COVID-19 Resources for Health Care Access in Washington State

Public Health Emergency is ending

Important Information for Apple Health Clients

  • Take action
  • What If I’m told I no longer have Apple Health?

For Everyone

 

Public Health Emergency is ending

During the COVID-19 public health emergency, the federal government made health care a priority, allowing people to keep Medicaid coverage, requiring health insurers to cover COVID-related costs, and making testing and treatment for COVID more accessible. Some of the changes to health coverage will soon expire. This publication provides information about some important changes in Washington state rules that may affect your health coverage (such as Apple Health, Qualified Health Plans, or other types of insurance), as well as help with costs of care if you are uninsured.

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Important Information for Apple Health Clients

During the COVID-19 public health emergency (PHE), the Health Care Authority (HCA) extended coverage for all Apple Health (Medicaid) clients. This extension is now ending and HCA will resume normal operations April 1, 2023.  In the 12 months after that, Apple Health enrollees will have their eligibility reviewed. You will receive a renewal notice prior to the end of your certification period to see if you are still eligible -- sometime over the next 12 months.

If you are no longer eligible or you do not complete the renewal process, your Apple Health coverage may be terminated

Normal operations resumed April 1, 2023.  Apple Health (Medicaid) clients will receive a renewal notice prior to the end of their renewal period to redetermine their eligibility -- sometime over the next 12 months.  Apple Health coverage may be terminated as early as April 30, 2023.

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Apple Health Clients: Take action

1) Update your contact information

Make sure the Health Care Authority and/or DSHS has your current mailing address, phone number, email, or other contact information.  If you have a Healthplanfinder or Washington Connection online account, you can make changes there.  This will allow them to contact you about your Apple Health, Medicaid or CHIP coverage.  Learn more about how to update your contact information.

2) Check your mail

Washington Healthplanfinder or DSHS will mail you a letter about your Apple Health coverage. This letter will also tell you if you need to complete a renewal form to see if you still qualify for Medicaid or CHIP.

3) Complete your renewal form (if you get one)

Fill out the form and return it to Washington Healthplanfinder or DSHS right away, even if you can’t answer all the questions, to help avoid a gap in your coverage.

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What if I'm told I no longer have Apple Health?

If you are not eligible for Apple Health, Healthplanfinder will tell you about any other coverage options available, such as Qualified Health Plans with subsidies to help with the costs of coverage.

Marketplace plans are:

  • Affordable. 4 out of 5 enrollees can find plans that cost less than $10 a month.
  • Comprehensive. All plans cover things like prescription drugs, doctor visits, urgent care, hospital visits, and more.
  • Losing Medicaid or CHIP coverage is a Qualifying Life Event (QLE), which allows you to enroll in a Marketplace plan outside of the Open Enrollment Period.
  • Visit wahealthplanfinder.org or call 1-855-923-4633 (TTY: 1-855-627-9604) to get details about health coverage.

Even if you can get one of these other coverage options, you can appeal the denial of Apple Health. If you think you should be getting Apple Health, you should appeal. Coverage through Apple Health is free. It offers benefits you cannot get through a Qualified Health Plan, like dental care.

How do I appeal my Apple Health denial?

If Apple Health coverage is denied or terminated, you have the right to appeal and ask for an administrative hearing.

You generally have 90 days to appeal. However, you must appeal earlier than that if you want your coverage to continue (“continued benefits”) during your appeal. To get continued benefits, you must appeal either within ten days from the notice date or before your coverage ends, whichever is later. You should start your appeal and ask for continued benefits right away by phone to make sure you are on time. Follow up in writing.

You can appeal by filling out the form that came with your termination letter, or download an Appeal Request Form here and fill it out. If possible, include a copy of the letter denying or terminating (ending) Apple Health coverage. Make a copy of the form before sending, to keep for your records. More information on how to file Apple Health Appeals (mail, online, phone) is available at the Office of Administristrative Hearings webpage

For everyone:

Vaccination for COVID-19

Everyone can currently receive COVID-19 vaccines for free. The vaccine itself is purchased by the federal government and is free to doctors and the public.

Find out where you can get a vaccine using the Vaccine Locator (see drop-down menu at upper right for available languages). More information on COVID-19 vaccines is available here.

All people living or working in Washington can get vaccinated regardless of citizenship or immigration status. The medical provider may ask you for a Social Security Number or insurance card, but you can say no and still get a COVID-19 vaccine for free.

While the vaccine provider may charge a vaccine administration cost which is the cost the provider charges to give you the vaccine, your insurance will cover this cost. If you do not have insurance, you should not be charged or billed by your provider or the vaccination site if you only go in to get vaccinated. This applies to people who have private insurance, Medicaid, Medicare, or are uninsured. If you get charged, please email covid.vaccine@doh.wa.gov. If you have insurance, contact your insurance plan first. If this doesn’t address the issue, you can also file a complaint with the Office of the Insurance Commissioner.

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Testing for COVID-19

The Washington State Department of Health has information on testing in a number of languages; see the language selection box to the right of the page title.

If you have symptoms or have been in close contact with someone with confirmed COVID-19, get tested. There is no out-of-pocket cost for tests performed at county or state-supported test sites. At other sites, many tests for people experiencing symptoms, can be billed to insurance or subsidized by the Department of Health.

Care Connect Washington is a free program providing food and other necessities to people who have either tested positive for COVID-19 or been exposed and need support to isolate or quarantine at home.

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Treatment for COVID-19

Washington provides free telehealth video appointments for COVID-19 treatment with oral antivirals.

Washington’s Health Care Authority (HCA) distributed funds to health care providers to serve uninsured and underinsured individuals under 200% of the federal poverty level, regardless of immigration status.  This is for people not on Apple Health.  Find a list of these providers organized by type of health care including COVID-19 testing or treatment, dental care, treatment of chronic conditions, and behavioral health. This information is also available in Spanish courtesy of Latino Community Foundation. Note: providers are required to provide notification when they are out of funds and resume billing.

Alien Emergency Medical is an HCA program for those with serious medical conditions who are not eligible for Apple Health due to immigration status. AEM was temporarily extended to cover COVID-19 related testing and treatment during the pandemic but this could change. Learn more here. Information in 35 other languages is available here (click on the small blue box with a capital A).

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Additional COVID-19 Resources 

For more information on immigrant access to health care, click here.

Nondiscrimination PDF: Office of Civil Rights/DHHS bulletin requiring covered entities receiving federal funding to comply with nondiscrimination on the basis of race, color, national origin, disability, age, sex, and exercise of conscience and religion, “including in the provision of health care services during COVID-19.”

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