Behavioral Health Services Only Plan

If you already have health coverage through another program, like Medicare, Tribal Health, or Foster Care, you can get additional coverage just for mental health and substance use disorder services through our Behavioral Health Services Only (BHSO) plan.  

The best part? You won’t have copays for services that are covered or approved from in-network providers. 

What is a Behavioral Health Services Only plan?

Behavioral Health Services Only (BHSO) is a type of Apple Health (Medicaid) coverage for people who are not eligible for a full medical managed care plan — for example, those who have Medicare as their primary insurance or those who have Tribal Health medical coverage.

BHSO plans make sure everyone who is eligible has access to behavioral health benefits. Through BHSO, members get coverage for things like mental health and substance use disorder treatment.

Some behavioral health services are funded by the Washington State Legislature (outside of Apple Health) or by federal grants. These services complement Apple Health benefits and may be available to BHSO-covered Apple Health clients who meet specific program and medical necessity criteria.

If you have questions about your eligibility or BHSO plan, please contact our Customer Service team at 1-800-440-1561 (TTY:711) Monday – Friday, 8 a.m. to 5 p.m.

Who is eligible for a BHSO plan?

The Washington state Health Care Authority (HCA) will automatically enroll clients in BHSO coverage when a person is eligible for behavioral health services under Apple Health but receives their physical health coverage outside the managed medical care program.

This includes:

• Individuals with primary insurance through Medicare (traditional or Part C).
• Individuals in foster care who receive their medical care through Apple Health without a managed care plan (also known as fee-for-service).
• Certain individuals who have private insurance coverage.

Note: Dual-eligible American Indian/Alaska Native (AI/AN) clients may opt in or out of BHSO coverage at any time.

What’s included in a BHSO plan?

As a CHPW member on our BHSO plan, you also qualify for the following programs*:

Other services

Other services that may be covered under your BHSO plan include emergency services, hospital services, evaluations, and lab services. See your Member Benefits Handbook for more details.

Prescriptions are covered through your physical health benefit, not as part of CHPW’s BHSO plan.

*This is not a full list of our covered benefits. Some services require a referral from your primary care provider or prior authorization from us. There are limits to some benefits and services, and some are covered if we determine that they are medically necessary or under Apple Health without a managed care plan.

How to get care after normal office hours

If you need care after hours, call your behavioral health provider or your PCP to see if they offer after-hours care.

You can also call our 24-hour Nurse Advice Line at 1-866-418-2920 (TTY: 711) and ask for assistance.

For 24-hour emotional support and referrals, contact the Washington Recovery Help Line or the mental health crisis line in your area.

For a life-threatening emergency, call 911.

Member Benefits Handbook

For more information about your BHSO plan or benefits, download the Member Handbook, available in:

➔ Behavioral Health Benefit Handbook (English)  | English (Large Font) | Español – Spanish | العربية – Arabic |中文 – Chinese | دری – Dari | Pусский – Russian | af Soomaali – Somali | українська – Ukranian | Tiếng Việt – Vietnamese

To request a free hard copy of the Member Handbook, please call Customer Service at 1-800-440-1561 (TTY Relay: Dial 711), from 8 a.m. to 5 p.m., Monday through Friday. We will send you a copy within 5 business days of your request.

Become a CHPW member

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