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Best Washington Apple Health Plan

author
Paul Gonzalez
• Friday, 20 November, 2020
• 8 min read

Our friendly Telehealth experts are knowledgeable and take the time to get to know you and your health needs. Telehealth offers integrated managed care plans in all regions statewide.

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Contents

Integrated managed care (IMC) coordinates physical health, mental health, and substance use disorder treatment services to help provide whole-person care under one health plan. Most Telehealth clients have managed care, which means Telehealth pays a health plan a monthly premium for your coverage, which include preventive, primary, specialty, and other health services.

Their managed care enrollment is backdated to the beginning of the current month. Clients can change their managed care plan at any time.

24/7 regional crisis hotline for mental health and substance use disorder crises Mobile crisis outreach teams Short-term substance use disorder crisis services for individuals who are intoxicated or incapacitated in public Application of behavioral health involuntary commitment statutes, available 24/7 to conduct Involuntary Treatment Act (ITA) assessments and file detention petitions Regional Om buds Within available funding, a HAS also has the discretion to provide outpatient behavioral health services or voluntary psychiatric inpatient hospitalizations for individuals who are not eligible for or enrolled in Telehealth.

The Telehealth Foster Care (AFC) program provides integrated managed physical and behavioral health coverage statewide, known as integrated managed care. You can choose any one of the five available plans that serve your area when you enroll in Telehealth.

File a complaint because you're not happy with the service you were provided by your doctor or the health plan. Replace your Apple Health plan benefits card.

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That’s what we call it when Telehealth pays providers directly for each service they do, using the Provider payment system. In some situations, clients are able to choose whether they receive FFS coverage or are enrolled in a health plan.

Statewide Crisis services are available to support you, based on where you live. When selecting a WEBB medical plan, your options are limited based on eligibility and where you live.

You must report your new address to your personnel, payroll, or benefits office no later than 60 days after your move. All medical plans, except for Premiere Blue Cross Medicare Supplement Plans, cover the same basic health care services but vary in other ways, such as provider networks, premiums, and drug formularies.

Get a side-by-side comparison of common medical benefits and costs for services. However, classic plans may have lower annual deductible, copay, or coinsurance costs.

Some plans require you to pay a fixed amount, called a copay. Other plans require you to pay a percentage of an allowed fee when you receive care, called a coinsurance.

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The annual out-of-pocket limit is the most you pay in a calendar year for covered benefits. Once you have reached the out-of-pocket limit, the plan pays 100 percent of allowed charges for most covered benefits for the rest of the calendar year.

Certain charges (such as your annual deductible, copay, and coinsurance) may count toward your out-of-pocket limit. Some plans allow you to self-refer to network providers for specialty care.

All health carriers in Washington are required to maintain provider networks that offer members reasonable access to covered services. For more information, see Engrossed Substitute House Bill 1099 (Brennan’s Law).

In general, WEBB plans don’t require you to file claims. However, Uniform Medical Plan (UMP) members may need to file a claim if they receive services from a non-network provider.

It ensures the highest level of reimbursement for services when a person is covered by more than one plan. If you are also covered by another health plan, call the plan to ask how they coordinate benefits.

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This is especially important for those coordinating benefits between the WEBB and WEBB programs, and those enrolled in Telehealth (Medicaid). Also, not everyone qualifies to enroll in a CDP with a health savings account (HSA).

Value-based plans aim to provide high quality care at a lower cost. The WEBB Program offers three types of medical plans.

Camps let you use a health savings account (HSA) to help pay for out-of-pocket medical expenses tax-free, have a lower monthly premium than most plans, and a higher deductible and a higher out-of-pocket limit. In general, WEBB retirees may choose from the plans listed below.

If you or a covered dependent are enrolled in Medicare Part A and Part B and you choose Kaiser Permanent NW or Kaiser Permanent WA, you must enroll in the Medicare Advantage plan if they offer it in your county. Neither the health plan nor Medicare will pay for services received outside the plan’s network except for authorized referrals and emergency care.

Medicare Advantage Prescription Drug (MAP) plans offered by UnitedHealthcare include Medicare Part D coverage and are available nationwide (including American Samoa, Guam, the Northern Marianas, Puerto Rico, and the U.S. Virgin Islands). If you or a covered dependent are enrolled in Medicare Part A and Part B, and you choose Kaiser Permanent NW or Kaiser Permanent WA, you must enroll in the Medicare Advantage plan if they offer it in your county.

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Enrollment in the Medicare Advantage or MAP plans may not be retroactive. Premiere Blue Cross Medicare Supplement Plan G lets you use any Medicare-contracted physician or hospital nationwide.

This plan supplements your Original Medicare coverage by reducing most of your out-of-pocket expenses and providing additional benefits. It pays most deductibles, coinsurance, and copay covered by Medicare.

Medicare Supplement Plan G does not include prescription drug coverage. Telehealth provides preventative care, like cancer screenings, treatment for diabetes and high blood pressure, and many other health care services.

For most people, WashingtonAppleHealth is free, but some families may have to pay a monthly premium. Sign in and update (report a change) your income to see if you qualify for free or low-cost Apple Health or other financial help.

Sign in and update (report a change) your income to see if you qualify for free or low-cost Apple Health or other financial help. Sign in to your account and select “Report a Change” to update your information.

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Press question mark to learn the rest of the keyboard shortcuts Perhaps someone here has already looked into this and come to a conclusion as to pluses and minuses of each plan.

News, current events in & around Seattle, Washington, USA. All medical plans cover the same basic health care services, but vary in other ways such as provider networks, premiums, your out-of-pocket costs, and prescription drug coverage.

When selecting a WEBB medical plan, your options are limited based on eligibility and where you live. Remember, if you cover eligible dependents, everyone must enroll in the same medical and dental plans.

You must report your new address to your payroll or benefits office no later than 60 days after your move. A premium is the monthly amount the employee or employer pays to the plan to cover the cost of insurance.

Generally, plans with higher premiums may have lower annual deductibles, copay, or coinsurance costs. Plans with lower premiums may have higher deductibles, coinsurance, copay, and more limited networks.

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Medical plans may also have a separate annual deductible for specific prescription drugs. Covered preventive care services are exempt from the medical plan deductible.

When you receive care, some plans require you to pay a fixed amount, called a copay. Other plans require you to pay a percentage of an allowed fee, called coinsurance.

These amounts vary by plan and are based on the type of care received. Once you have reached the out-of-pocket limit, the plan pays 100 percent of allowed charges for most covered benefits for the rest of the calendar year.

If you have a long-term relationship with your doctor or health care provider, you should verify whether they are in the plan's network. For more information, see Engrossed Substitute House Bill 1099 (Brennan’s Law).

It ensures the highest level of reimbursement for services when a person is covered by more than one plan. If you are also covered by another health plan, call the medical plans directly to ask how they will coordinate benefits.

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This is especially important for those coordinating benefits between the WEBB and WEBB programs, and those also enrolled in Telehealth (Medicaid). WEBB medical and dental coverage is limited to a single enrollment per individual.

Most plans offer online resources to help you easily find information about your care to support you in making the decisions that work best for you. Value-based plans aim to provide high quality care at a lower cost.

Camps let you use a health savings account (HSA) to help pay for out-of-pocket medical expenses tax-free, have a lower monthly premium than most other plans, and a higher deductible and a higher out-of-pocket limit.

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Sources
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