Washington Apple Health (Medicaid) 

Have you received information asking you to take action so that you can keep getting benefits?

We’re here to help you.

Call us toll-free at

1-866-686-9323, TTY 711.

Don’t let your health care coverage end. It’s too important.

You can also renew by contacting the Washington Health Benefits Exchange.

Online: wahealthplanfinder.org

Or call: 1-855-923-4633, TTY/TDD 1-855-627-9604.

If you have questions about your health plan, please call us. Our toll-free Member Services number is 1-877-542-8997 (TTY: 711).

There will be people who can speak to you 24 hours a day, 7 days a week in English, Spanish and Vietnamese when you call.

UnitedHealthcare Community Plan has practice guidelines that help providers make healthcare decisions. These guidelines come from nationally recognized sources. UnitedHealthcare Community Plan has practice guidelines for conditions including:

• Asthma
• Attention deficit hyperactivity disorder (ADHD)
• Bipolar disorder
• Chronic obstructive pulmonary disease (COPD)
• Depression
• Diabetes
• Heart disease
• Heart failure
• High blood pressure
• Obesity
• Prenatal care
• Pediatric preventive healthcare
• Substance abuse disorders
• Transplants

Click here to view the entire list of guidelines or call our Member Services at 1-877-542-8997 (TTY: 711) to request a printed copy.

Provider Advisory Committee Approval - July 24, 2019

We have a Notice of Privacy Practices that tells you how health information about you may be used and shared. We are required by law to let you know that the Notice is available, and how you can get a copy of it. View a copy of our Notice of Privacy Practices. 

You have certain rights and responsibilities when you enroll. It is important that you fully understand both your rights and your responsibilities. For detailed information about your rights and responsibilities download here.

If you are not happy with the service UnitedHealthcare Community Plan has provided, you can file a grievance. Download our Grievance and Appeals Process Form. It's available in English and Espanol.

We require prior authorization on all out-of-network referrals. The request is generally processed like any other authorization request. The nurse reviews the request for medical necessity and/or service. If the case does not meet criteria, the nurse routes the case to the Medical Director for review and determination. Out-of-network referrals are generally approved for, but not limited, to the following circumstances:

• Continuity of care issues
• Necessary services are not available within network.

Out-of-network referrals are monitored on an individual basis. Trends related to individual physicians or geographical locations are reported to Network Management for review.

To find out if a prior authorization request has been approved, check with your provider or call member services, at 1-877-542-8997 (TTY: 711). If the prior authorization request is denied, you will be notified in writing, including your right to appeal this decision.

UnitedHealthcare Community Plan provides member materials to you in a language or format that makes it easier for you to understand. Our provider network includes many doctors who are multilingual. Our provider directory shows which languages doctors speak. Additionally, many of our Member Services representatives speak multiple languages, so when you call they will be able to help you or connect you with our interpreter service which covers more than 170 languages.

If you have trouble hearing over the phone you can use a text telephone. This free service allows persons with hearing or speech disabilities to place and receive telephone calls. Call 711, give them the Member Services number 1-877-542-8997, and they will connect you to us. You can also get information in large print, Braille or audio tapes. We can also assist with interpreter services, including American Sign Language. To ask for help, please call 1-877-542-8997, TTY 711, Monday through Friday, 8:00 a.m. to 5:00 p.m.

Our toll-free Member Services number is 1-877-542-8997 (TTY: 711).

Many patients suffer from behavioral health problems such as depression, anxiety, and substance use disorder. This model enhances services provided by primary care providers by collaborating with behavioral health providers. And helps patients live a healthier life.

Services include:

• Care management support for patients receiving behavioral health treatment
• Regular psychiatric inter-specialty consultation
• Shared targeted treatment plans that incorporate patient goals.

You can find a list of participating providers in English, Spanish or call 1-877-542-8997, TTY 711. For more information visit https://aims.uw.edu