Washington Apple Health (Medicaid) FAQs

We’re a managed care organization (MCO). That means we provide health benefits for individuals and families who qualify for Apple Health.

 

What is Apple Health?

 

In Washington State, Medicaid is called Apple Health. It is available to certain individuals and families who meet the eligibility requirements. To find out if you are eligible for Wellpoint, visit our eligibility page.

 

Will I receive an ID card from Wellpoint?

 

Yes, our members get a member ID card in the mail soon after they enroll. Members should bring their Wellpoint ID card and their ProviderOne card every time they receive healthcare services.

I want to choose Wellpoint as my health plan. How can I enroll?

 

To choose us, go to the Washington Healthplanfinder website. If you have questions, call 855-WAFINDER (855-923-4633) or TTY/TDD 855-627-9604.

 

I want to switch to Wellpoint. How can I enroll?

 

Apple Health members can change plans anytime unless you are in the Patient Review and Coordination program. There are several ways to switch your plan:

 

  Log in to your account at Washington Healthplanfinder. If you have questions or need help, call 855-923-4633 or TTY/TDD 855-627-9604.

 

  Visit the ProviderOne Client Portal website.

 

  Request a change online:

• Select the topic "Enroll/Change Health Plans."

  Call the Health Care Authority (HCA) at 800-562-3022 (TRS: 711).

Is my doctor in the Wellpoint health plan?

 

You can find out using our Find a Doctor tool. Or call Member Services and a member of our team can tell you.

 

Can I change my PCP?

 

Yes, once you’re enrolled in our plan you can change your PCP at any time (unless you’re in the Patient Review and Coordination program). To change your PCP, log in to our secure website and click on Change PCP. Or call Member Services and a member of our team can help you.

 

How do I choose a doctor or other provider to be my PCP?

 

Choose from a list of plan providers using our Find a Doctor tool. It lets you search by name, specialty and distance from your home. It also tells you if he or she is accepting new patients.

 

As long as the provider is in our plan, you may choose any of the following as your PCP:

 

  Family physician

 

  General practitioner

 

  Nurse practitioner

 

  Physician assistant

 

  Pediatrician (for kids)

 

  Internal medicine doctor (for adults)

 

  Geriatrician (for elderly adults)

 

  Naturopathic physician

 

Can I keep the PCP I have now?

 

Yes, as long as he or she is in our plan. To find out, use our Find a Doctor tool online:

 

  If your PCP is in our plan, you can keep seeing him or her. Call Member Services and tell us the name of the provider you want as your PCP.

 

  If your PCP is not in our plan, call Member Services. We can ask him or her to join our plan or help you find a new PCP.

 

What if I go to a doctor who doesn’t work with Wellpoint?

 

You may have to pay for healthcare services you get from a doctor who isn’t in our plan. Before you get medical services, always show your Wellpoint ID card to the doctor’s office. They should be able to tell you if they don’t accept your insurance.