Amerigroup washington apple health coverage

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To view additional services that may be provided under specific Apple Health programs if the individual meets all the criteria required to receive the service , visit the program benefit packages and scope of service page. Breadcrumb Home Free or low-cost health care I need medical, dental, or vision care What are my basic covered services? What are my basic covered services?

Learn which services are covered under Apple Health Medicaid programs. Services covered by Apple Health Medicaid Apple Health offers complete major medical coverage for individuals who meet the eligibility requirements.

Services covered by Apple Health: Appointments with a doctor or health care professional for necessary care Medical care in an emergency Maternity and newborn care Mental health services Treatment for chemical or alcohol dependence Pediatric services, including dental and vision care Limited dental and vision care for adults Prescription medications Laboratory services Hospitalization Transportation to and from medical appointments, when necessary An interpreter for your appointment, if you do not speak English arranged through your provider Note: This list is for general information only and does not guarantee Apple Health will cover the service.

Related links Health care coverage program benefit packages and scope of service categories Eligibility requirements for Apple Health. How do I get dental care? Can I get vision care? Are my dependents eligible? The drugs within a chosen therapeutic class are evaluated by the Drug Use Review Board, which makes recommendations to HCA regarding the selection of the preferred drugs. To obtain authorization for a nonpreferred drug, a client must have tried and failed, or is intolerant to, a designated number of preferred drugs within the drug class unless contraindicated or not clinically appropriate.

In addition to approval criteria for nonpreferred products, some drugs have additional criteria that must be met. Note: For continuity of care, all plans will use the same PA criteria, step therapy edits, and quantity limits developed by HCA.

If you can't find the versions you're looking for, email us applehealthpharmacypolicy hca. Note: For information on billing and rates, the Apple Health PDL, and expedited authorization codes, please visit the Prescription Drug Program on our provider billing guide and rates webpage.

See what drugs are preferred and whether they need a prior authorization PA. How to use the Apple Health PDL Preferred drugs within a chosen therapeutic class are selected based on clinical evidence of safety, efficacy, and effectiveness.

Related forms and publications Emergency fill policy. Related links Request a pharmacy prior authorization Barcoded document submission cover sheets Apple Health Medicaid drug coverage criteria Implementation status reports under Agency reports.

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If a service you need is not listed, check with your health care provider or your health plan. To view additional services that may be provided under specific Apple Health programs if the individual meets all the criteria required to receive the service , visit the program benefit packages and scope of service page. Breadcrumb Home Free or low-cost health care I need medical, dental, or vision care What are my basic covered services?

What are my basic covered services? Learn which services are covered under Apple Health Medicaid programs. Services covered by Apple Health Medicaid Apple Health offers complete major medical coverage for individuals who meet the eligibility requirements. Services covered by Apple Health: Appointments with a doctor or health care professional for necessary care Medical care in an emergency Maternity and newborn care Mental health services Treatment for chemical or alcohol dependence Pediatric services, including dental and vision care Limited dental and vision care for adults Prescription medications Laboratory services Hospitalization Transportation to and from medical appointments, when necessary An interpreter for your appointment, if you do not speak English arranged through your provider Note: This list is for general information only and does not guarantee Apple Health will cover the service.

Related links Health care coverage program benefit packages and scope of service categories Eligibility requirements for Apple Health. How do I get dental care? Can I get vision care?

If you can't find the versions you're looking for, email us applehealthpharmacypolicy hca. Note: For information on billing and rates, the Apple Health PDL, and expedited authorization codes, please visit the Prescription Drug Program on our provider billing guide and rates webpage. See what drugs are preferred and whether they need a prior authorization PA. How to use the Apple Health PDL Preferred drugs within a chosen therapeutic class are selected based on clinical evidence of safety, efficacy, and effectiveness.

Related forms and publications Emergency fill policy. Related links Request a pharmacy prior authorization Barcoded document submission cover sheets Apple Health Medicaid drug coverage criteria Implementation status reports under Agency reports. How do I get dental care? Can I get vision care? Are my dependents eligible? Are my survivors eligible?