General Information

Apple Health

• All new immigrants to Washington state should get a Health Card with Apple Health for Refugees via DSHS. The Apple Health program offers a wide range of medical services including doctor appointments, immunizations, dental care, pharmacy and medication services.  Once you have your medical card, you can choose a doctor or clinic near you for your visits. 
• Apple Health doctors and clinics  include:
  • Amerigroup Washington
  • Community Health Plan of Washington
  • Coordinated Care of Washington
  • Molina Healthcare of Washington
  • UnitedHealthcare Community Plan

How does healthcare function in the US? (definitions)

• Hospitals are typically where you go in an emergency or to have serious illnesses diagnosed and to be prescribed medication by your doctor. 
• Medications: In the US, medications are distributed through a pharmacy after being given your prescription rather than given directly by your doctor.
• Clinics are where you go for routine medical care. They focus on “regular” medical problems, meaning conditions that allow you to return home rather than being admitted for overnight or extended care. Most visits are done via appointments or drop-in services at a Clinic. Services offered vary by clinic, but can include specialist care like dental, eye, and Women’s and pregnancy health services.
• Urgent Care facilities are often open later and on weekends, and can provide care for immediate non-life threatening conditions.  Check to make sure the one you choose is in your insurance network. (show your card) 
• Emergency Care facilities are available to treat immediate or life-threatening conditions.
• Prescriptions are orders for medicine that your doctor will tell you to get at a pharmacy.  Some medications in the USA require prescription (a doctor order), but many are available at a drugstore or grocery store.  Be sure to ask where to get the medicine the doctor tells you to take. (In the USA the doctor does NOT usually give you medicine at your appointment). 
• Pharmacies which are often a special office at a drugstore or grocery store, but sometimes at a clinic, use prescriptions from your doctor to provide you with medication.
• Drug Stores like Walgreens or Rite-Aid (even most grocery stores) carry non-prescription medication for a wide range of common conditions. Mild pain relievers, fever reducers, cold and flu medicine, and a number of other products are available to buy over-the-counter without a prescription.
• Insurance networks contract with specific hospitals, doctors, and care providers. This means that locations are either in-network (accepts your insurance) or out-of-network (does not accept your insurance). Finding locations that are in-network allows you to bill your insurance company for treatment and pay the associated copays or fees rather than paying the entire bill yourself.

There are various types of costs associated with health insurance plans and healthcare services. Premiums are what you pay every month to maintain your healthcare coverage. Deductibles are what you must pay before your insurance plan steps in to help you. Copays are fixed fees that you pay once you’ve reached your deductible amount.

Primary Care

• Primary Care Providers (PCPs) are doctors who provide health exams, prescribe medication, and other non-emergency services during scheduled appointments. There are often many PCPs to choose from with expertise in different healthcare areas.
• You can search for doctors currently accepting new patients within your insurance network on your insurance provider’s website, typically listed as “Find a Doctor.” To choose your PCP, you will need to confirm them as your primary doctor either through your insurance provider or by contacting the doctor directly. After confirming your PCP, you can begin making appointments and they will become your primary contact for managing any new or continuing health conditions, which may include referrals to specialist care clinics and additional health screening or testing.

• Some locations may not accept all insurance plans, even if you have Apple Health. You may need to search your insurance provider’s website to find available in-network locations. Please note that you may also need to make a payment during your visit (called a copay) even if you have insurance. While some plans do not have a copay, those that do typically range from $20 to $50 depending on the nature of the visit.

Urgent Care

• Urgent care clinics do not require an appointment and provide immediate services for non-life threatening conditions or injuries. Visiting a location that does not accept your insurance can involve very high costs, so be prepared by knowing which locations near you accept your insurance. If you require urgent care, go to the nearest in-network location and sign in by providing your name, insurance information, and the nature of your condition. If you need to pick up a prescription after your visit, make sure to choose a pharmacy you have access to.
• Some locations may not accept all insurance plans, even if you have Apple Health. You may need to search your insurance provider’s website to find available in-network locations. Please note that copays for urgent care visits are often higher than those for primary care appointments, typically ranging from $45 to $75.

Emergency Care

• Emergency Rooms (ERs) are hospitals that provide life-saving care for people experiencing life-threatening conditions or injuries. If someone requires emergency medical attention you do not need an appointment, you can take them to an ER or dial 9-1-1 to receive additional assistance or transportation to an ER. When dialing 9-1-1 you will need to describe your medical emergency. If you require an interpreter, tell the operator you need a “translator” and your preferred language so they can contact someone who can translate the conversation.
• Although all insurance plans are accepted at the ER, copays are more expensive than primary or urgent care. These can range from $100 to $200, but are waived if someone is admitted into the hospital.
• Go to the ER if any of the following apply:
  • Coughing up or vomiting blood
  • Difficulty breathing
  • Feelings of wanting to harm yourself or others
  • Major life- or limb-threatening injuries
  • Pain or swelling in the leg that may be signs of a blood clot deep in a vein
  • Poisoning
  • Severe allergic reaction
  • Severe eye injuries, including exposure to chemicals
  • Severe migraines and headaches
  • Severe wounds or amputations
  • Signs of a heart attack, such as chest pain
  • Signs of stroke, like sudden numbness in the arms or legs
  • Sudden or severe stomach or pelvic pain

Mental Health/Behavioral Health Services

• Mental health and Behavioral health services cover a wide range of conditions, often taking the form of therapy/counseling and psychiatry. Trauma and stress are very difficult to manage and can make you ill, anxious or even depressed.  Therapy and counseling services can vary depending on your situation, typically involving one-on-one or group discussions with your therapist or counselor. Therapists and counselors can help you learn coping skills to manage difficult emotions or thoughts, including those resulting from diagnosed mental health conditions. Psychiatry is focused on the diagnosis, prevention, and treatment of mental health conditions. A psychiatrist is a specialized doctor who will be your main point of contact regarding medications that can be used to manage your mental health.
• Please know that most therapy and counseling services are only available in English. Your first appointment with a mental healthcare professional will usually be about understanding your current mental health struggles and determining appropriate care. Therapy sessions tend to be scheduled on a weekly basis whereas a psychiatry appointment might only need to be made every four to six weeks.
• Some locations may not accept all insurance plans, even if you have Apple Health. You may need to search your insurance provider’s website to find available in-network locations. Fees and copays for behavioral health services also vary depending on the service provided. While copays for therapy appointments usually range from $10 to $30 per session, initial psychiatric evaluations can cost around $250 to $300 with follow-up appointments that cost about $100 to $200 not including additional medication fees.

Dental Care

• Dentists are doctors who specialize in mouth health relating to your teeth and gums. They provide teeth cleanings, x-rays, fillings, and tooth extractions. Basic dental care is covered by Apple Health.  Schedule well in advance.  

Tip: Apple health does not cover root canals or crowns.  You can search for dentists currently accepting new patients within your insurance network on your insurance provider’s website.

• Orthodontists are different from regular dentists, specializing in correcting the alignment and orientation of teeth and jaws using braces, retainers, and other methods. While Apple Health covers a number of important dental procedures, orthodontics coverage is limited to serious dental problems and usually requires prior authorization.
• You can search for dentists currently accepting new patients within your insurance network on your insurance provider’s website. After choosing your dentist, you can call them to make your first appointment. Dentists typically schedule a teeth cleaning and checkup every 6 months to maintain your oral health. They can also be available for dental emergencies depending on their specific policies.  More information here:  https://doh.wa.gov/you-and-your-family/oral-health/finding-dental-care. 
• Costs:  Dentists can cost more than Doctors. Some locations may not accept all insurance plans, even if you have Apple Health. You may need to search your insurance provider’s website to find available in-network locations. Additionally, the dental coverage provided by Apple Health is limited so please confirm your benefits by contacting your insurance provider. Teeth cleanings and checkups are often completely covered by your insurance, but please note that some procedures can have a related copay. Fillings can cost around $50 to $150 per filling, simple tooth extractions can cost between $75 and $250 per tooth, while surgical extractions requiring the use of anesthetics can cost $180 to $550.
• There are also resources available to uninsured individuals in need of dental care. The Muslim Health Professionals of Seattle partner with Medical Teams International to offer a Mobile Dental Program for people without insurance. Click here to schedule an appointment by providing your name, email address, phone number, your desired appointment time,  and the nature of your dental concerns.

Tip: The King County Adult Dental Program is available to King County residents who are not eligible for Apple Health due to citizenship requirements. Call 1-800-756-5437 to be screened for eligibility.  More info on Public Health Dental Clinics available here.   

Crowns and Root Canals can be addressed by UW Dental teaching clinic, or other specialized programs.

Eye/Vision Care

• Optometrists are doctors focusing on eye and vision health who can prescribe glasses, contact lenses, or address other vision-related issues. Finding providers can be complicated, so your primary care doctor or clinic will often help you coordinate these benefits by referring you to an optometrist.
• After choosing or being referred to your optometrist, you can call them to make your first appointment. You will then work directly with your optometrist to schedule appointments as needed.
• Some locations may not accept all insurance plans, even if you have Apple Health. You may need to search your insurance provider’s website to find available in-network locations. Additionally, the vision coverage provided by Apple Health is limited and can differ depending on age, so please confirm your benefits by contacting your insurance provider. Vision care appointments typically have a set copay ranging from $10 to $40 while eyeglass and contact prescriptions range from $100 to $200 annually.

Women’s Health and Pregnancy (OB/GYN) Care

• Obstetricians and gynecologists (OB/GYN) are doctors specializing in pregnancy and female reproductive health. How often a woman  sees her OB/GYN will vary, but many choose to schedule appointments at least once a year. If someone is pregnant, they should see their OB/GYN at least once a month, more frequently as the pregnancy progresses, and for the first 3 months after childbirth for postnatal care.
• Girl children: It is also recommended that parents schedule annual checkups for their girls starting between age 13 and 15. This parent’s guide is very important to maintaining the safety and well-being of your family during these visits. Typical OB/GYN services include breast and gynecological cancer screenings, blood testing, and STI screenings.
• After choosing an OB/GYN you are comfortable with (you can specify if you would like a male or female doctor), you can call them to make your first appointment. You will then work directly with your OB/GYN to schedule appointments and services as needed.
• Some locations may not accept all insurance plans, even if you have Apple Health. You may need to search your insurance provider’s website to find available in-network locations. While typical checkups have small copays, additional services that are not routine can have additional costs depending on insurance coverage.

Medicine: Pharmacies and Over-The-Counter Drugstores

• In the US, you will receive prescriptions for medications from your Doctor but will have to pick up your medication from either an on-site pharmacy or a comparable drugstore pharmacy (Walgreens, Rite-Aid, CVS, etc.). That pharmacy will maintain records on your current prescriptions to avoid any adverse drug interactions, so it is recommended that you fill all your prescriptions at the same location. When filling a prescription for the first time, you will usually need your insurance information, prescription form, and your name and address. Many pharmacies also offer home delivery services to ensure that your medication arrives when you need it. Be sure to ask about these services and discuss any other questions you may have about your medication with the pharmacist assisting you.
• Many drug stores (and grocery stores)  also sell non-prescription medications for less severe or common ailments including pain relievers, fever reducers, cold/flu medicine, and many others without a prescription. You can visit any of these locations and regularly purchase these medications.

Search Engine/Services Guide

• The Apple Health ProviderOne website can help you find a doctor near you.  Healthcare search engines will primarily ask for your current zip code/city and desired care type (specialty).

Tip: For children choose “Pediatrics”  For adult doctor: choose “Internal Medicine”, for Women’s healthcare choose “Obstetrics and Gynecology”, for Dentist choose “Dentist”.  . Entering this information will provide lists of care providers in your area.

• When using the search engines provided below, please note that not every location or practitioner will be up to date. To ensure that you can access care through any resources found online, please contact your insurance provider to confirm that the location or practitioner you would like to visit is still operating and accepting new patients.
• If you are looking for pharmacy services, please reach out to the location directly to ask any questions you may have.

Vaccination Requirements

• Children

Washington state law requires that children enrolled in public school are vaccinated against highly communicable diseases that could put other children at risk. Children who have not completed the entire series before the start of school will be granted conditional status. This means they will be allowed to attend school if they continue to get the remaining doses within 30 calendar days of the recommended immunization catch-up schedule.

• CDC’s Recommended Immunizations for Children from Birth through 6 Years Old
• CDC’s Recommended Immunizations for Children from 7 through 18 Years Old

• Adults
  • CDC’s Recommended Immunizations for Adults 19 Years and Older

COVID-19 Safety

COVID-19 is still spreading throughout Washington. Remember to follow public health guidance around COVID-19 to keep yourself and your community safe and healthy. (Dari) (Pashto)

For GreenCard Application Health Exams – please see Immigration.