Wash. HCA Hospice Services Billing Guide, What if your patient has not applied for Apple Health?

Patients who have not yet applied for Apple Health may do so in one of the

following ways:

Client

demographic

Application form

number Online applications Phone contact

Fax

number:

Parents,

pregnant

people, children

under age 19 and

adults under age

65 without

Medicare

HCA 18-001* Washington Apple

Health Plan Finder

In-person application

assistance is also

available. To get

information about where

to get help in your area,

visit the Washington

Apple Health Plan Finder

website or call HCA’s

Customer Service Center

for free at 855-WAFINDER

(855-923-4633) or 855-

627-9604 (TTY)

Call 1-855-

WAFINDER (855-

923-4633) or 855-

627-9604 (TTY)

N/A

Age 65+ Blind

Disabled has

medicare, who

DOES need

LTSS**

HCA 18-005*

Mail to:

DSHS

Home &

Community

Services

PO Box 45826

Olympia, WA

98504-5826

Washington Connection

To locate a local HCS

office, visit the DSHS

HCLA resource webpage.

Contact your local

HCS office

1-855-

635-8305

Age 65+ Blind,

disabled,

medicare, who

DOES NOT need

LTSS**

HCA 18-005*

Mail to:

DSHS

Community

Services Division –

Customer Service

Center

PO Box 11699

Tacoma, WA

98411-6699

Washington Connection

To locate a local

Community Services

Office, visit the DSHS Find

a Community Services

Office webpage

Call 1-877-501-

2233

1-888-

338-7410

* These forms are available on HCA’s Electing hospice services – DSHS agency

and client webpage.

** Nursing facility care, in-home personal care, assisted living facility and adult

family home programs