Paul Sanchez
Washington State offers a range of health insurance plans to cater to the healthcare needs of its residents. One of the most well-known programs is Apple Health, which provides coverage for a diverse range of services, including primary care, emergency visits, maternity services, dental, and vision care. Apple Health also has an expansion program to assist adults aged 19 or older with specific immigration statuses in obtaining health insurance. Additionally, there are other insurance providers in the state, such as Ambetter from Coordinated Care, which offers affordable health insurance plans and personalized health management for chronic conditions.
| Characteristics | Values |
|---|---|
| Name | Washington Apple Health Plan |
| Other Names | Apple Health, Medicaid, Medicare |
| Eligibility | People aged 19 or older with certain immigration statuses |
| Customer Support Availability | Monday–Friday, 7:30 a.m.–5:30 p.m. |
| Contact Number | 1-866-262-5342 |
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What You'll Learn
Washington Healthplanfinder
All plans on Washington Healthplanfinder cover essential benefits, including doctors' visits, trips to the emergency room, and preventative care. Additionally, free or low-cost Apple Health coverage includes primary care, emergency visits, maternity services, pediatric care, dental services, vision care, prescription medications, and more.
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Apple Health Expansion
Washington state lawmakers approved the Apple Health Expansion program to help adults without legal status in the state gain health insurance. The program, which began in July, is the state's version of Medicaid and was created with an initial budget of $45 million, with an additional $28 million allocated to continue the program.
The Washington Health Care Authority has set an enrollment cap of 13,000 people, so those interested in the program are encouraged to register as soon as possible. Applications can be made through the Washington Healthplanfinder website, with customer support available over the phone.
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Medicaid and Medicare
Washington State offers its residents Apple Health (Medicaid) and Medicare coverage. Apple Health is the name of a new program in Washington State to help people aged 19 or older with certain immigration statuses gain health insurance. Apple Health is also available to individual adults ages 19 up to 65, parents or caretakers, pregnant individuals, children, noncitizens, people aged 65 or older or those eligible for Medicare, and people in foster care.
Medicaid is a government health insurance program available to people with very limited income and resources. It does not pay money to the policyholder but sends payments directly to the health care providers. Medicaid can pay for medical services in your own home or if you live in a residential care facility that accepts Medicaid.
To apply for Medicaid, you must be 18 or older and can apply through your local Home and Community Services (HCS) office or online. The application process involves filling out and turning in an application, a financial review to determine financial eligibility, and a personal care needs assessment to determine functional eligibility. HCS employees can explain the current Medicaid eligibility rules but cannot provide personal, financial, or legal advice.
Medicare is a federal health insurance program for people aged 65 or older and younger people with disabilities. It covers a wide range of health services, including hospital stays, doctor visits, prescription drugs, and more.
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Insurance plans and programs
Washington State offers various insurance plans and programs to help residents access affordable healthcare. One such program is the Community Health Plan of Washington (CHPW), which aims to put individuals at the centre of their care. CHPW offers Apple Health, which provides Medicaid and Medicare coverage, along with additional benefits. Apple Health Expansion is a new program that helps individuals aged 19 or older with certain immigration statuses gain health insurance.
King County, Washington, also offers a free and confidential telephone assistance program called CHAP. CHAP connects residents to health insurance, healthcare services, and other resources. Residents who meet the Qualified Health Plan (QHP) eligibility requirements, have an income at or below 250% of the Federal Poverty Level, and are not enrolled in a Cascade Care Silver or Gold Plan are eligible for a Special Enrollment Period (SEP). This SEP allows them to enrol in a Cascade Care Silver or Gold Plan any month of the year without experiencing a qualifying life event.
Additionally, Washington State has insurance plans and programs to help residents pay for healthcare. These include free programs that assist with the cost of prescriptions that may not be covered by their health plan. Residents can call the provided phone number or fill out an online form to get in touch with an insurance expert and explore their options.
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Health insurance eligibility
Apple Health
Apple Health, also known as Washington's Medicaid program, offers health insurance coverage for qualifying individuals based on their income and life circumstances. As of mid-2024, Apple Health provides coverage for children, pregnant women, parents, seniors, and individuals with disabilities, regardless of their immigration status. Eligibility is typically determined by income thresholds, and those who qualify may receive free or low-cost health insurance. Apple Health Expansion is a new program within Apple Health that helps individuals over the age of 19 with certain immigration statuses gain health insurance coverage.
Washington Healthplanfinder
Washington Healthplanfinder is a state-run health insurance exchange that offers health insurance plans with prices based on income. Unlike private health plans, Washington Healthplanfinder allows for enrollment throughout the year, providing flexibility for individuals to enroll or change their plans during special enrollment periods. Native Americans and Alaska Natives enrolled in a federally recognized tribe can enroll at any time.
Medicaid and Medicare
Washington State has taken steps to ensure access to Medicaid and Medicare for its residents. Medicaid enrollment is primarily managed through Washington Healthplanfinder. Individuals can explore Medicare, Medicare Advantage, and Medigap coverage options, as well as Medicare supplement plans, to find the best fit for their needs.
It is important to note that eligibility requirements and specific program details may change over time. Therefore, individuals seeking health insurance in Washington State should refer to the official websites and resources for the most up-to-date information on eligibility criteria and enrollment processes.
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Frequently asked questions
It is called Washington Apple Health Plan or Apple Health for short.
Apple Health is the name for Medicaid in Washington. It is free or low-cost health and dental coverage for those who qualify.
Apple Health Expansion is a new program in Washington to help people aged 19 or older with certain immigration statuses gain health insurance. You may also be eligible for Apple Health (Medicaid) and Medicare coverage plus extra benefits.
You can contact the Customer Support Center, which is available Monday-Friday from 7:30 a.m.-5:30 p.m. Local support is also available in your community and online.
You can answer a few questions about your household to see what plans and savings you may be eligible for. You can then browse your options and select a plan.
