Molina Healthcare Inc. Molina Healthcare is a managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare.
Molina Healthcare Apple Health (Medicaid) provides quality, no-cost health for your family. Molina Healthcare Apple Health (Medicaid) provides quality, no-cost health for your family. Find out more about your health plan, what's covered and the many programs we offer you and your family.
Molina Healthcare has an in-plan referral process. It is designed to eliminate the need for Molina Healthcare involvement when you, the PCP, determine that a Member needs to see an in-plan specialist.
Molina Healthcare is very well regarded thanks to its focus on helping underserved populations and lower-income customers and its wellness services that complement healthcare offerings. However, it's only available in 15 states.
When you travel away from your hometown, Molina Medicare pays for emergency care for you. You may go to a local emergency room (ER) or an urgent care clinic. Routine care, such as normal provider visits or pre-planned surgery, is not covered outside of your service area.
One screening mammography every 12 months may be paid for a Molina Healthcare member who is over the age of 39. Massage Therapy Not covered.
Beginning December 16, 2016, in lieu of a prior authorization requirement, Molina Healthcare Inc. will request the CPAP device-generated compliance data for the first 90 days of member utilization. As you know, CPAP therapy devices are reimbursed based upon monthly rental units.
Molina Healthcare covers dental services, including oral surgeons, X-rays, fillings, crowns (caps), root canals, dentures and extractions (pulling). Molina Healthcare covers dental exams every six months as a value-added service. Molina Healthcare covers one cleaning every six months as a value-added service.
Children (18 & under)–Apple Health eligibility
| Total number in family (children and adults) | Monthly income limit for free coverage | Monthly income limit: $30 per month fee |
|---|
| 1 | $2,287 | $3,371 |
| 2 | $3,089 | $4,555 |
| 3 | $3,892 | $5,738 |
| 4 | $4,695 | $6,922 |
In Washington State, Medicaid is called Apple Health. Apple Health provides preventative care, like cancer screenings, treatment for diabetes and high blood pressure, and many other health care services. If you are a biller, provider, or partner: visit our Billers, providers, and partners webpage.
You can also learn the dates for annual open enrollment. Apple Health for Kids with $20 Premium $990 Apple Health for Kids with $30 Premium $1,184 Income amounts effective April 1, 2020, through March 31, 2021.
What's the difference between Washington Apple Health and Medicaid? Washington Apple Health is the name for Medicaid in Washington State. Your provider or the receptionist may call it Medicaid. They mean the same thing.
Apple Health (Medicaid) pays for covered
dental services for eligible children, age 20 and younger.
Some covered dental services include:
- Routine exams.
- Cleaning.
- X-rays.
- Sealants.
- Fillings.
- Stainless steel crowns.
- Fluoride application.
- Extractions (pulling teeth)
Medicaid covers eyeglasses that includes the frames, lenses, fittings, repairs and replacements of glasses. Medicaid only covers contact lenses if they are considered medically necessary and if there is no other alternative treatment.
The average national monthly health insurance cost for one person on a benchmark plan is $462, or $199 with a subsidy. * Monthly premiums for ACA Marketplace plans vary by state and can be reduced by subsidies. The quickest way to get accurate costs is to obtain a quote from a licensed insurance agent.
Program requirements
| Program | Single person | 7-person household |
|---|
| Apple Health for Adults (age 19 through 64 years of age) | $1,468 monthly | $4,559 monthly |
Mileage, meals, and lodging are covered while receiving Medicaid-covered medical care outside the client's community. Allowances for meals and lodging are also a set amount. The Transportation Center must approve all travel assistance before the trip. If advance notice is insufficient, the trip may not be covered.
Apple Health for Adults
You may be eligible if: • You are between 19 and 65 years old. You are a Washington resident. You are a U.S. citizen or meet Medicaid immigration requirements. You are not incarcerated.Eyeglasses are covered for children under age 21 through your Washington State Medicaid Services Card. They are provided through Correctional Industries Optical only. Your vision provider can orders the eyeglasses for you.
Anyone with Apple Health has coverage for dental services through the Washington Health Care Authority. Use your ProviderOne card with a provider who accepts Apple Health. Community Health Plan of Washington only covers accidental injury to teeth.
Top Rated Health Insurance Plans in Washington
| Medicare | Type | Rating |
|---|
| Kaiser Foundation Health Plan of the Northwest, Inc. | HMO | 5.0 |
| Kaiser Foundation Health Plan of Washington | HMO | 5.0 |
| Aetna Life Insurance Company (Washington) | PPO | 4.5 |
A person receiving Apple Health coverage must stay with her ill grandmother in another state.
Applying for Apple Health coverage
- Online: Go to Washington Healthplanfinder - select the "Apply Now" button under Washington Apple Health.
- Mobile app: Download the WAPlanfinder app to create an account and apply for coverage.
- Phone: Call the Washington Healthplanfinder Customer Support Center at 1-855-923-4633.
Today, Apple Health covers adults with incomes up to 138 percent of the federal poverty level. In April 2019 that translated to about $17,236 for a single person or $35,535 for a family of four.
Acupuncture Not covered. Alcoholism Treatment Molina Healthcare will cover inpatient or outpatient treatment for medical conditions resulting from or associated with alcoholism or chemical dependency.
Medicaid is a government health insurance program available to people with very limited income and resources. Medicaid does not pay money to you. Medicaid can pay for medical services in your own home or if you live in a residential care facility that takes Medicaid residents.
Becoming an HMO
Molina Healthcare has focused on government-paid health care programs such as SCHIP and Medicaid since it became a health maintenance organization in 1985. From 1985 to 1997, the company was only in California.Contact Us. Our Member Services representatives are available from 7 a.m. - 7 p.m. local time, Monday to Friday at (888) 665-4621 / TDD/TTY: 711 and (310) 507-6186 (Fax).
You may get chiropractic services from any chiropractor who will accept your Forward Health ID Card if you are a BadgerCare Plus or Medicaid SSI member. Your Chiropractic Services are provided by the State, not Molina Healthcare.
Apply today
Contact Health Care Options (HCO) at (800) 430-4263 to get an enrollment form. Health Care Options can also help you find your county eligibility worker.All provider types can register using their Molina Provider ID. National Provider Identifier is a unique identification number given to health care providers by the Centers for Medicare and Medicaid/Marketplace Services. If you have an NPI Number, please enter it in the designated field.
Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income. Medicaid is a state and federal program that provides health coverage if you have a very low income. They will work together to provide you with health coverage and lower your costs.
Go to and print a temporary Member ID Card. Go to and ask to have a new card sent to you. Call Member Services at (800) 642-4168, or for hearing imparied TTY/Ohio Relay, please call (800) 750-0750 or 7-1-1.
Jessica Schule, and Dr. Ashlee Llamas are Molina Naturopathic Physicians, meaning they are in network with Molina Healthcare of Washington for coverage of Naturopathic Medicine. With Molina, patients are provided with 10 visits per year for spinal manipulation coverage with a Naturopathic Physician.
Medicare is the federal health insurance program for: People who are 65 or older. Certain younger people with disabilities. People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
