Business Details
34 Years
experience
Emergency
services
Your Trusted Washington Health Insurance Partner
Founded in 1992, we are a not-for-profit health insurance plan dedicated to improving healthcare access across Washington State. Our mission centers on providing comprehensive coverage through Apple Health (Medicaid), Medicare Advantage, and specialized behavioral health plans. We prioritize community-based care, partnering with over 2,700 primary care providers and 14,700 specialists to ensure accessible services. Our team offers unique benefits like free glasses, preventive care rewards, and telehealth options, emphasizing whole-person wellness. With a focus on underserved populations, we provide language assistance services and culturally competent care.Our network includes 21 community health centers operating 190+ clinics, ensuring localized support. We maintain transparency through detailed member handbooks and 24/7 nurse advice lines. Our eligibility specialists guide members through enrollment processes, while case managers support behavioral health goals. We continuously expand services based on community needs, recently integrating 77 MultiCare clinics into our network. Our commitment to Washington's health is reflected in programs like MemberFirst Rewards, which incentivizes preventive screenings and maternal care.
Services
Apple Health Plans
Medicare Advantage
Behavioral Health Services
Member Rewards Programs
Provider Network Access
Details
- Year established: 1992
Highlights and features
- We offer comprehensive health insurance plans including Apple Health and Medicare Advantage
- We provide free language assistance services in multiple languages
- Our network includes 190+ community health clinics statewide
- We operate 24/7 nurse advice lines for urgent medical guidance
- We offer preventive care rewards programs for members
Services
Apple Health Plans
We provide comprehensive Medicaid coverage (called Apple Health in Washington) for eligible residents through our HMO network. Our plans include preventive care, prescription coverage, and specialized services. Members receive additional benefits like free glasses and dental accident coverage without extra premiums.
Medicare Advantage
Our Medicare Advantage plans offer enhanced benefits beyond Original Medicare, including dental and vision coverage. We serve seniors and individuals with disabilities through coordinated care networks. Our dual-eligible plan combines Medicare and Medicaid benefits for qualifying members.
Behavioral Health Services
We offer comprehensive mental health and substance use disorder treatment through in-network providers. Services include counseling, medication management, and crisis intervention. Telehealth options like CHPW Virtual Care and Brightside provide accessible treatment for anxiety, depression, and addiction.
Member Rewards Programs
Our preventive care rewards program pays members for completing health screenings and wellness visits. Participants can earn up to $200 annually for cancer screenings, $150 for prenatal care, and $540 for children's wellness visits through our MemberFirst and ChildrenFirst initiatives.
Provider Network Access
We maintain a statewide network of 2,700+ primary care providers and 14,700+ specialists. Our members access care through 21 community health centers operating 190+ clinics, including recently integrated MultiCare locations offering primary and specialty services.
Questions
What health plans do you offer?
We offer Apple Health (Medicaid), Medicare Advantage, and Behavioral Health Services Only (BHSO) plans for Washington residents.
How do I check provider network participation?
Use our online provider directory or call Customer Service to verify if your doctor accepts our insurance.
Are preventive services free?
Yes, in-network preventive care services have no cost-sharing for members.
Do you cover out-of-state emergencies?
Emergency services are covered anywhere in the U.S. when medically necessary.
How do I get prescription coverage?
All Apple Health and Medicare Advantage members receive prescription drug coverage through our pharmacy network.
What support exists for behavioral health?
We offer 24/7 nurse advice lines, telehealth therapy, and in-network specialist access for mental health treatment.
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