Be Well: Access to Care Goes Beyond Your Doctor’s Office - Washington State Local Health Insurance - CHPW
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Be Well: Access to Care Goes Beyond Your Doctor’s Office

Your doctor’s office or clinic is usually the first place you go to get care. But getting access to care can mean much more than just a trip to your regular doctor.

You deserve to be able to conveniently get the right care for your health needs at the right time, from a quality health provider. And you shouldn’t have to worry about being able to afford it.

It’s good to know your options for care, because life is busy and illness is something that’s hard to predict.

As a CHPW Apple Health member, here are a couple of important things to remember:

  • High-quality care is available to you 24 hours a day, seven days a week.
  • You don’t have to pay for any covered services when you see any doctor or go to any clinic or hospital in our network. (You might have to pay if you get care from a provider who is not in our network and it is not an emergency or pre-approved by us.)

Types of care and how to access them

Primary Care Provider (PCP)

Your PCP will take care of most of your health care needs. You don’t see them only when you’re sick. You may also see them to get your annual exam, get a health screening, or get immunizations (shots). If you don’t have a PCP, try our Find a Doctor tool.

Tip: If you make appointments now for visits you know you’ll need — like your child’s back-to-school wellness visits —  you’ll have a better chance to get the appointments that work for your schedule.

Specialty care – Your PCP will refer you to a specialist if you need care they cannot give, like treatment for some diseases or complex conditions. CHPW will get you the care you need from a specialist outside our network if we don’t have one in network.

Virtual Care/Telehealth

You don’t always need to see a doctor in person. Many of your providers can diagnose, treat, and prescribe medications for common ailments via the phone or video visits. If that’s not an option, or it’s after hours or on the weekend, you can always reach a licensed doctor by phone or video through CHPW Virtual Care. It’s available 24/7. We cover these telehealth visits, so there’s no cost to you.

Urgent care

Urgent care or walk-in clinics help fill an important gap when you become sick or injured but your regular doctor is not available, and you can’t wait for an appointment. Contact CHPW Customer Service at 1-800-440-1561 (TTY: 711) to find an urgent care facility in our network, so that your visit will be covered.

Emergency care

Call 911 or go to the nearest emergency room if you have a sudden or severe health problem that you think is an emergency. You do not need pre-approval from us or your regular doctor. You can use any hospital or emergency setting.

Nurse Advice Line

Sometimes, you’re not sure if you need to go to the doctor, to urgent care, or to the emergency room. Our Nurse Advice Line at 1-866-418-2920 (TTY: 711) is a telephone hotline you can call for this kind of situation. A registered nurse will help you figure out the type of care you need. It’s available  24 hours a day, seven days a week.

Alternative Treatments

Therapies such as acupuncture, massage, and chiropractic can be helpful if you’re seeking a nondrug alternative for treating chronic pain, stress, and similar ailments. Your CHPW Apple Health plan covers a combined 20 visits a year for these alternative treatments. You don’t need a referral from your doctor or prior approval from us to see any acupuncturist, massage therapist, or chiropractor licensed in Washington State.

Behavioral Health care

You don’t need a referral to see a behavioral health provider for mental health or substance use issues. That means you can pick any in-network provider who you think is a good fit. For a mental health emergency, call or text 988. The line is free, confidential, and available 24/7.

Remember, our team at CHPW is here to support your whole health. If you need help getting care or scheduling an appointment, call us: 1-800-440-1561 (TTY: 711) Monday through Friday, 8 a.m. – 5 p.m.

Did you know
Many clinics have family medicine doctors (also called family practitioners) who can see multiple members of a family. Family practitioners can be a newborn’s pediatrician when the baby leaves the hospital and can also see teenagers, adults, and even grandparents. Accessing care at one location and with one doctor can make life just a bit simpler for you and your family.



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