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Tusmada Ugu Weyn

Washington Apple Health (Medicaid) Behavioral Health Services Only (BHSO) Frequently Asked Questions

If you are not enrolled in the Washington Apple Health (Medicaid), you may be eligible. To find out if you qualify visit wahealthplanfinder.org or call 1-855-WAFINDER (1-855-923-4633) TTY/TTD 1-855-627-9604.

If you are currently enrolled in Apple Health (Medicaid) and would like to change to UnitedHealthcare Community Plan we can help. 

There are several ways to switch your plan:

For more information on Washington Apple Health (Medicaid), visit the Washington State Apple Health website.

Currently, this plan is available in all counties, but UnitedHealthcare Community Plan only offers the plan in the following counties: Clallam, Cowlitz, Grays Harbor, Island, Jefferson, King, Kitsap, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Snohomish, Thurston, Wahkiakum, and Whatcom.

Members of Washington Apple Health (Medicaid) will receive two ID cards

One from UnitedHealthcare Community Plan and one from Washington State called your ProviderOne ID card. Every family member enrolled in the plan should have his or her own ID cards.

 Washington Member ID Card
You will need your UnitedHealthcare Community Plan ID card and your ProviderOne card for all visits to the doctor, hospital, and pharmacist. If you haven't received your ID cards within one week of your effective date of enrollment with UnitedHealthcare Community Plan, please contact Member Services, at 1-877-542-8997. Haddii aad tahay qof naafo ka ah maqalka ama hadalka, fadlan wac TTY: 711 Washington Medicaid Member ID Card

Waan ku farxi doonaa inaan kuu soo dirno mid cusub. Please contact Member Services toll-free, at 1-877-542-8997. Haddii aad tahay qof naafo ka ah maqalka ama hadalka, fadlan wac TTY: 711. You can also go to myuhc.com/communityplan, register, and print a copy of your card.

If you move, you will need to contact one of the following agencies to let them know your new address.

Washington Apple Health (Medicaid) – Family Coverage, with Premium (SCHIP) or Foster Care Please visit wahealthplanfinder.org or call 1-855-WAFINDER (1-855-923-4633) TTY/TTD 1-855-627-9604.

Washington Apple Health (Medicaid) –Blind/Disable please call your DSHS Community Service Office (CSO) or if you do not know the number in your area, call DSHS toll free, at 1-877-501-2233, Monday–Friday, 8 sn. to 5 gn. If you are hearing or speech impaired, call TTY/TDD 1-800-848-5429.

UnitedHealthcare Community Plan

1111 3rd Ave, Suite 1100
Seattle, WA 98101

Medicaid is a program funded by the federal and state governments, which pays for medical care for those who can't afford it. Washington Apple Health (Medicaid) is Washington State’s Medicaid managed care program for Adults and Families.

To see if you qualify please visit wahealthplanfinder.org or call 1-855-WAFINDER (1-855-923-4633) TTY/TTD 1-855-627-9604.

For more information about eligibility or for additional information on Washington Apple Health (Medicaid) information, please visit the Health Care Authority website.

You can apply for Washington Apple Health (Medicaid) on any computer with an internet connection at Washington Healthplanfinder, wahealthplanfinder.org.

When you're ready to apply, you'll need this information:

  • Your household monthly income.
  • The Social Security numbers and dates of birth for each member of your household.
  • Your immigration information, if that applies to you.

It should take about 45 minutes to apply online — and you'll get a response right away. If you need additional assistance, you can call 1-855-WAFINDER (1-855-923-4633) TTY/TTD 1-855-627-9604 or visit wahealthplanfinder.org to find a list of in-person assisters in your area that can help you apply.

See the Health Care Authority website for more information on how to apply for Washington Apple Health (Medicaid).

We are available and eager to hear from our members about any questions, complaints or concerns you may have. If you have a grievance, please call Member Services toll-free, at 1-877-542-8997. Haddii aad tahay qof naafo ka ah maqalka ama hadalka, fadlan wac TTY: 711.

If Member Services can't resolve your grievance, or if you aren't happy with the response you get, please send your grievance in writing to:

Grievance Coordinator
Digniin: Appeals and Grievance
P.O. Box 31364
Salt Lake City, UT 84131-0364

Gudaha warqadaada, fadlan ku dar magacaaga, ciwaankaaga, lambarrada aqoonsiga macmiilka, sababta cabashadaada, iyo macluumaad kasta oo kale oo aad u malaynayso inay muhiim yihiin.

For more information, see the Grievance and Appeals Process

If you have questions about grievances and appeals, please call us toll-free, at 1-877-542-8997. Haddii aad tahay qof naafo ka ah maqalka ama hadalka, fadlan wac TTY: 711.

Khiyaanada iyo xadgudubku waa dembiyo culus. Waxaa jiri kara ciqaab sharci oo waafaqsan. You can report fraud or abuse by calling Member Services. Or call 1-866-242-7727. You do not have to give or leave your name.


For more information or to report online go here.

Si aad uga warbixiso xogta khaldan, u dir iimayl provider_directory_invalid_issues@uhc.com. Bogoskan iimaylka waxaa loogu talagalay xubnaha si ay uga warbixiyaan khaladaadka suurtagalka ah ee macluumaadka qofka (cinwaanka, telefoonka, iwm.) ee ku jira hagaha diiwaanka onlaynka ah ama waraaqaha. Ka warbixinta arrimaha iyadoo loo marayo bogoskan boostada waxay keeni doontaa in la gaaro xafiiska bixiyaha si loo xaqiijiyo dhammaan xogta dadka ee ku jira diiwaanka, taasoo qaadan karta qiyaastii 30 maalmood. Shakhsiyaadka sidoo kale waxay soo sheegi karaan khaladaadka suurtagalka ah iyagoo adeegsanaya telefoonka. UHC Members should call the number on the back of their ID card, and non-UHC members can call 1-888-638-6613 TTY 711.

Washington Apple Health / UnitedHealthcare logos

Wax Badan Ogow

Apple Health (Medicaid) Behavioral Health Services Only (BHSO)

Macluumaadka diiwaangelinta

Visit Washington Healthplanfinder site for more information on eligibility and enrollment. 

Washington Healthplanfinder

Naga soo wac:
1-855-923-4633 / 1-855-627-9604 / TTY: 711

Interpreter Services

Waxaan sidoo kale kaa caawin karnaa adeegyada turjubaanka, oo ay ku jiraan Luqadda Farahadalka Mareykanka. 

Naga soo wac:
1-877-553-0098 / TTY: 711

8:00 sn. ilaa 5:00 gn. waqtiga maxalliga ah, Isniinta – Jimcaha

Tallaabooyinka Isdiiwaangelinta
Get the details

The Washington Behavioral Health Services Only (BHSO) plan specialists can answer questions and help you enroll.

Naga soo wac:
8:00 sn. to 5:00 gn. pacific time, Monday – Friday

Interpreter Services

Waxaan sidoo kale kaa caawin karnaa adeegyada turjubaanka, oo ay ku jiraan Luqadda Farahadalka Mareykanka. 

Naga soo wac:
1-877-553-0098 / TTY: 711

8:00 sn. ilaa 5:00 gn. waqtiga maxalliga ah, Isniinta – Jimcaha

Macluumaadka Xubinta

Waxaad geli kartaa mareegtayada xubinta loogu talagalay. Daabac kaararka aqoonsiga, iyo wax badan. Hoos ka daawo buug-gacmeedkayaga.

Mareegta Xubinta

Member Handbooks

Getting Started Guides


Individual & Family ACA Marketplace Plans Disclaimer
(ku dhex wad bogoskan si aad u aragto)

Faaiidooyinka laga helo ayaa laga yaabaa inaan lagu bixin karin dhammaan qorsheyaasha aana laga bixin karin gobolada oo dhan. Qorsheyaasha qaarkood waxay u baahan karaan bixinta qiimeyaal goan, qarashaad la jarayo iyo/ama inta qarash kaga aaddan qofka caymiska kujira qarashka baxaya taasi oo loogu tala galay dadka faaiidooyinka caymiska hela. Qorshahaan wuxuu leeyahay waxyaabo aan kujirin, xadidaad, faaiidooyinka oo la dhimo, oo sharuudo soo hoos galaya siyaasada caymiska ayaa dhaqangal sii ahaan kara ama la joojin karaa. For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. Waxyaabaha qorshe caymis ugaar ah iyo faaiidooyinka caymiska ayaa kukala duwan waxa caymis kujira iyo qeybta qorshaha caymiska. Fadlan dib u eegid ku samee faahfaahinta qorshaha si aad wax badan uga ogaato.

UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization oo Katirsan CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in AL, KS, LA, MO, NJ, and TN; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of Mississippi, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Ohio, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of South Carolina, Inc.; UnitedHealthcare of Texas, Inc.; UnitedHealthcare of Oregon, Inc. in WA; and UnitedHealthcare of Wisconsin, Inc.  Administrative services provided by United HealthCare Services, Inc. or its affiliates.

This policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. Qiimeyaasha iyo faahfaahinta buuxda ee caymiska haddii aad dooneyso inaad ogaato, soo wac ama warqad usoo qor wakiilka caymiska ama shirkada, kii hadba labadaas arrin la isticmaali karo. By responding to this offer, you agree that a representative may contact you.

1 Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. Virtual visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. Services may not be available at all times, or in all locations, or for all members. Check your benefit plan to determine if these services are available. Ascaarta internetka ayaa ku jiri kara. Certain prescriptions may not be available and other restrictions may apply.

2 Tier 2 prescriptions for $5 or less not available on all medications. 3-month fills apply to select maintenance medications only. Applicable formulary requirements such as prior authorization and quantity limits may apply to your pharmacy benefits. Qiime dhimista Walgreens waxay shaqeyneysaa ilaa 12/31/24. Discount valid only for in-store purchases of eligible Walgreens brand health and wellness products by current members eligible for the UnitedHealthcare discount program. Qiime dhimis onlayn laguma adeegsan karo. Si aad u hesho liiska dhammaystiran ee agabka caafimaadka iyo fayo-qabka ee leh summada shirkadda Walgreens iyo ka-dhaafitaanada, fadlan booqo www.walgreens.com/smartsavings.

Cusbooneysintii Ugu Dambeysay: 04.18.2024 at 12:11 sn. CDT

Macluumaadka afeefta
(ku dhex wad bogoskan si aad u aragto)

Ma waxaad raadinaysaa mareegta dawladda dhexe ee Medicaid? Halkan ka eeg Medicaid.gov.

UnitedHealthcare Dual Complete Plans

Qorsheyaasha waxaa la doolaa iyadoo loo sii marayo Shirkadda Caymiska UnitedHealthcare ama mid ka mid ah shirkadaheeda xiriirka la leh, Hay'adda Medicare Advantage ee haysata qandaraaska Medicare iyo qandaraaska kula jirto Barnaamijka Medicaid ee Gobolka. Iska diiwaangelinta qorshaha waxay ku xiran tahay heshiiska cusboonaysiinta qorshaha ee Medicare. Qorshahan waxaa heli kara qof kasta oo haysta Medical Assistance ee laga helo Gobolka iyo Medicare. Dheefaha, qaybaha iyo/ama aaladuhu waxay ku kala duwan yihiin qorshe/aagga. Xaddidaadyada, ka-dhaafitaanada iyo/ama xannibaadyada shabakadeed ayaa laga yaabaa in lagu soo dabaqo. Macaashyada, khidmadaha iyo/ama kharashka la wada bixiyo/qaybsiga caymiska ayaa laga yaabaa inay isbeddelaan markay tahay 1-da Janaayo ee sannad kasta.

Khidmadda afeefta billaha ah

Qorshayaasha Dual Special Needs waxay leeyihiin $0 khidmado bille ah oo loogu talagalay xubnaha haysta Caawimaada Dheeraadka ah (Kabka Dadka Dakhligoodu Hooseeyo).

Dheefaha afeefta

Dheefaha, sifooyinka, iyo/ama aaladaha way ku kala duwan yihiin qorshe/aag ahaan. Xaddidaadyada, ka-dhaafitaanada iyo/ama xannibaadyada shabakadeed ayaa laga yaabaa in lagu soo dabaqo.

Afeefta Khadka-furan ee Kalkaalisada

Adeegani waa inaan loo isticmaalin baahiyada gurmadka ama daryeelka ee degdegga ah. Marka ay jirto xaalad degdega ah, wac 911 ama tag qolka gurmadka ee kuugu dhow. Macluumaadka lagu bixiyay adeegan waxaa laga leeyahay ujeedooyin waxbixin oo keliya. Kalkaaliyeyaashu ma sheegi karaan dhibaatooyinka ama kuma talin karaan daaweyn mana u noqon karaan beddel daryeelka daryeel bixiyahaaga. Macluumaadkaaga caafimaad waxaa loo keydiyaa si qarsoodi ah oo waafaqsan sharciga. Adeeggu maaha barnaamij caymis waxaana laga yaabaa in la joojiyo wakhti kasta. Khadka Taleefanka ee Kalkaalisada looma isticmaalo xaaladaha degdegga ah, ujeeddooyin macluumaad oo keliya ayaa loo isticmaalaa.

UnitedHealthcare Connected® ee MyCare Ohio (Medicare-Medicaid Plan)

UnitedHealthcare Connected® ee MyCare Ohio (Medicare-Medicaid Plan) waa qorshe caafimaad oo kunturaad la leh labadaba Medicare iyo Medicaid Ohio si ay u siiso macaashyada labada barnaamij dadka ka diiwaangashan. 

UnitedHealthcare Connected® (Medicare-Medicaid Plan)

UnitedHealthcare Connected® UnitedHealthcare Connected® (Medicare-Medicaid Plan) waa qorshe caafimaad oo kunturaad la leh labadaba Medicare iyo Texas Medicaid si uu u siiyo dheefaha labada barnaamij dadka ka diiwaangashan.

UnitedHealthcare Connected® oo loogu tala galay One Care (Qorshaha Medicaid - Medicare)

UnitedHealthcare Connected® oo loogu talagalay One Care (Medicare-Medicaid Plan) waa qorshe caafimaad oo kunturaad la leh labadaba Medicare iyo MassHealth (Medicaid) si ay u siiso dheefaha labada barnaamij dadka ka diiwaangashan. 

Afeefta dheefaha guud UnitedHealthcare Connected®

Kani ma ahan liis dhammeystiran. Macluumaadka macaashka waa qoraal kooban, ma ahan sharraxaadda dhammeystiran ee macaashyada. Wixii macluumaad intaas ka badan la xiriira qorshaha mise akhri Buug-gacmeedka Xubinta. Xaddidaado, wada-bixinno, iyo xannibaado ayaa lagu dabaqi karaa. Wixii macluumad dheeraad ah, wac Adeegyada Xubnaha ee ku xiran UnitedHealthcare ama aqri Buugyaraha Xubnaha ee UnitedHealthcare Connected®. 

UnitedHealthcare Senior Care Options (HMO SNP) Plan

Dookhyada Daryeelka Waayeeladda ee UnitedHealthcare (SCO) waa qorshaha Daryeelka Isku Dubaridan ee la leh qandaraas Medicare iyo qandaraas kula jira barnaamijka Common Wealth Massachusetts of Medicaid. Iska diiwaangelinta qorshaha waxay ku xiran tahay heshiiska cusboonaysiinta qorshaha ee Medicare. Qorshahan waa barnaamij isxilqaan ah uu heli karo qof kasta oo jira 65 iyo ka weyn oo u-qalma MassHealth Standard iyo Original Medicare oo aan lahayn caymis caafimaad ee kale ee dhamaystiran, marka laga reebo Medicare. Haddii aad leedahay MassHealth Standard, balse aadan u-qalmin Original Medicare, waxaa laga yaabaa inaad weli u-qalanto inaad iska diiwaangeliso qorshaheena MassHealth Senior Care Option oo aad hesho macaashyadaada MassHealth oo dhan adoo u maraya barnaamijkeena Dookhyada Daryeelka Waayeeladda ee UnitedHealthcare (SCO).

Afeefta qiimeynta xidigeed

Sannad kasta, Medicare waxay qiimaysaa qorsheyaasha iyadoo ku salaysa nidaamka qiimeynta 5-ta Xiddig. Qiimeynta 5-ta Xiddig waxay khuseysaa qorshaha sannadka 2024.

Macluumaadka bixiyaha ee muhiimka ah

Go'aanka Adigaa Leh.

Waxaan ku siin doonaa macluumaad kaa caawin doona inaad gaarto go'aano wargal ah, sida aqoonsashada dhakhaatiirta iyo xirfadleyaasha daryeelka caafimaadka. Macluumaadkan, si kastaba ha ahaatee, ma ahan mid ayidaya dhakhtar gaar ah ama xirfadlaha daryeelka caafimaadka ee ku habboon baahidaada.

Bixiyeyaasha la heli karo iyadoo loo marayo codsigan ma ahan inay xaqiiqdii uga turjumayaan si buuxda shabakada UnitedHealthcare ee bixiyeyaasha qandaraaska lagula jiro. Waxaa laga yaabaa inay jiraan bixiyeyaal ama takhasusleyaal gaar ah oo aan lagu darin codsigan oo qayb ka ah shabakadeena. Haddii aadan helin bixiyaha aad raadinayso, waxaad si toos ah ula xiriiri kartaa bixiyaha si aad u xaqiijiso xaaladda kaqaybgalka ee shabakadda UnitedHealthcare, ama kala xiriir Mamber Services lambarka bilaashka ah ee ku qoran kaarkaaga aqoonsiga UnitedHealthcare. Waxaan sidoo kale kugula talineynaa, kahor inta aadan la kulmin dhakhtar kasta, oo ay ku jiraan takhasusleyaal kasta, inaad wacdo xafiiska dhakhtarka si aad u xaqiijiso xaaladda kaqaybgalka iyo helitaanka.

Qaar kamid ah shabakadda bixiyeyaasha ayaa laga yaabaa in lagu daray ama laga saaray shabakadeena kadib markii diiwaankan la cusbooneysiiyay. Ma dammaanad qaadi karno in bixiye kasta weli aqbalayo xubno cusub.

Bixiyeyaasha shabakadda ka baxsan/kuwa aan qandaraaska lahayn kuma khasbana inay daaweeyaan xubnaha kujira qorshaha UnitedHealthcare, marka laga reebo xaaladaha gurmadka dagdagga ah. Fadlan soo wac lambarkeena adeegga macmiilka ama ka eeg Caddayntaada Caymis wixii macluumaad dheeraad ah, oo ay ku jiraan kharash wadaagga khuseeya adeegyada shabakadda ka baxsan.

Ogeysiiska Xeerka Naafada Mareykanka

Sida waafaqsan shuruudaha Xeerka Naafada ee Dawladda Dhexe Maraykanka 1990 iyo Qeybta 504 Xeerka Baxnaaninta 1973 ("ADA"), Shirkadda Caymiska UnitedHealthcare waxay bixisa adeegyada la daboolay oo buuxa oo loo siman yahay mana takooraan shakhsiyaadka u-qalma ee naafada ah iyadoo lagu salaynayo naafanimada markay bixinayaan adeegyadooda, barnaamijyadooda, ama waxqabadooda.

Gudbinta

Bixiyeyaasha shabakadda ayaa idin ka caawin doona adiga iyo xubnaha qoyskaaga ee caymiska leh inaad heshaan daryeelka aad u baahan tihiin. Helitaanka dhakhaatiirta takhasuska leh waxaa isku dubaridi kara dhakhtarkaaga daryeelka aasaasiga ah.

Codsiyada diiwaanka waraaqaha

Nuqullada warqadaha ee ku jira diiwaanka bixiyaha shabakadda waxay ku heli karaan xubnaha si bilaash ah iyagoo wacaya lambarka adeegga macmiilka ee ku yaala gadaasha kaarka aqoonsiga. Dadka aan xubinta ka ahayn waxay natiijooyinka ka soo dejisan karaan oo ka daabacan karaan diiwaanka onlaynka ah.

Macluumaadka khaldan

Si aad uga warbixiso xogta khaldan, u dir iimayl provider_directory_invalid_issues@uhc.com. Bogoskan iimaylka waxaa loogu talagalay xubnaha si ay uga warbixiyaan khaladaadka suurtagalka ah ee macluumaadka qofka (cinwaanka, telefoonka, iwm.) ee ku jira hagaha diiwaanka onlaynka ah ama waraaqaha. Ka warbixinta arrimaha iyadoo loo marayo bogoskan boostada waxay keeni doontaa in la gaaro xafiiska bixiyaha si loo xaqiijiyo dhammaan xogta dadka ee ku jira diiwaanka, taasoo qaadan karta qiyaastii 30 maalmood. Shakhsiyaadka sidoo kale waxay soo sheegi karaan khaladaadka suurtagalka ah iyagoo adeegsanaya telefoonka. Xubnaha UnitedHealthcare waa inay wacaan lambarka ku yaalla dhabarka dambe ee kaarkooda aqoonsiga, halka dadka aan xubinta ka ahayn UnitedHealthcare ay soo wici karaan 1-888-638-6613 TTY 711, ama waxay isticmaali karaan adeegga gudbinta ee ay doorbidayaan.

Ku Dhawaaqida Masiibo ama Xaalad Dagdag ah

Haddii ay ku saamayso ku dhawaaqida musiibo ama xaalad dagdag ah ee Madaxweynaha ama Gobarnatooraha, ama ogeysiiska xaalad caafimaadka dadweynaha ee dagdaga ah oo uu ku dhawaaqay Xoghayaha Caafimaadka iyo Adeegyada Aadanaha, waxa jira taageero dheeraad ah oo gaar ah oo adiga diyaar kuu ah.

  • Qaybta A, Qaybta B, iyo dheefaha qorshaha Qaybta C ee dheeraadka ah waa in lagu bixiyaa xarumo aan kunturaad lahayn oo gaar ah (ogsoonoow in dheefaha Qaybta A iyo Qaybta B ay tahay in laga helo xarumaha shahaadaysan ee Medicare);
  • Meeshii ay ku habboon tahay, shuruudaha loogu talagalay gudbinta albaab-ilaaliyaha si buuxda ayaa looga dhaafay;
  • Wadaagista kharashka shabakada ka baxsan ee qorshaha la ansixiyay ilaa qadarada wadaagista kharashka shabakada ayaa si ku meelgaar ah loo dhimay; iyo
  • Shuruudaha oggeysiiska ee 30-ka maalin ah ee ku aadan xubnaha waa la dhaafay, ilaa inta dhammaan isbeddellada dheefta (sida dhimista wadaagista kharashka iyo oggolaanshaha ka dhaafitaanka) ee xubinta.

Haddii CMS aysan bixin taariikhda dhammaadka ee loogu talagalay musiibada ama xaaladda degdegga ah, qorshooyinka ayaa dib u bilaabi doona maalmaha 30 shaqada ee caadiga ah ka dib ku dhawaaqista hore.

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