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Health Screening Form One Member per Form - This form is also available online. *Required Field a a a a a a Last Name: a a a a a a a a aaaaaaa aaaaaaaa Member ID*: a a a a a a Member Date of Birth.

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We are here for you. 1-877-644-4613 (TTY 1-866-862-9380).

In Washington State, we call the Medicaid program “Apple Health.” Apple Health provides health care coverage to nearly 2 million residents—adults and children.

Coordinated Care provides your essential Washington Apple Health (Medicaid) benefits, plus additional programs such as a free cell phone, a free car seat or pack 'n play, $10 fruit and vegetable vouchers, dollar rewards for completing healthy activities, and more. Get benefits that help you get and stay healthy.

Payer IDs: Coordinated Care Medical – 68069.

We are here for you. 1-877-644-4613 (TTY 1-866-862-9380).

Coordinated Care is a managed care organization that provides healthcare services to more than 200,000 members across Washington state. Coordinated Care has a commitment to improving the health of the community one individual at a time through affordable and reliable health care plans.

services from a nonparticipating provider? The provider can bill you if both of these are true: You knew the provider was outside your MCO's network. You chose to get nonemergency services from it anyway without the MCO's authorization.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232