Benefits Overview: Out of Home Placement
View some of Coordinated Care's benefits below. Click here to view a complete list of benefits available.
Care coordination and disease coaching are part of your health benefits and are provided to you at no cost. Coordinated Care pays for these services. We provide services for many conditions, such as asthma, diabetes, COPD, high-risk pregnancy and many more. Call Member Services at 1-844-354-9876 (TTD/TTY: 711).
Our Care Managers can help you understand and manage your chronic health conditions like diabetes or asthma. They provide education and personal help. Disease and care management are part of your health benefits with us. They are provided to you at no cost.
Apple Health Core Connections’ nurses and social workers work with you and your doctors to help you get the care you need. The nurse can also set up home health services, refer you for a MemberConnections® visit, or help you get other needed services.
In addition, you can work with a health coach and get educational materials to help you understand and take control of your health. Take advantage of the many resources we have for:
- Heart disease
- Tobacco cessation (Pediatric Tobacco Cessation – 12-17 years old)
- Weight management (Pediatric Obesity – 2-17 years old)
A member can personally refer themselves for these services or have a doctor refer you. Call Member Services to find out more about our care and disease management programs.
Dental Care is covered under Washington Apple Health, not Coordinated Care. You must use a dental provider that will bill DSHS. Remember to contact your dental provider before setting up an appointment to see if they accept Washington Apple Health.
Preventative care visits are covered by Coordinated Care. This means visiting the doctor for a regular check-up, rather than waiting until you are sick.
Coordinated Care covers an annual physical for adults.
Regular child check-ups are also covered for those under the age of 21. These doctor visits should occur at the below ages. Children also need a blood lead test at 12 and 24 months of age. We cover this. After that, if they are high risk, they need the blood lead test each year age 3 to 6.
- Birth or neonatal exam
- 2 to 4 days for newborns discharged less than 48 hours after delivery
- By 1 month
- 2 months
- 4 months
- 6 months
- 9 months
- 12 months
- 15 months
- 18 months
- Once per year from 2 years old through 20 years old
Did you know?
- More than 200,000 people are taken to the hospital each year because of the flu?
- 30,000 people die every year related to the flu?
- The flu shot is recommended for everyone ages 6 months and older?
- That pregnant women, children and those over 50 years of age have a higher risk for catching the flu?
That’s why the flu shot is so important to protect you and those around you!
The flu shot is FREE to our members and available at your doctor’s office or for members who are 7 or older, you may get your flu shot at one of these participating pharmacies (PDF).
Our Nurse Advice Line is ready to answer your health questions 24 hours a day – every day of the year. It is staffed with Registered Nurses. These nurses have spent lots of time caring for people. Now they are ready and eager to help you.
Feel free to contact our nurse advice line at any time 1-844-354-9876 (TTD/TTY: 711). Press 3 for Members, then press 3 to speak to a nurse.
Coordinated Care provides the following resources:
- Interpreter Services – provided through the state, free of charge, during any service or grievance process. If you need an interpreter at your medical appointment, contact Coordinated Care Member Services at 1-844-354-9876 (TTD/TTY: 711) at least seven days before your appointment. We will arrange for one to be at your appointment.
- Translation of health coverage benefits - Coordinated Care can also help translate available services. If you need something translated into a language other than English, please call Coordinated Care.
- Sign language, Braille, CD or Large Print - We can provide other aids for communication to members with visual impairments upon request.
- Language line assistance for questions or help in any language.
- The Coordinated Care provider directory notes providers who are accessible by ADA standards.
- Assistance finding a physician or practice that speaks your primary language as needed. Please call our Member Services at 1-844-354-9876 (TTD/TTY: 711).
- Some member resources are available translated on this site and are indicated by language following the title.
To request material in an alternative format, contact Coordinated Care at 1-844-354-9876 (TTD/TTY: 711).
We have a special program that helps you get care. The program connects you to community groups that can help. It’s called MemberConnections. A MemberConnections team member can talk to you on the phone. They will send you information and can visit your home. They will be glad to talk to you about:
- How to choose a doctor (PCP)
- How to change doctors
- The healthcare you get at Coordinated Care
- How to use Coordinated Care’s services
- How to get medical advice when you can not see the doctor
- How to live a healthy life
- How to get shots and health screenings
- Other healthcare problems you may have
MemberConnections representatives will connect you to community social service programs. These programs will help you with food, housing and clothing.
Connections Plus is a program for eligible Coordinated Care members. The program provides a cell phone at no cost to high-risk members who do not have safe, reliable access to a telephone. This program allows our members to have 24-hour access to physicians, care coordinators, telehealth services and 911. If you qualify, a MemberConnections Representative will come to your home to teach you how to use the phone.
Start Smart for Your Baby (Start Smart) is our special program for women who are pregnant. We want to help you take care of yourself and your child throughout your pregnancy. Information will be given by mail and telephone. Our Start Smart staff can answer questions and give you support if you are having a problem. We can even arrange for a home visit, if needed.
You will receive a free car seat if you submit the form at least six weeks before your due date.
Our tobacco cessation program is designed to help members quit smoking and other tobacco use.
Program Goal: To reduce tobacco-related health risks by promoting cessation of all tobacco products.
- Expert coaching over the phone
- Personalized plan to quit using tobacco
- Evidence-based guides and education
- Coordinated Care members (adults and teens)
- Currently using tobacco in any form, including cigarettes, smokeless tobacco, or e-cigarettes (“vape pens”).
- Willing to set a quit date within 30 days of enrollment in the program.
How to Enroll?
Members may self-refer or providers can refer members by calling:
Washington Apple Health (Medicaid) – 1-866-274-5791, Ext. #6
Apple Health Core Connections (Foster Care) – 1-844-882-3827, Ext. #4
If you are a caregiver who has recently had a child in foster care placed in your home, we want to help. Call us at the Apple Health Core Connections phone number, 1-844-354-9876 (TTD/TTY: 711) so we can assist members with:
- PCP assignments and changes within 72 hours of a placement change
- Replacing lost prescriptions
- Connecting to Health Care Coordinators to help manage chronic conditions, provide coaching, and make arrangements for needed medical services/supplies
- 24 hour Nurse Advice Line
We are here for you. Please contact us with questions as soon as a placement change takes place so we can keep members cared for throughout the transitions.
Coordinated Care will cover eye exams every 12 months for members under age 21 and every 24 months for members 21 and over. To find a vision provider, search our Provider Directory and select “Vision” for type of provider.
Hardware (the eye glasses themselves) is covered for members under 21 years of age with the Washington Apple Health program. Click to find a list of locations where you may purchase eye wear. Under Specialty, select "Eyewear Supplier."