered service. You might
have to pay if:
• You get a service that is not covered or medically
necessary, such as chiropractic care or cosmetic
surgery.
• You don’t give your provider your health coverage
information.
• You get care from a service provider who is not in
your health plan’s network unless it’s an emergency
or has been pre-approved by your health plan.
• You don’t follow your health plan’s rules for getting
care from a specialist.
See the ProviderOne Find a Provider search tool at
https://fortress.wa.gov/hca/p1ndaprovider to nd a
fee-for-service provider.
For a list of benets paid directly by Apple Health, see
your Welcome to Washington Apple Health booklet
available online at hca.wa.gov/ah-client-booklets.
How do I get dental care?
You get dental care from a provider who accepts Apple
Health. Use the Find a Provider search tool to nd a fee-
for-service provider. Use your ProviderOne services card
when accessing dental services.
