- Select the topic “Enroll/Change Health Plans.”
Get the details.
To find out if you qualify visit wahealthplanfinder.org or call 1-855-WAFINDER (1-855-923-4633) TTY/TTD 1-855-627-9604.
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.
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Find medications covered by this plan.
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Tooth IconValue-added benefits
As a member of UnitedHealthcare Community Plan, you get access to many value-added benefits. These extra benefits are offered statewide and in addition to the required Medicaid services.
You can find details on value-added benefits here.
Benefits & features
Virtual Care – UHC Doctor Chat 24/7
When you’re ill or have health questions and can’t get to your primary care doctor, you can talk to one in seconds, 24/7, with UHC Doctor Chat. Get the answers, treatment and follow-up care you need, when you need it — at no cost to you.
To download the app, search for “UHC Doctor Chat” on the App Store® or Google Play®, or visit www.uhcdoctorchat.com.
Mental Health IconBehavioral health
Behavioral Health is as important as physical health. That's why we have coverage for both. You have access to mental health and substance use disorder treatment services, known together as behavioral health services. Behavioral health services can help you with personal problems that may affect you and your family. These problems may be stress, depression, anxiety or using drugs or alcohol.
Talk to your Primary Care Provider (PCP) today about any health or behavioral health problems you have. Your PCP will refer you to a behavioral health provider with UnitedHealthcare Community Plan. They can refer you to specialists, and other facilities, such as hospitals and substance use disorder treatment services.
You don't need a referral from your PCP to see behavioral health specialists in your plan or to access substance use disorder treatment services.
There are some treatments and services that need preapproval before you can get them. To learn more, talk to your doctor.
Search for a Behavioral Health Provider
Required care is 100% covered. If you need behavioral health care, your PCP and UnitedHealthcare Community Plan can help coordinate your care.
- Evaluation and assessment
- Medication management and monitoring
- Individual and group counseling
- Peer support
- Family counseling
- Education about mental health, treatments and medications
- Rehab case management
- Withdrawal management (detox)
- Opiate replacement treatment
- Case management
Additional health resources can be found here. Find the balance, support and care you need to live the healthiest life possible.
You may also be eligible for additional grant funded services such as care coordination, family hardship services and recovery support services. These provide comprehensive community-based services that supplement your current benefits.
If you need help finding mental health services or if you feel that your rights have been violated, please call your Regional Behavioral Health Ombuds. An Ombuds is someone who is hired to assist you with any difficulties with your services or with getting services. Services are free and all information is kept confidential.
Mental Health IconMental health crisis services
What if I have a behavioral health crisis?
You are always covered for a behavioral health emergency. An emergency means a behavioral health condition that comes on suddenly, is life threatening, is painful, or other severe symptoms that cannot wait to be treated. You may have a mental health, drug, or alcohol use emergency.
Emergency services are covered anywhere in the United States. If you think you have a life threatening emergency, call 911 or go to the nearest hospital location where emergency providers can help you.
As soon as possible, call us to arrange for follow-up behavioral health care after an emergency.
A mental health crisis is a moment when someone's behavior can put themselves or others in danger, especially if they do not get help, such as:
- Threatens to or talks about hurting or killing themselves
- Feels hopeless
- Feels rage or uncontrolled anger
- Feels trapped, like there is no way out
- Engages in reckless behaviors
- Feels anxious, agitated, or unable to sleep
- Increases alcohol or drug use
- Withdraws from friends and family
- Encounters dramatic mood changes
- Sees no reason for living
Crisis Services:
If you think you have an emergency, no matter where you are, call 911 or go to the nearest hospital location where emergency providers can help you. As soon as possible, call your doctor or behavioral health provider to arrange for follow-up care after the emergency is over.
If you are experiencing a mental health crisis, your ID card has a phone number to access crisis services in your area. Our list of crisis services phone numbers are available in English and Español
Here are additional Behavioral Health Services and Crisis Intervention Contacts:
County crisis line phone numbers
You may call your local county crisis line to request assistance for you or a friend or family member (24/7/365).
Important: Crisis lines are available for all Washingtonians (regardless of your insurance status or income level).
| County | Organization* | Phone number |
| Adams County | Spokane County BH-ASO | 1-877-266-1818 |
| Asotin County | Greater Columbia BH-ASO | 1-888-544-9986 |
| Benton County | Greater Columbia BH-ASO | 1-888-544-9986 |
| Chelan County | Beacon Health Options | 1-800-852-2923 |
| Clallam County | Salish BH-ASO | 1-888-910-0416 |
| Clark County | Beacon Health Options | 1-800-626-8137 |
| Columbia County | Greater Columbia BH-ASO | 1-888-544-9986 |
| Cowlitz County | Great Rivers BH-ASO | 1-800-803-8833 |
| Douglas County | Beacon Health Options | 1-800-852-2923 |
| Ferry County | Spokane County BH-ASO | 1-877-266-1818 |
| Franklin County | Greater Columbia BH-ASO | 1-888-544-9986 |
| Garfield County | Greater Columbia BH-ASO | 1-888-544-9986 |
| Grant County | Beacon Health Options | 1-800-852-2923 |
| Grays Harbor County | Great Rivers BH-ASO | 1-800-803-8833 |
| Island County | North Sound BH-ASO | 1-800-584-3578 |
| Jefferson County | Salish BH-ASO | 1-888-910-0416 |
| King County | King County BH-ASO | 1-866-427-4747 |
| Kitsap County | Salish BH-ASO | 1-888-910-0416 |
| Kittitas County | Greater Columbia BH-ASO | 1-888-544-9986 |
| Klickitat County | Beacon Health Options | 1-800-626-8137 |
| Lewis County | Great Rivers BH-ASO | 1-800-803-8833 |
| Lincoln County | Spokane County BH-ASO | 1-877-266-1818 |
| Mason County | Thurston-Mason BH-ASO | 1-800-270-0041 |
| Okanogan County | Beacon Health Options | 1-800-852-2923 |
| Pacific County | Great Rivers BH-ASO | 1-800-803-8833 |
| Pend Oreille County | Spokane County BH-ASO | 1-877-266-1818 |
| Pierce County | Beacon Health Options | 1-800-576-7764 |
| San Juan County | North Sound BH-ASO | 1-800-584-3578 |
| Skagit County | North Sound BH-ASO | 1-800-584-3578 |
| Skamania County | Beacon Health Options | 1-800-626-8137 |
| Snohomish County | North Sound BH-ASO | 1-800-584-3578 |
| Spokane County | Spokane County BH-ASO | 1-877-266-1818 |
| Stevens County | Spokane County BH-ASO | 1-877-266-1818 |
| Thurston County | Thurston-Mason BH-ASO | 1-800-270-0041 |
| Wahkiakum County | Great Rivers BH-ASO | 1-800-803-8833 |
| Walla Walla County | Greater Columbia BH-ASO | 1-888-544-9986 |
| Whatcom County | North Sound BH-ASO | 1-800-584-3578 |
| Whitman County | Greater Columbia BH-ASO | 1-888-544-9986 |
| Yakima County | Greater Columbia BH-ASO | 1-888-544-9986 |
*Behavioral Health - Administrative Services Organizations (BH-ASO)
Additional health resources can be found here. Find the balance, support and care you need to live the healthiest life possible.
Document Folder IconWell and Sick Care
Get the assistance you and your family needs to stay healthy, to get better if you are injured or sick or — simply achieve your potential. That includes
- Virtual Care – UHC Doctor Chat. Chat with a doctor 24/7.
- Hospitalization. You pay nothing for care in a hospital.
- Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
- Therapy Services. Therapy visits to help you recover or achieve your potential.
- Nurse Hotline. Speak with a registered nurse 24/7.
- Well Visits. Annual checkups and screenings (for those under 21) to help keep you or your family healthy.
- Foot Care. More covered visits to keep your feet healthy.
- Shots and Vaccines. Routine shots to help protect against illness.
- No Copays. You pay nothing for doctor visits or prescriptions.
Pregnancy Care
Nothing is more important than the health and well-being of you and your baby. That's why our plan benefits include:
- Choice of Birth Center. Pick from a large network of hospitals across Washington.
- Choice of Doctor. Find a doctor or OB/GYN you trust in our network.
- Healthy First Steps®. Get extra support and rewards to keep you and your baby healthy.
- Prenatal Visits. Care for you before your baby is born.
- Wellhop for Mom & Baby. Connect with a community of moms. Get support and information as you welcome your baby.
Care for Conditions
If you have asthma, diabetes or another health condition, you can depend on us. Our plan makes sure you get the care and services you need. Benefits include:
- Asthma and COPD Care. Exams, testing and supplies are covered.
- Diabetes Support. Medicine, needles and more for managing diabetes.
- Kidney Disease Care. Dialysis, medicine and treatments are covered.
- Mental Health. Testing, medication and treatments are covered.
- Personal Care Manager. If you qualify, get personal help managing health conditions.
- Residential Care. Brief stay at a care facility while you recover from sickness or injury.
Vision and Hearing Care
Make sure your sight and hearing are at their best. Benefits include:
- Hearing. Exams and testing are covered, as well as hearing aids for enrollees.
- Vision. Eye exams every twenty-four months for adults and once every twelve months for children and age 21. Eyeglasses, contact lenses, and hardware fittings are covered separately under Apple Health (Medicaid) coverage without a managed care plan (also known as fee-for-service).
Home Care and Supplies
Get the medical care and equipment you or a family member needs to recover or live at home. Benefits include:
- Personal Care. Someone to help with dressing, bathing and dining.
- Equipment and Supplies. In-home medical and safety equipment is covered.
- Home Health Care. Medical and personal care at home, if needed.
Personal Care Manager
Do you or a family member have a serious health problem? If your health needs qualify then our care managers are in your corner. They will:
- Help manage your physical and mental health care needs.
- Work with your physician, behavioral health specialists and outside agencies.
- Coordinate your doctor appointments.
- Provide your care team with your medical records.
Your care manager will stay with you throughout the medical journey. He or she will:
- Make sure you have support at home.
- Connect you to the social services you may need.
Advanced Directives
View Advance Directives in English | Español.
Added Benefits IconAdditional Benefits and Services
Get extra benefits and support. You can rely on:
- Healthy Rewards. Earn rewards for completing important preventive services.
- Health Education. Free coaching to help improve your health.
- Language Help. Connect to a translator through Member Services.
- Interpreters. Have an interpreter with you at your child's doctor visits.
- Programs for Kids and Teens. Free Boys & Girls Club memberships.
- Quitting Tobacco. Coaches and supplies to help you quit using tobacco.
- Member Services. Your benefit questions are answered 24/7.
- Dental. Services and annual exams are covered separately.
- WISe.Wraparound with Intensive Services (WISe)
- Applied Behavior Analysis. Autism (ABA) dedicated phone number 1-866-456-5376
Asthma and COPD Support
Individual care to help control your child's asthma.
Does your child have trouble managing asthma or COPD symptoms? A nurse who specializes in breathing issues can really help. Your child will get a customized treatment plan and medicine to:
- Manage flare-ups.
- Reduce symptoms.
- Let your child stay active.
Choose a Birth Center
Where you have your baby is an important choice. That's why you can pick from large network of hospitals all across Washington.
We also encourage you to tour the hospital's birthing center. This way you will be familiar with it. And you'll be more relaxed when you have your baby.
Stethoscope IconChoice of Doctor
You will have a primary care physician (PCP) who will be your main doctor. Your PCP is the person you should see for most of your care. This includes checkups, treatments, vaccinations, minor injuries and health concerns. Talk to your PCP about any behavioral health concerns you may have. Your PCP can help you decide the right options for you.
Your PCP is your main doctor for:
- Preventive care.
- Treatment if you are sick or injured.
- Referrals to specialists for certain conditions.
Use the Doctor Lookup tool to see if your doctor is in our network. If you don’t have a doctor or if your doctor is not in our network, we can help you find a new one close to you.
Diabetes Monitoring IconDiabetes Support
If you have diabetes, we'll help make life a little easier for you. You'll get medicine, supplies and education to help you reach and stay your best. You are also rewarded with gift cards for taking simple steps to manage your diabetes.
Our diabetes program also includes self-care training and classes focused on:
- Planning healthy meals.
- Managing stress.
- Living a healthy lifestyle.
Equipment and Medical Supplies
Your health and safety at home are important.
Our plan covers medical equipment ordered by your doctor or case manager. This can include supplies like:
- Hospital beds.
- Oxygen tanks.
- Wheelchairs or walkers.
Foot Care
If you have diabetes or a circulatory condition, good foot care can help prevent much more serious problems. We provide the needed exams to help keep your feet in great shape.
Our podiatry coverage includes:
- Routine foot exams.
- Tips about foot care and choosing the right shoes.
- Information about nerve damage warning signs.
Health Education
Free coaching to help improve your health or to address a condition.
Our plan includes coaching on diabetes, nutrition and more. You can even get a ride, if needed, to and from the class at no cost to you.
Pregnancy IconHealthy First Steps®
Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up.
We will help you:
- Choose a pregnancy provider and a pediatrician (child’s doctor).
- Schedule visits and exams and arrange rides to your visits.
- Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
- Get supplies, including breast pumps for nursing moms.
- Connect with community resources such as Women, Infants and Children (WIC) services.
Hearing Care
Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to help protect your hearing.
We cover exams and testing, as well as hearing aids for enrollees.
Home Health Care
After surgery or a serious illness—or if you have a disability—you may need extra help with day-to-day tasks. You may even need an in-home medical visit to check on how well you are healing. With approval, our plan covers:
- An in-home medical visit.
- Medical equipment like hospital beds, walkers or wheelchairs.
- Disposable medical supplies.
- Help with personal care or housekeeping.
Hospitalization
This plan pays for all expenses related to a hospital stay, so you can rest and heal.
Our plan covers:
- Nursing care.
- Room and board.
- Supplies and equipment.
- Treatment and therapies.
- Diagnostic tests and exams.
And after you leave the hospital, you are not alone. We make sure you get follow-up care to continue healing at home.
Globe IconInterpreters
Your doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to be at your appointments.
We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language or they can connect you with our interpreter service which covers more than 170 languages.
Checkup IconKidney Disease Care
Kidney disease is a serious medical condition. After the kidneys stop working, regular treatments, called renal dialysis or an organ transplant are needed to live. Dialysis uses a machine to clean the blood just like healthy kidneys do.
Our plan includes:
- Dialysis.
- Medications.
- Health education and support.
- Organ transplant if needed.
Lab and X-rays
Knowing what's wrong and finding it early can make all the difference. Our plan covers:
- Labs and testing.
- X-rays, scans and other imaging.
We'll help you get the information needed to improve your health or be at your best.
Globe IconLanguage Help
You can receive information in your preferred language. Just ask. We also have people at our customer service centers who speak more than one language. Chances are, we have someone who speaks your language or they can connect you with our interpreter service which covers more than 170 languages.
Virtual Care IconMember Services
Sometimes you might need a little help understanding your health care options. With us, you have someone you can call. We’ll answer your questions simply and completely.
We can also help you find:
- Home care providers.
- Dentists and vision providers.
- Adult Day Health Centers.
Medicines
Our plan includes prescription drugs and refills with no copays. We also cover over-the-counter medicines with a written order from your doctor.
And we make getting your medicine easy. You can fill your prescriptions at:
- Local pharmacies.
- Services that deliver routinely right to your door.
Mental Health Services for Children and Youth
Problems such as depression and anxiety can also be challenging for children and teens.
There are no costs for covered services. We have therapists and doctors for youth and teens that can address their specific behavioral health or substance use. Help get them extra support to live a heathier life.
Additional Resources
Teens can connect with teens during specific hours: 866-833-6546, teenlink@crisisclinic.org, www.866teenlink.org
Zero Dollar IconNo Cost for Covered Services
Get the quality health care you deserve at no cost for covered services. You get:
- Care from highly skilled and compassionate doctors.
- Treatments at respected hospitals and clinics.
- Home medical equipment and supplies to help you be at your best.
Nurse Hotline
Medical questions and situations sometimes happen at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week: 1-877-543-3409 (TTY 711).
Our nurses will:
- Listen to symptoms.
- Help with self-care.
- Advise you about getting care at a doctor visit or an urgent care center.
- Help you know when to go to the emergency room.
Nurse Visits
Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:
- Provide medical care.
- Answer any questions and concerns.
Personal Care
Sometimes the basics are hard to do yourself after an illness or injury.
If needed, we provide someone to help with:
Network IconPersonal Care Manager
Do you or a family member have a serious health problem? If your health needs qualify then our care managers are in your corner. They will:
- Help manage your physical and mental health care needs.
- Work with your physician, behavioral health specialists and outside agencies.
- Coordinate your doctor appointments.
- Provide your care team with your medical records.
Your care manager will stay with you throughout the medical journey. He or she will:
- Make sure you have support at home.
- Connect you to the social services you may need.
Programs for Kids and Teens
Kids with positive role models make more healthy choices. That's why we provide free memberships to the Boys & Girls Clubs in your area.
Along with fun and games, these clubs offer help with:
- Homework.
- Mentoring.
- Coaching.
Prenatal Visits
Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN. With our plan, you will also be rewarded with gift cards for prenatal and postpartum doctor visits.
All recommended prenatal clinical visits and tests are covered by our plan.
At these visits, the clinic will:
- Make sure both you and your baby are healthy.
- Explain what to expect at each stage of your pregnancy.
- Answer your questions.
Residential Care
After a serious illness, surgery or injury you may need extra nursing and therapy. If needed, our plan covers short stays in a rehabilitation center where you can heal. Included are:
- Nursing home services.
- 24-hour nursing care.
- Help with activities of daily living.
- Physical, occupational and speech therapy.
Quitting Tobacco
You know the bad health effects of smoking. You know you need to quit. We support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture. Call 1-866-QUIT-4-LIFE (1-866-784-8454) Or visit www.quitnow.net.
Immunology IconShots and Vaccines
Routine shots help protect you from illness.
So, our plan covers:
- Recommended shots and vaccines.
- Influenza shots.
Therapy Services
Physical, occupational and speech therapy can help you recover from a serious injury or illness, or simply reach your full potential.
Our plan provides:
- Occupational therapy.
- Physical therapy.
- Speech therapy.
- In-home therapy.
Transportation
Get a ride – at no cost to you - to and from health care locations. That includes trips to:
- Doctor or therapy visits.
- Vision clinics.
- Urgent care centers.
Apple Health (Medicaid) pays for transportation services to and from needed non-emergency health care appointments. If you have a current ProviderOne Services Card, you may be eligible for transportation. Call the transportation provider (broker) in your area to learn about services and limitations. Your regional broker will arrange the most appropriate, least costly transportation for you. See the list of brokers
Eye Exam IconVision Care
You'll get the care and treatment that let you see life more clearly. Coverage includes:
- Eye exams every twenty-four months for adults and once every twelve months for children and age 21. Eyeglasses, contact lenses, and hardware fittings are covered separately under Apple Health (Medicaid) coverage without a managed care plan (also known as fee-for-service).
- Annual eye exams for members to age 21.
Well Visits
Well visits with your doctor can help you stay healthy. These visits can catch health problems early, so they can be treated. Preventive services include:
- Checkups children.
- Screenings for adults.
- Well-baby care.
- Care for women expecting a baby.
- Routine shots and tests.
- Mammograms.
There are no copayments for preventive care.
Pregnancy IconWellhop for Mom & Baby
Connect with other expectant moms. Get support and information during your pregnancy and after you deliver. This program is part of your health plan and there is no extra cost to you.
Here’s how it works:
- Join video conversations every other week with women who have similar due dates and a group leader.
- Chat and share experiences with moms from your group on the Wellhop app or website.
- Visit the Wellhop library. You’ll find articles, videos and more.
Member resources
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Virtual Care IconMember Resources
Apple Health (Medicaid)
Important Information and Disclosures
Information about Renewing Your Coverage
Renewing Your Coverage
Apple Health (Medicaid)
Have you received information asking you to take action so that you can keep getting benefits?
You can renew your coverage by contacting Washington Healthplanfinder.
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.
Member handbook
Member Handbooks
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Getting started guides
Getting Started Guides
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Member newsletters
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Advance directives
Advanced Directive
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How To Contact Us
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.
Clinical Practice Guidelines
Clinical Practice Guidelines
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
View the entire list of guidelines or call our Member Services at 1-877-542-8997 (TTY: 711) to request a printed copy.
For Prior Authorization Guidelines, click here. For Policies and Clinical Guidelines, click here.
Provider Advisory Committee Approval - July 24, 2019
Notice of privacy practices
Notice of Privacy Practices
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.
Your rights and responsibilities
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.
(Opens in new window) PDF 755.22KB - Last Updated: 09/09/2024
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Filing a Grievance
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 below.
Grievance and Appeals Form
(Opens in new window) PDF 204.20KB - Last Updated: 07/01/2024
Conversion Rights
Members have the right to obtain a conversion agreement to continue health and medical benefits upon termination of Apple Health (Medicaid) eligibility.
If you have questions or to obtain a conversion agreement, please call us. Our toll-free Member Services number is 1-877-542-8997 (TTY: 711).
Medical prior authorizations
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.
Translation resources
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).
Forms and notifications
Pharmacy Direct Member Reimbursement Form
The Medically Intensive Children's Program
(Opens in new window) PDF 384.72KB - Last Updated: 04/21/2023
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Authorized Representative
Download the Appointment of Authorized Representative Form. This form lets a UnitedHealthcare Community Plan member choose someone to help or act on their behalf.
Collaborative care model
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.
- 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 below in English, Español or call 1-877-542-8997, TTY 711. For more information visit https://aims.uw.edu
List of Collaborative Care Participating Providers
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Learn more
Apple Health (Medicaid)
- Frequently Asked Questions
- Glossary
- Links to Health Information
Enrollment information
Visit Washington Healthplanfinder site for more information on eligibility and enrollment.
You have chosen to enroll in
This plan is not currently available in the ZIP code entered.
Get the details
Apple Health (Medicaid) specialists can answer questions and help you enroll.
8:00 am to 5:00 pm pacific time, Monday – Friday
Interpreter Services
We can also assist with interpreter services, including American Sign Language.
8:00 am to 5:00 pm local time, Monday – Friday
Enrollment information
Visit Washington Healthplanfinder site for more information on eligibility and enrollment.
You have chosen to enroll in
This plan is not currently available in the ZIP code entered.
Get the details
Apple Health (Medicaid) specialists can answer questions and help you enroll.
8:00 am to 5:00 pm pacific time, Monday – Friday
Interpreter Services
We can also assist with interpreter services, including American Sign Language.
8:00 am to 5:00 pm local time, Monday – Friday
Member information
You have access to our member-only website. Print ID cards and more. View our handbook below.
Member Handbooks
(Opens in new window) PDF 668.53KB - Last Updated: 08/06/2024
(Opens in new window) PDF 1.90MB - Last Updated: 08/13/2024
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Getting Started Guides
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Member information
You have access to our member-only website. Print ID cards and more. View our handbook below.
Member Handbooks
(Opens in new window) PDF 668.53KB - Last Updated: 08/06/2024
(Opens in new window) PDF 1.90MB - Last Updated: 08/13/2024
(Opens in new window) PDF 2.24MB - Last Updated: 08/13/2024
(Opens in new window) PDF 2.81MB - Last Updated: 08/13/2024
(Opens in new window) PDF 2.33MB - Last Updated: 08/13/2024
(Opens in new window) PDF 2.64MB - Last Updated: 08/13/2024
(Opens in new window) PDF 1.09MB - Last Updated: 08/13/2024
Getting Started Guides
(Opens in new window) PDF 3.54MB - Last Updated: 04/28/2023
(Se abre en una ventana nueva) PDF 2.43MB - Last Updated: 04/28/2023
See what UnitedHealthcare has to offer.
Video transcript
It’s your health. It’s your choice.
Everyone deserves affordable health care, including you.
Working adults, people with disabilities, pregnant women, and children who qualify for Medicaid should check out UnitedHealthcare Community Plan.
We have the Medicaid benefits and extras that can make a real difference in your life. All at no cost to you.
- Find a doctor you trust in our network
- A wide range of treatments and services for mental health and substance misuse
- Prescription coverage
- Transportation to and from doctor appointments
- 24/7 Nurse Hotline to answer your health questions
Sometimes, you might need a little extra help. Get extras not covered by Medicaid.
- Earn rewards for keeping you and your baby healthy
- Earn gift cards for getting preventive services
- Coaching and support to help you quit the use of nicotine
- Online and mobile tools to help live a healthier life
- Support with complex conditions such as asthma, diabetes or other chronic conditions
We also offer resources to help you make the most of your plan. Including:
- Member Advocates
- Social Services Support
- Health Education Tools
- Care Management
Visit HCA.WA dot gov for more information.
Helping you live a healthier life.
We are here for you, Washington.
Remember to choose UnitedHealthcare Community Plan. And get the plan that gets you more.
To learn more about UnitedHealthcare Community Plan, visit UHCCommunityPlan dot com forward slash WA.
Please select your county.
Individual & Family ACA Marketplace Plans Disclaimer (scroll within this box to view)The benefits described may not be offered in all plans or in all states. Some plans may require copayments, deductibles and/or coinsurance for these benefits. This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. Plan specifics and benefits vary by coverage area and by plan category. Please review plan details to learn more.
UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, 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 Mississippi, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Ohio, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of South Carolina, Inc.; UnitedHealthcare of Texas, 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. For costs and complete details of the coverage, call or write your insurance agent or the company, whichever is applicable. 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. Data rates may apply. 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 discount valid until 12/31/24. Discount valid only for in-store purchases of eligible Walgreens brand health and wellness products by current members eligible for the UnitedHealthcare discount program. Discount cannot be used online. For a full list of Walgreens brand health and wellness products and exclusions, please visit www.walgreens.com/smartsavings.
Last Updated: 08.21.2024 at 10:19 PM CDT
Disclaimer information (scroll within this box to view)Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.
UnitedHealthcare Dual Complete plans
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.
Premium disclaimer
Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).
Benefit disclaimer
Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.
Nurse Hotline disclaimer
This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only.
UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan)
UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees.
UnitedHealthcare Connected® (Medicare-Medicaid plan)
UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.
UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan)
UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees.
UnitedHealthcare Connected® general benefit disclaimer
This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook.
UnitedHealthcare Senior Care Options (HMO SNP) plan
UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.
Star ratings disclaimer
Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2024.
Important provider information
The choice is yours
We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.
The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.
Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.
Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.
American Disabilities Act notice
In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.
Referrals
Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.
Paper directory requests
Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.
Inaccurate information
To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 / TTY 711, or use your preferred relay service.
Declaration of disaster or emergency
If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.
- Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
- Where applicable, requirements for gatekeeper referrals are waived in full;
- Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
- The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.
If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.
