Health Care Coverage and Coordination

Kid with mom to see doctor

 

Apple Health for Kids

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Health for Kids

Washington Apple Health for Kids provides medical, dental, vision and mental health benefits to children under age 19. There are no deductibles or co-pays. The insurance is free or low cost depending on your family’s gross monthly income and is available to both citizen and non-citizen children. For more information, call the WithinReach Apple Health hotline at 206-204-3503 (weekdays) or visit ParentHelp123.

 

Early Periodic Screening, Diagnosis, and Treatment

Early Periodic Screening, Diagnosis, and Treatment (EPSDT) is an important benefit for children, youth and young adults enrolled in Apple Health (Medicaid). EPSDT covers regular check-ups and treatment for medical issues found during an exam up to age 21. Call the Apple Health Customer Service Center at 1-800-562- 3022 to ask about EPSDT services. Learn about Well Child Check-Ups, which are a part of EPSDT.

 

Medically Intensive Children’s Program (Age 17 and Younger)

The Medically Intensive Children’s Program provides in-home skilled nursing care to Apple Health clients under age 18, either through Apple Health coverage without a managed care plan (also known as fee-for-service) or coverage through a managed care organization. MICP supports children who have complex medical needs like ventilators, tracheostomies, feeding tubes, complex respiratory treatments or continuous IV infusions and require skilled nursing care on a continuous and daily basis. The MICP program is designed to support clients and their families who must assume a portion of the client’s care. MICP hours are determined by the DDA Nursing Care Consultant, up to 16 hours per day. MICP Fact Sheet | MICP Nursing Agency Contact List | MICP Policy

 

Nurse Delegation (all ages)

Nurse Delegation allows a non-nurse to legally perform nursing tasks, such as giving medication. With Nurse Delegation, a long-term care worker is delegated by a registered nurse to provide tasks that are usually performed only by a licensed nurse. State law requires that when a task is delegated, specific rules are followed by both the delegating nurse and caregiver who performs the task. The rules are written by the Washington State Board of Nursing to ensure public safety.
Nurse Delegation Policy | Find a Nurse Delegator

 

Additional Resources

Children and Youth with Special Health Care Needs

CYSHCN promotes connected systems of care for children and youth with special care needs from birth through transition to adulthood.

Kids’ Mental Health Washington

Kids’ Mental Health Washington regional teams connect youth with complex mental and behavioral health needs with the supports they need to live and thrive in their communities.

WithinReach Parent Help 123

WithinReach helps families across Washington state navigate complex health and social service systems and connect with the resources they need to be healthy and safe, such as food assistance, health insurance, childhood screenings and more. Call the Help Me Grow Washington Hotline at 1-800-322-2588 to speak to someone in person or use the Help Me Grow benefit finder to find out what you may be eligible to receive.