FAQs

Medicaid is a federal and state program that provides health care coverage to those who meet eligibility requirements. In Washington State, Medicaid is called Washington Apple Health. On January 1, 2014, Washington expanded Medicaid to a larger and more diverse group of people, including adults and children below certain income levels.

To qualify for Medicaid, you must meet certain requirements. For instance, you must have a certain income based on the Federal Poverty Level Guidelines.

See if you may qualify for Medicaid.

You must qualify for Medicaid and live in a county where Kaiser Permanente has a contract to provide Medicaid medical services. You will need to request assignment to Kaiser Permanente through your Managed Care Organization and receive Washington Apple Health coverage. If there are no open providers during enrollment, you must also meet one of the following criteria:

• Is the applicant under the age of 19, OR
• Were you a Kaiser Permanente established patient in the past 12 months, OR
• Do you have a current Kaiser Permanente established patient in your household?

An immediate family member is a family member who lives in the home of a current Kaiser Permanente member and is a:

• Spouse (including Domestic Partners)
• An unmarried dependent child under age 21
• A disabled dependent over the age of 21
• A married/unmarried stepparent of children under age 21
• A foster child or stepchild
• A Legal guardian
• A grandparent, parent, guardian, or other relative who applied for Medicaid on behalf of a current Kaiser Permanente established patient that is under 21

If you think you qualify for Medicaid, visit Washington Health Plan Finder at https://wahealthplanfinder.org/ to start your application process online, or call the Health Benefit Exchange at 1-855-923-4633 to apply by phone.

You can apply at any time during the year — there is no deadline. When you’re confirmed eligible for Medicaid, in most cases you may be able to get Washington Apple Health (Medicaid) coverage right away.

Learn more about the Medicaid enrollment process.

If you do not qualify for Medicaid, you might still be eligible for federal financial assistance. Visit https://wahealthplanfinder.org/ for more information and to apply.

Yes, families with higher incomes may find that only their children qualify for Medicaid coverage.

Please visit https://wahealthplanfinder.org/ or call the Health Benefit Exchange at 1-855-923-4633 for more information.

Most individuals who qualify for Medicaid will have no monthly premium, no copay, and no out-of-pocket cost for most covered services. Depending on your income and the eligibility rules, you may have to pay a share of the cost of your care.

Medicaid (Washington Apple Health) and the Washington Health Benefit Exchange both offer health coverage. Whether you get health coverage through Washington Apple Health or the Health Benefit Exchange depends on your household income. If you qualify for Medicaid, your health care will be free or at a lower cost to you and your eligible family members. If you are not eligible for Medicaid (Washington Apple Health) you may be able to get financial assistance through the Washington Health Benefit Exchange.

Yes, you can choose your own doctor from our network of doctors.

All of our available doctors take Washington Apple Health patients. Contact Molina Member Services at 1-800-869-7165 to choose a Kaiser Permanente doctor.

Southwest Washington (Clark/Cowlitz counties):

• You can find information on medical facility locations, departments, and care at kp.org.
• You can also call Member Services: 1-800-813-2000 (toll-free) or TTY 711.
• Hours: Open Monday through Friday from 8 a.m. to 6 p.m.

Greater Puget Sound and Spokane areas:

• Call Molina Member Services at 1-800-869-7165 or TTY 711, 7:30 a.m. to 6:30 p.m., Monday through Friday.

Get more complete benefit information at www.MolinaHealthcare.com or contact Molina Member Services at 1-800-869-7165.

Southwest Washington (Clark/Cowlitz counties):

If you are eligible for Medicaid and choose to receive your care from Kaiser Permanente, your medications are included. To check if your medication is covered, please contact Member Services: 1-800-813-2000 (toll-free) or TTY 711.
Hours: Open Monday through Friday, from 8 a.m. to 6 p.m.

Greater Puget Sound and Spokane areas:
Visit www.MolinaHealthcare.com or contact Molina at 1-800-869-7165 or TTY 711, 7:30 a.m. to 6:30 p.m., Monday through Friday.

Southwest Washington (Clark/Cowlitz counties):

To speak with a pharmacy representative who can help you transfer your prescription(s), call Member Services:
1-800-813-2000 (toll-free) or TTY 711
Hours: Open Monday through Friday from 8 a.m. to 6 p.m.

When you call, please have your prescription number(s) and the name and phone number of the pharmacy where you wish to transfer them from ready. We’ll handle the rest.

You can also visit New Member Prescription Transfer for information on how to transfer your prescriptions.

Greater Puget Sound and Spokane areas:

Refer to your Molina provider directory to locate the specific pharmacy to transfer your prescriptions to. Or contact Molina at 1-800-869-7165 or TTY 711, 7:30 a.m. to 6:30 p.m., Monday through Friday.

Southwest Washington (Clark/Cowlitz counties): 
Please be sure to bring both your Molina ID card and your Kaiser Permanente ID card any time you receive services.

Greater Puget Sound and Spokane areas: 
Please be sure to bring your Molina ID card any time you receive services.

Providers use the information on the card(s) to check your eligibility.

Your Medicaid benefits will stay active for one year if you have no change in circumstances (such as income, moving, adding a family member, or divorce). Every year, the state will check whether you meet the Medicaid requirements before your Medicaid benefits can be renewed.

Learn more about the annual renewal process.

Yes, if you no longer qualify for Medicaid, you still have an opportunity to choose Kaiser Permanente for your health care by visiting continuecoverage.kaiserpermanente.org.