Wa State Medicaid Phone Number


Impact On Uninsured Rate

Medicaid Update Webinar Session 7

According to U.S. Census data, the uninsured rate in Washington was 14% in 2013, and had fallen to 6% by 2016 a drop of 57%. Only eight states had a higher percentage point drop in uninsured rate during that time, and Washingtons drop was far higher than the 5.9 percentage point drop across the country as a whole. Its clear that Medicaid expansion played a significant role in reducing the uninsured rate in the state.

However in 2020, the coronavirus triggered widespread job losses and subsequent losses of employer-sponsored health insurance. Washington States uninsured rate climbed to 12% as of May 2020.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

About our health insurance quote forms and phone lines

We do not sell insurance products, but this form will connect you with partners of healthinsurance.org who do sell insurance products. You may submit your information through this form, or call to speak directly with licensed enrollers who will provide advice specific to your situation. Read about your data and privacy.

If you have questions or comments on this service, please contact us.

What Should I Expect After I Submit My Application

  • HCA strives to process applications within 30 days from when they are received.
  • An application may take longer to process if it is:
  • Is missing required information or documents. You will be contacted if additional information is required.
  • If your enrollment is approved you will be mailed a welcome letter.
  • How Can I Get Back Into My Online Enrollment Application

    If you started an online enrollment but have not completed the required steps, you may track your enrollment application* by using your 14-digit application ID and the Social Security number or Federal Employer Identification Number you entered in step one of your application. This allows you to complete the enrollment and submit it for review and approval.

    *Link does not work for Health Care Authority staff.

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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.

    Choosing A Washington Managed Care Plan

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    Most Washington Medicaid members will be enrolled in an Apple Health Managed Care Plan. Managed care means that you have a set doctor network to choose from, which means that your doctors and specialists are more likely to have a line of communication with each other and you are more likely to get the best care possible. There are five separate managed care plans: Amerigroup Washington, Coordinated Care of Washington, Community Health Plan of Washington, Molina Healthcare of Washington, and United Healthcare Community Plan. The plans are not all available in every area. Use this map to find out which of the five are available in your area.

    All WA Medicaid plans include the same basic benefits, but each plan offers extras that may convince you to join one over another.

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    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.

    What Should I Know Before I Start My Application

    You must send all required documentation noted above with signatures, if required. At the end of the application process, you will be given instructions for sending the necessary documents.

    Once you have completed step one of the application you will be given a 14-digit application ID number. Write this number down in case you need to save and access your application at a later time. The online application has up to 18 steps. If you do not have time to complete it now you will need your application number to regain access.

    Important! This is not the end of the online application. There are 16 additional steps. Click OK in the bottom right corner of the screen once you receive your application ID number to continue and complete your application.

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    Washington State Health Care Authority

    WSHA works closely with the state Health Care Authority on a broad variety of issues, especially around opportunities to improve the health of Washington residents through innovation. Between the states Apple Health program and coverage for public employees, the HCA provides health insurance for almost a third of Washington State residents.

    HCA is also the lead agency for Healthier Washington, the five-year Health Care Innovation Plan that has brought together hundreds of people from many communities to put the best solutions to work for the people of our state. This work will improve the quality of life for everyone regardless of their income, education or background.

    About the Health Care Authority

    The Washington State Health Care Authority purchases health care for more than 2 million Washingtonians through two programs Washington Apple Health and the Public Employees Benefits Board Program. We work with partners to help ensure Washingtonians have access to better health and better care at a lower cost.

    Their mission is to provide high quality health care through innovative health policies and purchasing strategies.

    How Do I Apply For Medicaid In Washington

    Washington state bracing for tidal wave of Medicaid applicants

    In Washington State, most Medicaid enrollment is managed through the state-run exchange, Washington Healthplanfinder. Unlike private health plans, Medicaid enrollment continues year-round there is no specific time during the year that you must enroll.

    One of the benefits of the streamlined exchange application process is that its dramatically expedited compared with the pre-2014 enrollment system. The state notes that eligibility determination in the past took about 45 days, and they now take about 45 minutes.

    But if youre 65 or older or have Medicare, use this website to apply for Medicaid and several other social services benefits. You can also request an application by calling 1-877-501-2233. Visit a Department of Social and Health Services Community Services Office to apply for Medicaid for the aged, blind and disabled in person visit a Home and Community Services Office to apply for long-term care benefits.

    Recommended Reading: What Are The Requirements For Medicaid In Colorado

    Washington Medicare Special Needs Plans

    If you qualify for Medicaid and are over the age of 65, disabled, or have either ALS or ESRD, you can enroll in a Dual-Eligible Special Needs Plan . A DSNP is a type of Medicare Advantage plan that can effectively combine your Medicaid and Medicare benefits into one very low or no-cost plan.

    We have licensed Medicare agents in Washington state that can lay out all of your DSNP options and help you figure out which one makes the most sense for you. For help, call 833-438-3676 or send us a message now.

    Washington Medicaid Enrollment Now Exceeds 2 Million People

    As a result of Medicaid expansion, total enrollment in Washington Medicaid and CHIP grew by nearly 644,000 people between the fall of 2013 and November 2017. By mid-2021, total enrollment growth since 2013 had increased to nearly 850,000. That was a total enrollment growth of 76%, the sixth-highest percentage increase in the nation. The national average growth in Medicaid/CHIP enrollment was 44%, although that includes the dozen states that had not expanded their Medicaid programs during that timeframe.

    Medicaid enrollment has increased during the COVID pandemic. This is due to the widespread job/income losses, as well as the Families First Coronavirus Response Act, which provides additional federal Medicaid funding to states on the condition that people not be disenrolled from Medicaid during the COVID public health emergency. So enrollment has trended upward since March 2020, and that will continue to be the case until the public health emergency period ends.

    Total Medicaid enrollment in Washington was 1,965,401 as of May 2021, and had exceeded 2.1 million by October 2021.

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    What Enrollment Type Option Should I Select

    • Individual: If you are enrolling as an individual provider who owns your own practice. Note: If you choose to use your Social Security number as your tax ID you will need to update the servicing type to Regular Individual Provider.” Additionally, individual NPI type must be used for this enrollment.
    • Group practice: If you are enrolling as an organization of individual providers who offer services. Note: Organizational NPI type must be used for this enrollment.
    • Fac/agncy/orgn/inst: If you are enrolling as a facility agency, organization or institution. Note: Organizational NPI type must be used for this enrollment.
    • Tribal health services: If you are enrolling as a tribal health provider. Note: Organizational NPI type must be used for this enrollment.

    Washington Apple Health Dental

    Arkansas Medicaid

    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.

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    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.

    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.

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    Dshs Community Services Customer Service Contact Center


    Do you need to apply for assistance, do a review, report a change or have questions about cash, food, Housing and Essential Needs referral, Medicaid for people who are 65 and older, blind or disabled, receiving SSI or eligible for Medicare? The Customer Service Contact Center call agents are available to assist you.

    Unitedhealthcare Senior Care Options Plan

    HHSC Medicaid Provider Agreement

    UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

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    Sorry We May Not Have An Apple Health Plan For You At This Time But There Are Other Ways That You May Be Able To Get Health Coverage Contact Molina Today To Discuss Our Health Plans That May Meet Your Needs

    Weve heard your questions. Please read on for answers.

    Everyone at Molina Healthcare has the same job: helping you feel your best.

    We work hard to make sure its easy for you to get what you need, from medical treatment to extra money-saving benefits. To earn the trust you put in us, we put you first, every day.

    Get the quality care you need now. Lean on Molina.

    Questions? Weve got answers. Call 936-9545, TTY 711.

    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.

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    Washington Has Accepted Federal Medicaid Expansion

    • 1,965,401 Number of Washingtonians covered by Medicaid/CHIP as of May 2021
    • 847,825 Increase in the number of Washingtonians covered by Medicaid/CHIP fall 2013 to May 2021
    • 54% Reduction in the uninsured rate from 2010 to 2019
    • 76% Increase in total Medicaid/CHIP enrollment in Washington since 2013

    What You Need To Know

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    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:

  • Nonstandard Plans offer the ten essential health benefits.
  • Cascade Standard Plans offer more benefits with just a copay instead of having to meet your deductible first. These plans typically offer a lower deductible with more transparent, predictable cost-sharing.
  • Cascade Public Option Plans takes the Cascade Care Standard Plans a step further. These Public Option plans may cost less because they will cap aggregate statewide provider reimbursement rates at 160% of Medicare rates. The Health Care Authority is partnering with the Exchange to establish public option plans.
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    You Have More Insurance Options For Your Health Than You Think Washington

    If youre self-employed or without insurance from your employer in other words, youre looking for individual or family health insurance in Washington you might be looking for Affordable Care Act insurance, what’s often called Obamacare. However, we want to make you aware of the whole range of individual and family insurance products we have available in your state.

    Coordinated Care Of Washington

    There are two Coordinated Care of Washington plans. The Apple Health Core Connections plan is for youth in foster care or adoption support, while Washington Apple Health Plan is for most other members. The adult plan includes a cell phone program with unlimited texting, and both plans include a comprehensive rewards program:

    • Get $60 for infant well-care
    • Get $10 for annual well-child visits
    • Get $40 for annual adolescence well-care
    • Get $10 for annual adult well-care visits, breast cancer screenings , and cervical cancer screenings .
    • Get $60 for comprehensive diabetes care

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    What Documents Do I Need To Submit

    You will need to submit a number of documents with your application. Listed below are required and optional documents. You may also need to complete provider-specific documents based on your provider type.

    All forms requiring a signature must be signed by an individual with legal authority to bind provider. Signatures are required on: Core Provider Agreement, Debarment Statement, Electronic Funds Transfer and W-9 for the form to be considered complete.

    Documentation sent to Provider Enrollment requires a document submission cover sheet. You will be prompted to complete and print the cover sheet once you have submitted your online application.


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