Am I eligible for medical coverage after I turn 18 years old?
You may be eligible if you answer “yes” to one of the statements below:
- I am currently under 21 years of age and in foster care or other eligible out-of-home placement with DSHS or a federally recognized tribe within Washington state.
- I left foster care or other eligible out-of-home placement on or after my 18th birthday and I am under 26 years of age.
Eligible out-of-home placements include:
- Licensed foster and relative care
- Tribal foster care
- ICPC foster care in Washington state
- Dependency Guardianships established prior to June 2010
- Suitable other placements (unlicensed, court ordered)
Note: Youth in the Adoption Support program are eligible until their 18th birthday or up to age 21 if still in high school.
Fee for Service or Managed Care????
If you are eligible for Apple Health to 26, then you may choose between fee for service or managed care with Apple Health Core Connections for your coverage.
Fee for service: You may see any Washington Apple Health provider that accepts the ProviderOne card. You have to find your own providers and make sure all your providers know about your health status and any specialty care you need.
Apple Health Core Connections (AHCC): Help with all parts of your health care. This includes physical, behavioral and access to dental providers. AHCC has care managers to help find providers and coordinate information about your health to make sure you get the care you need.
If you are 18 – 26 years of age, you can choose to stay in AHCC (no action needed) or change your Apple Health coverage to “fee for service.” Contact the Foster Care Medical Team (FCMT) at 1-800-562-3022 or FCMT@HCA.WA.GOV to help you decide what type of coverage is best for you.
What is Apple Health Core Connections (AHCC)?
Apple Health Core Connections is the health plan provided by Coordinated Care and the Health Care Authority for youth currently in care and alumni of foster care in Washington State. If you were in foster care on your 18th birthday, you are automatically covered through the month of your 26th birthday.
We’ve got you covered for things like:
- Urgent care and ER
- Doctor and specialist visits
- Drug and alcohol treatment
- Over the counter and prescription medications
- Dental visits
- Eye exams, glasses, contacts
- Mental health visits
- Transgender health services
- Help to quit smoking
- Family planning
Yep, you’re covered for these too:
- CentAccount Rewards (18 and older): Earn rewards for staying healthy – buy personal care products, groceries, and more.
- Care Management & Member Connections (all ages): Receive personalized help managing your benefits, resources, and health conditions.
- Online Member Account (18 and older): Access your benefits and get a new ID card 24/7 through your account.
- 24-Hour Nurse Advice Line (all ages): Call anytime for medical and mental health support, get help deciding if you should go to an ER or urgent care.
- SafeLink Cell Phone (18 and older): Get a cell phone with 350 minutes and unlimited texting, calls to Coordinated Care don’t count towards your minutes.
Connect with Coordinated Care about your AHCC health care benefits:
@CoordinatedCare on Facebook and Twitter
What else do I need to know?
- Your Apple Health (fee for service or AHCC) eligibility will continue until your 26th birthday as long as you were in foster care on the day you turned 18.
- Apple Health (fee for service or AHCC) is for medical and behavioral health care services only. You can apply for TANF or food assistance by going to your local Community Services Office.
- KEEP your ProviderOne and your AHCC cards when you leave foster care.
- Contact FCMT for questions about eligibility and enrollment.
- Always update your address and phone number with the FCMT. This will make sure you get important information about your health care.
What if I lose my ProviderOne card?
To call the Foster Care Medical Team (FCMT), use these directions:
The phone system is very sensitive so make sure there isn’t a lot of noise around you.
- Dial: 1-800-562-3022
- Stay on the line.
- Say, “Dial” when the system asks you if you have an extension.
- When the system asks if you are a “client, provider, or other.” DO NOT answer; just press “3” on your phone.
- The system will say it is transferring you and then ask you to dial the extension number.
- Dial the FCMT .What if I lose my AHCC card?
These instructions also work for non-English speaking youth. The FCMT uses interpreter services when needed.
There is no cost if you need a new card. Contact Health Care Authority and you will get one in 7-10 days. This card is used for things such as dental, certain behavioral health services, substance use services, maternity support services, transportation for medical appointments and more.
What if I lose my AHCC card?
Call 1-844-354-9876 and request a new card or go to www.coordinatedcarehealth.com and use the Online Member Account to get a new ID card 24/7.
There is no cost if you need a new card. Contact Coordinated Care Apple Health Core Connections at 1-844-354-9876 or login to your Member Account (if over 18). Always keep this card and your Provider One Services Card with you. However, you do not need this card in order to receive health care services. If you ever have problems at a doctor’s office or pharmacy, make sure and call Coordinated Care 24/7 so they can help. 1-844-354-9876.
Get the most from Apple Health
You may not know all the helpful benefits and services that are covered by Apple Health.
In addition to all the things you would expect to be covered like doctor office visits, emergency room, lab tests/x-rays, prescriptions, hospital care, there is a whole lot more.
Check out the list below for covered services that can help you be healthier and save you money.
Are you a Coordinated Care Apple Health Core Connections member? Call 1-844-354-9876 for assistance with any of these benefits below.
Adult Dental Benefits for age 21 and over includes: exams, annual teeth cleaning, x-rays, fillings, extractions and more. Youth under 21 have additional dental benefits. You must go to a Dentist that accepts the ProviderOne Services Card.
Over the Counter Medications with a doctor’s prescription: such as painkillers, antacids, allergy and cold medicines, athlete’s foot cream, diabetic testing supplies, prenatal vitamins and many more.
Help Quitting Smoking
Including no-cost medication (such as gum, lozenges, patch) to help you quit and someone to encourage and support you in the process of quitting smoking.
No-cost condoms ( men and women) and the method of birth control of your choice (for women) including birth control pills, ring, emergency contraceptive and long-acting methods such as birth control shots and IUDs provided at no cost with a prescription from your doctor. Over-the-counter birth control methods do not require a prescription. Did you know you can get a 12-month supply of the birth control at a time?
Help with no cost rides or gas money to get to and from the doctors, dentist, hospital, and/or drug store for medically necessary services
- If eligible, transportation will be provided to services covered by Apple Health.
- Your Regional Broker will arrange the most appropriate, least costly type of transportation to the closest medical provider offering the service you need.
- It is best to plan ahead 7-14 days if you want to use this benefit.
- Contact your Regional Broker for more information and to arrange transportation http://www.hca.wa.gov/medicaid/transportation/pages/phone.aspx
Eye Exams, Eye Glasses, and Contacts
Eye exams, including tests for refraction and visual fields, are provided for children up to 20 years old once every 12 months and for adults 21 and over every 24 months.
For children up to 20 years old, eyeglass frames, lenses, contact lenses, and fitting services are covered by the Provider One Services Card. Your eye doctor will help you get this service. It is a great idea to get glasses/contacts if you need them prior to turning 21 while you still have them as a no-cost benefit!
For adults, eyeglass frames, lenses, and contact lenses are not covered by Apple Health, but if you wish to buy them, you can order them through participating providers at a discounted price. You’ll find a list of participating providers at http://www.hca.wa.gov/assets/free-or-low-cost/Optical_Providers_Adult_Medicaid.pdf
Did you know in recent years the flu has made many young people very sick? Protect yourself and those around you by getting a flu shot every year at no cost. You can get the flu shot at covered pharmacies or from your primary care doctor’s office.
Urgent Care or Emergency Room
If your problem is not an emergency, you may wait a long time in the ER. Instead of going to the ER for something that is not life-threatening, call your doctor or go to an urgent care clinic.
For Coordinated Care Apple Health Core Connections members you can call your doctor or call 24/7 the Nurse Advice Line for help on what to do. They can assist with medical and mental health questions. You may be advised to go to an Urgent Care Center. To find the nearest Urgent Care Center call the Coordinated Care Nurse Advice Line at 1-844-354-9876 or use the Find A Doctor tool on www.coordinatedcarehealth.com
If you feel your life is in serious medical danger, you should call 911 or go to an Emergency Room (ER). ERs are open 24 hours a day. They provide immediate, emergency medical care. Some reasons to go to an ER or call 911 right away include:
- Chest pain or other severe pain
- Suddenly not able to see, move or
- Miscarriage/pregnancy with vaginal bleeding
- A bad burn
- You are in labor
- Drug overdose
- Bleeding that won’t stop
- Gun or knife wounds
- A broken bone
No Health Care Bills!
On Apple Health you should never get a bill for covered health care services. There is never any co-pays or fees for the services provided with Apple Health. If you get a bill, don’t panic! Contact FCMT or your health plan. If you are a Coordinated Care Apple Health Core Connections Member, contact 1-844-354-9876 if you receive a bill and they will do the work to get it fixed for you.
A behavioral health condition, also called a mental health issue, causes changes in a person’s thinking, mood or behavior. This includes problems like:
- Feeling sad or hopeless
- Drug and alcohol abuse
Many mental health issues are medical problems just like cancer or heart disease. These can happen to anyone. They can be treated. Treatment may include talking to a therapist or taking medication. Left alone, mental health problems can get worse.
You can get counseling, outpatient treatments, office visits for behavioral health issues, medications, inpatient behavioral health services, intensive behavioral health services and substance abuse treatments as part of your Apple Health benefits.
If you are a Coordinated Care Apple Health Core Connections Member, call 1-844-354-9876 to talk with a behavioral health care coordinator to get help with behavioral health services.
Receive anonymous, confidential support by teens for teens by calling 866-TEEN-LINK or chat via the web at www.866TEENLINK.org. The helpline is open 6pm-10pm 365 days a year.
Extra Programs for Coordinated Care Apple Health Core Connections Members
Coordinated Care provides pregnant members and new moms programs to support you and your baby’s health. You are automatically enrolled into Start Smart for Your Baby® when you complete the Notice of Pregnancy (NOP) form (this form must be completed at least 6 weeks before your due date to qualify for a car seat). This program includes extras like:
- No Cost Car Seat: Sent to the member when you tell us you’re pregnant! (Must complete NOP form as stated above)
- Breastfeeding Support: Includes a no-cost, high-quality breast pump for moms who are nursing.
We want to help you have good health. Coordinated Care gives you rewards for taking care of your health. Through the CentAccount® Rewards program, you can earn reward dollars on a pre-paid gift card. There are no fees or costs to you. It’s our way of celebrating your choice for better health. Earn rewards by doing healthy activities like getting your annual wellness exam. After you complete one of the healthy activities, we automatically mail a CentAccount® card to you. You can use your card to buy hundreds of items like groceries, baby care or personal care products at participating stores. Visit our website to learn more and see a list of items available to purchase.
A cell phone at no cost is made available to qualifying members through SafeLink®, a federally funded phone program. Coordinated Care members get a phone with 350 minutes per month and unlimited texting. In addition, calls to our Member Services line or 24/7 Nurse Advice Line do not count towards your minutes.
Receive personalized assistance getting social services and accessing your health plan benefits. Our team of Community Health Workers (CHWs) is part of the Care & Disease Management department.