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.
OR
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.

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.

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.

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 have many programs to help meet your needs:

Adolescent to Adult (a2A) – connecting you to resources, health education and care as you transition to adulthood
Alcohol and drug use – screening, specialized care management, connection to treatment and support services
Depression management
Support for LGBTQIA+ – we help you get the most out of your health care with service to support you and your sexual orientation and gender identity
Care management for transgender health and gender-affirming care
Zero Suicide – our program for members to reduce suicidal thoughts and self-harm behaviors with ongoing support

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
Behavioral health visits

…and more

Yep, you’re covered for these too:

Rewards Program (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 3 GB. Calls to Coordinated Care don’t count towards your minutes.

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.

Dental

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.

Family Planning Services

Family Planning Services for Apple Health (Medicaid) recipients provides birth control and family planning services for women and men.

Your Apple Health (Medicaid) coverage will cover the cost of your annual exam and chosen birth control method, including:

Emergency contraception pills
Condoms
Birth control pills
Vaginal Ring
Contraceptive Ring
Contraceptive Implant (Implanon)
Diaphragm
IUD
Depo Provera Shot
Tubal ligation
Vasectomy

Where you can get Family Planning services:

You can get Family Planning services at a local family planning clinic, doctor’s office or pharmacy.

Contact the Family Planning hotline at 1-800-770-4334 to receive information and referrals for:

Birth Control
Limited STD Screening
Annual Exams
Sterilization for men and women
Counseling for Natural Family Planning

You can use your ProviderOne Services card at pharmacies to buy over-the-counter birth control, including: condoms, spermicidal film, foam, creams, and jellies.

If you received -Apple Health coverage while pregnant, you are eligible for the Family Planning Program for up to 10 months following the pregnancy.

If you do not have health care coverage, you may apply online at www.wahealthplanfinder.org or by calling 1-855-923-4633.

You may also be able to get family planning services from a program called TAKE CHARGE. Contact the TAKE CHARGE hotline at 1-800-562-3022 extension 15481 to receive information.

Transportation to Medical Appointments

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 https://www.hca.wa.gov/assets/free-or-low-cost/optical_providers_adult_medicaid.pdf

Flu Shots

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.

Teladoc

Teladoc is an easy way for Coordinated Care members to talk with a doctor on a computer, tablet or phone.

24-hour access to in-network providers for non-emergency medical issues. Get medical advice, a diagnosis or a prescription.
You can make appointments that work with your schedule. Get help for:

Colds, flu, fevers
Rash, skin conditions
Sinuses, allergies
Respiratory infections
Behavioral health (18 years and older)

Set up an account so it’s ready when you need it. Visit Teladoc.com/CoordinatedCare or call 1-800-835-2362 (TTY:711). To get started, you need the member’s name, date of birth, and an email address.

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
Fainting/unconsciousness
Suddenly not able to see, move or
Miscarriage/pregnancy with vaginal bleeding
A bad burn
You are in labor
Seizures
Drug overdose
Bleeding that won’t stop
Gun or knife wounds
A broken bone
Poisoning

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.

Behavioral Healthcare

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
Depression
Anxiety
Drug and alcohol abuse
ADHD

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 https://www.teenlink.org/. The helpline is open 6pm-10pm 365 days a year.
And much more...