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Washington Apple Health (Medicaid) Behavioral Health Services Only (BHSO) 常見問答集

If you are not enrolled in the Washington Apple Health (Medicaid), you may be eligible. To find out if you qualify visit wahealthplanfinder.org or call 1-855-WAFINDER (1-855-923-4633) TTY/TTD 1-855-627-9604.

If you are currently enrolled in Apple Health (Medicaid) and would like to change to UnitedHealthcare Community Plan we can help. 

There are several ways to switch your plan:

For more information on Washington Apple Health (Medicaid), visit the Washington State Apple Health website.

Currently, this plan is available in all counties, but UnitedHealthcare Community Plan only offers the plan in the following counties: Clallam, Cowlitz, Grays Harbor, Island, Jefferson, King, Kitsap, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Snohomish, Thurston, Wahkiakum, and Whatcom.

Members of Washington Apple Health (Medicaid) will receive two ID cards

One from UnitedHealthcare Community Plan and one from Washington State called your ProviderOne ID card. Every family member enrolled in the plan should have his or her own ID cards.

 Washington Member ID Card
You will need your UnitedHealthcare Community Plan ID card and your ProviderOne card for all visits to the doctor, hospital, and pharmacist. If you haven't received your ID cards within one week of your effective date of enrollment with UnitedHealthcare Community Plan, please contact Member Services, at 1-877-542-8997. 如果您有聽力或語言障礙，請致電聽障專線 (TTY)：711 Washington Medicaid Member ID Card

我們很樂意寄給您新的。Please contact Member Services toll-free, at 1-877-542-8997. 如果您有聽力或語言障礙，請致電聽障專線 (TTY)：711. You can also go to myuhc.com/communityplan, register, and print a copy of your card.

If you move, you will need to contact one of the following agencies to let them know your new address.

Washington Apple Health (Medicaid) – Family Coverage, with Premium (SCHIP) or Foster Care Please visit wahealthplanfinder.org or call 1-855-WAFINDER (1-855-923-4633) TTY/TTD 1-855-627-9604.

Washington Apple Health (Medicaid) –Blind/Disable please call your DSHS Community Service Office (CSO) or if you do not know the number in your area, call DSHS toll free, at 1-877-501-2233, Monday–Friday, 08:00 to 17:00 If you are hearing or speech impaired, call TTY/TDD 1-800-848-5429.

UnitedHealthcare Community Plan

1111 3rd Ave, Suite 1100
Seattle, WA 98101

Medicaid is a program funded by the federal and state governments, which pays for medical care for those who can't afford it. Washington Apple Health (Medicaid) is Washington State’s Medicaid managed care program for Adults and Families.

To see if you qualify please visit wahealthplanfinder.org or call 1-855-WAFINDER (1-855-923-4633) TTY/TTD 1-855-627-9604.

For more information about eligibility or for additional information on Washington Apple Health (Medicaid) information, please visit the Health Care Authority website.

You can apply for Washington Apple Health (Medicaid) on any computer with an internet connection at Washington Healthplanfinder, wahealthplanfinder.org.

When you're ready to apply, you'll need this information:

  • Your household monthly income.
  • The Social Security numbers and dates of birth for each member of your household.
  • Your immigration information, if that applies to you.

It should take about 45 minutes to apply online — and you'll get a response right away. If you need additional assistance, you can call 1-855-WAFINDER (1-855-923-4633) TTY/TTD 1-855-627-9604 or visit wahealthplanfinder.org to find a list of in-person assisters in your area that can help you apply.

See the Health Care Authority website for more information on how to apply for Washington Apple Health (Medicaid).

We are available and eager to hear from our members about any questions, complaints or concerns you may have. If you have a grievance, please call Member Services toll-free, at 1-877-542-8997. 如果您有聽力或語言障礙，請致電聽障專線 (TTY)：711.

If Member Services can't resolve your grievance, or if you aren't happy with the response you get, please send your grievance in writing to:

Grievance Coordinator
請注意：Appeals and Grievance
P.O. Box 31364
Salt Lake City, UT 84131-0364

在您的信函中，請包括您的姓名、地址、投保人 ID 號碼、您的投訴理由，以及您認為重要的任何其他資訊。

For more information, see the Grievance and Appeals Process

If you have questions about grievances and appeals, please call us toll-free, at 1-877-542-8997. 如果您有聽力或語言障礙，請致電聽障專線 (TTY)：711.

欺詐和濫用是嚴重的罪行。依法可能會受到懲罰。You can report fraud or abuse by calling Member Services. Or call 1-866-242-7727. You do not have to give or leave your name.


For more information or to report online go here.

如欲通報錯誤資訊，請寄送電子郵件至 provider_directory_invalid_issues@uhc.com。此電子郵件信箱是供會員通報線上名錄或印刷版名錄中可能不正確的基本（地址、電話等）資訊。如果透過此電子郵件信箱通報問題，我們將會與服務提供者的診所聯絡，以確認名錄中的所有基本資料，這可能需要花費大約 30 天的時間。個人也可透過電話通報可能不正確的資訊。UHC Members should call the number on the back of their ID card, and non-UHC members can call 1-888-638-6613 TTY 711.

Washington Apple Health / UnitedHealthcare logos

深入了解

Apple Health (Medicaid) Behavioral Health Services Only (BHSO)

投保資訊

Visit Washington Healthplanfinder site for more information on eligibility and enrollment. 

Washington Healthplanfinder 計劃

致電我們：
1-855-923-4633 / 1-855-627-9604 / TTY: 711

口譯服務

我們還可以幫助提供口譯服務，包括美國手語。

致電我們：
1-877-553-0098 / 聽障專線 (TTY)：711

週一至週五，當地時間 08:00 至 17:00

投保步驟
獲取詳細資訊。

The Washington Behavioral Health Services Only (BHSO) plan specialists can answer questions and help you enroll.

致電我們：
08:00 to 17:00 pacific time, Monday – Friday

口譯服務

我們還可以幫助提供口譯服務，包括美國手語。

致電我們：
1-877-553-0098 / 聽障專線 (TTY)：711

週一至週五，當地時間 08:00 至 17:00

保戶資訊

您可享有權限登入我們的保戶專屬網站。列印 ID 卡等。請參閱下方我們的手冊。

保戶網站

保戶手冊

Getting Started Guides


Individual & Family ACA Marketplace Plans Disclaimer
（在此方塊中捲動來檢視）

並非所有計劃或所有州都提供上述承保福利。有些計劃可能要求為這些承保福利支付共付額、扣減款和／或共同保險。本保單有除外條款、限制條款、承保福利的扣減，以及可能使保單繼續維持有效或停止的條款。For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. 計劃詳情和承保福利根據承保內容和計劃類別而有所不同。請檢閱計劃詳情以瞭解更多資訊。

UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.；科羅拉多州 Rocky Mountain Health Maintenance Organization Incorporated ；UnitedHealthcare of 佛羅里達, Inc.；UnitedHealthcare of 喬治亞, Inc.；UnitedHealthcare of Illinois,Inc.；UnitedHealthcare Insurance Company in AL, KS, LA, MO, NJ, and TN; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of 密西西比, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of 北卡羅萊納,Inc.；UnitedHealthCare of Ohio, Inc.；UnitedHealthcare of 奧克拉荷馬,Inc.；UnitedHealthcare of 南卡羅萊納,Inc.；UnitedHealthcare of 德克薩斯,Inc.；UnitedHealthcare of Oregon, Inc. in WA; and UnitedHealthcare of Wisconsin, Inc.  Administrative services provided by United HealthCare Services, Inc. or its affiliates.

This policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. 有關承保範圍的費用和完整詳情，請致電或寫信給您的保險代理人或公司，以適用者為準。By responding to this offer, you agree that a representative may contact you.

1 Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. Virtual visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. Services may not be available at all times, or in all locations, or for all members. Check your benefit plan to determine if these services are available. 可能會收取數據傳輸費用。Certain prescriptions may not be available and other restrictions may apply.

2 Tier 2 prescriptions for $5 or less not available on all medications. 3-month fills apply to select maintenance medications only. Applicable formulary requirements such as prior authorization and quantity limits may apply to your pharmacy benefits. Walgreens 折扣有效期限至 24 年 12 月 31 日。Discount valid only for in-store purchases of eligible Walgreens brand health and wellness products by current members eligible for the UnitedHealthcare discount program. 折扣無法線上使用。如需 Walgreens 品牌健康與保健產品的完整清單以及排除項目，請造訪 www.walgreens.com/smartsavings。

最後更新日期：04.18.2024 at 00:11 CDT

免責聲明資訊
（在此方塊中捲動來檢視）

尋找聯邦政府的醫療網站？請至 Medicaid.gov 網站查詢。

UnitedHealthcare Dual Complete 計劃

本計劃是透過 UnitedHealthcare Insurance Company 或其一間附屬公司所承保，本公司是和 Medicare 簽約並與州立 Medicaid 方案簽約的 Medicare Advantage 機構。請先向 Medicare 進行本計劃的續約，才能繼續投保本計劃。本計劃提供給同時擁有州立與 Medicare 醫療協助的人。承保福利、功能和／或裝置視計劃／地區不同。可能適用限制、排除條款及／或網路限制。承保福利、保險費和／或共付額／共同保險額可能於每年的 1 月 1 日變更。

保險費免責聲明

雙重特殊需求計劃為擁有額外補助（Extra Help，低收入津貼）的保戶提供 $0 保險費。

承保福利免責聲明

承保福利、功能及／或裝置視計劃／地區而異。可能適用限制、排除條款及／或網路限制。

護士熱線 (Nurse Hotline) 免責聲明

此服務不應用於急救或急症護理需求。急救情況下，請撥打 911 或前往最近的急診室。透過此服務提供的資訊僅供資訊參考之用。護士無法診斷病情或建議治療方式，亦無法代替提供者提供照護。您的醫療保健資訊將依法保密。此服務非保險計劃且得隨時中止。護士熱線不供緊急情況使用，僅供參考。

UnitedHealthcare Connected® for MyCare Ohio（Medicare-Medicaid 計劃）

UnitedHealthcare Connected® for MyCare Ohio（Medicare-Medicaid 計劃）健康計劃同時與 Medicare 及 Ohio Medicaid 訂約，為投保人提供兩種計劃的承保福利。

UnitedHealthcare Connected®（Medicare-Medicaid 計劃）

UnitedHealthcare Connected®（Medicare-Medicaid 計劃）健康計劃同時與 Medicare 及德克薩斯 Medicaid 訂約，為投保人提供兩種計劃的承保福利。

UnitedHealthcare Connected® for One Care（Medicare-Medicaid 計劃）

UnitedHealthcare Connected® for One Care（Medicare-Medicaid 計劃）健康計劃同時與 Medicare 及 MassHealth (Medicaid) 訂約，為投保人提供兩種計劃的承保福利。

UnitedHealthcare Connected® 承保福利免責聲明

此非完整清單。本文的給付資訊僅為概要，並非給付的完整說明書。如需詳細資訊，請聯絡該計劃或閱讀保戶手冊。限額、部分負擔和其他限制可能適用。更多資訊請致電 UnitedHealthcare Connected® 保戶服務部或閱讀 UnitedHealthcare Connected® 保戶手冊。

聯合健康保險老人照護選擇 (HMO SNP) 計劃

UnitedHealthcare Senior Care Options (SCO) 是一項協調照護計劃，包含 Medicare 合約以及與 Commonwealth of 麻薩諸塞 Medicaid 方案簽署的合約。請先向 Medicare 進行本計劃的續約，才能繼續投保本計劃。本計劃為自願方案，提供給 65 歲以上符合 MassHealth Standard 及 Orginal Medicare 兩種投保資格且不具有任何其他綜合健康保險（但 Medicare 除外）的任何民眾。如果您已投保 MassHealth Standard，但不具備 Original Medicare 投保資格，您仍有資格投保我們的 MassHealth 老人照護選擇 (Senior Care Options, SCO) 計劃，並透過我們的老人照護選擇 (SCO) 計劃獲得您的 MassHealth 承保福利。

星號評級免責聲明

Medicare 每年使用五顆星的星號評級系統評估計劃。五顆星評級適用於 2024 年計劃年度。

重要服務提供者資訊

任您選擇

我們將會為您提供諸如醫師和醫療保健專業人員資格認證等資訊，以協助您在資訊充足的情況下作出決定。但是，提供此資訊並不代表我們保證某特定醫師或醫療保健專業人員適合您的需求。

此應用程式中現有的服務提供者，可能並不是 UnitedHealthcare 網路內所有的簽約服務提供者。可能有部分網路內的服務提供者，或特定專科醫生並未包含在此應用程式中。如果找不到您要尋找的服務提供者，請直接與服務提供者聯絡，以確認服務提供者與 UnitedHealthcare 網路的簽約狀態，或者致電 UnitedHealthcare 會員卡上所列的免費電話號碼與客戶服務部聯絡。我們也建議，在任何醫師（包括任何專科醫生）為您看診之前，您應與醫師診所聯絡，以確認其簽約狀態及服務提供狀態。

有些網路服務提供者可能是在本名錄更新之後才新增至網路中，或才從網路中退出。我們無法保證每位服務提供者願意接受新會員／病患。

除非發生緊急情況，否則網外／非簽約服務提供者沒有義務要為聯合健康保險計劃會員提供治療。請致電客戶服務部或參閱承保證明以瞭解更多資訊，包括適用於網外服務的成本分攤。

《美國殘障人士法案》聲明

根據聯邦政府 1990 年《美國殘障人士法案》(Americans with Disabilities Act, ADA) 以及 1973 年《康復法案》第 504 節的規定，UnitedHealthcare Insurance Company 提供完整且平等的管道讓民眾得以取得承保服務，且不會以殘障為理由，在服務、計劃或活動中歧視符合資格的殘障人士。

轉診

網路服務提供者可協助您及受保的家人取得所需的照護。使用專科醫生可能須由主治醫生協調。

索取印刷版名錄

我們免費為會員提供印刷版的網路服務提供者名錄，請致電會員卡背面的電話號碼與客戶服務部聯絡。非會員可下載線上名錄並列印搜尋結果。

錯誤資訊

如欲通報錯誤資訊，請寄送電子郵件至 provider_directory_invalid_issues@uhc.com。此電子郵件信箱是供會員通報線上名錄或印刷版名錄中可能不正確的基本（地址、電話等）資訊。如果透過此電子郵件信箱通報問題，我們將會與服務提供者的診所聯絡，以確認名錄中的所有基本資料，這可能需要花費大約 30 天的時間。個人也可透過電話通報可能不正確的資訊。聯合健康保險保戶請致電保戶卡背面的電話號碼，非聯合健康保險保戶請致電 1-888-638-6613／聽障專線 (TTY)：711，或使用您偏好的中繼服務。

災害或緊急情況聲明

如果受到總統或州長聲明的災害或緊急情況影響，或者是衛生及公共服務部部長所公佈的公共衛生緊急情況的影響，您可以獲得一些額外的支持協助。

  • A 部分、B 部分和 Supplemental C 部分計劃承保福利須在指定的非合約機構提供（注意：A 部分和 B 部分承保福利必須在 Medicare 認可的機構獲得）；
  • 如適用，豁免全部的轉診要求；
  • 暫時調降計劃批准的網外成本分攤與網路內成本分攤的金額；以及
  • 只要所有的變更（例如降低成本分攤和豁免事先授權）使保戶受益，即可免除保戶 30 天通知的要求。

如果 CMS 沒有提供災害或緊急情況的終止日期，計劃將於初始聲明的 30 天後恢復正常運作。

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