Yes, Washington Apple Health covers abortion. Both medication abortion and in-clinic (surgical) abortion are covered at no cost to enrolled members, along with follow-up care, birth control, and related reproductive health services. You do not need a referral or prior authorization, and you can go to any abortion clinic in the state regardless of your managed care plan’s network.1Community Health Plan of Washington. Family Planning
What’s Covered
Apple Health covers both methods of abortion:
- Medication abortion, sometimes called the abortion pill, which uses mifepristone and can be used up to 11 weeks (77 days) after the first day of your last menstrual period.1Community Health Plan of Washington. Family Planning
- Surgical, or in-clinic, abortion, available at various stages of pregnancy depending on individual circumstances.
Coverage also includes follow-up care for any complications, pregnancy testing, STI screening and treatment, annual wellness exams, and the full range of birth control methods: pills, IUDs, shots, condoms, permanent sterilization, and emergency contraception. Members pay nothing for any of it.1Community Health Plan of Washington. Family Planning
Washington funds abortion coverage with state dollars, so Apple Health is not limited to the federal Hyde Amendment’s exceptions for rape, incest, or life endangerment. Washington also does not require you or your provider to fill out a special form or document the reason for the abortion in order for Medicaid to pay.2National Health Law Program. Abortion Coverage Under Medicaid Washington law also sets no parental consent requirement, no mandatory waiting period, and no informed-consent restrictions, so people of any age can consent to their own abortion care.3Washington State Coalition Against Domestic Violence. Abortion Care in Washington
No Referral or Prior Authorization
Apple Health members can self-refer directly to any abortion clinic in Washington. You do not need a referral from a primary care provider, and your managed care plan cannot require prior authorization. The clinic you choose does not have to be in your plan’s network.1Community Health Plan of Washington. Family Planning In practice, that means you can call a clinic, book an appointment, and have the visit billed to Apple Health without going through your plan first.
Who Qualifies for Apple Health
Eligibility is based mainly on income. Adults generally qualify with income at or below 193% of the Federal Poverty Level.4Northwest Abortion Access Fund. Washington Immigration status does not disqualify you: undocumented immigrants and minors can get abortion coverage through Apple Health.5Legal Voice. Abortion Rights Washington
If you have just moved to Washington and intend to stay, you count as a resident and can apply the day you arrive.4Northwest Abortion Access Fund. Washington People who were not previously eligible may become eligible once pregnant.6King County Department of Public Health. Abortion Services If you already have private or employer insurance, you can still apply for Apple Health as secondary coverage if your income qualifies.
If your income is above the Apple Health limit, you may still qualify for Washington’s Family Planning Only program, which covers confidential reproductive health services for people with incomes up to 265% of the Federal Poverty Level, regardless of immigration status.7Northwest Health Law Advocates. Coverage for Adults
How to Apply
Enrollment is open year-round. The fastest route is online at Washington Healthplanfinder (wahealthplanfinder.org), which usually gives an immediate eligibility decision.4Northwest Abortion Access Fund. Washington You can get in-person help from Healthcare Navigators at public health clinics, or call the Community Health Access Program at 1-800-756-5437.6King County Department of Public Health. Abortion Services
If you are under 19 and want your pregnancy-related care to stay confidential, do not apply online. Use a paper application or call the WithinReach Family Health Hotline at 1-800-322-2588 instead.4Northwest Abortion Access Fund. Washington
Finding a Provider
Because you can self-refer, you don’t need to search a plan directory. Clinics that serve Apple Health patients include Planned Parenthood health centers across the state, Cedar River Clinics in Renton and Tacoma, UW Medicine’s Family Planning clinic in Seattle, and a number of independent clinics.6King County Department of Public Health. Abortion Services UW Medicine coordinates the Washington Reproductive Access Alliance, a network of public hospitals aimed at expanding access in rural and underserved areas.8UW Medicine. WA Reproductive Access
The Washington Department of Health keeps a current list of clinics, including telehealth providers, at doh.wa.gov.9Washington State Department of Health. Abortion AbortionFinder.org and the National Abortion Federation offer additional search tools.
Telehealth and the Abortion Pill by Mail
Washington has a shield law covering abortion care delivered by telehealth,10Guttmacher Institute. Abortion Policies – Washington and providers in the state can mail mifepristone to patients.11Washington State Department of Health. Telehealth Services Whether a given telehealth service is covered by Apple Health depends on whether that provider accepts Medicaid, and not all do.12Plan C Pills. Abortion Pill – Washington Call the clinic to confirm before you book. If telehealth isn’t an option through Apple Health in your area, in-person care at a clinic is still fully covered.
Privacy
Washington law and federal HIPAA rules protect the privacy of reproductive health care. As an Apple Health member, you decide who is authorized to receive information about your care, no matter who enrolled you in the plan.1Community Health Plan of Washington. Family Planning Communications about sexual and reproductive health services are sent only to the email or mailing address you provide, and are kept confidential.11Washington State Department of Health. Telehealth Services Washington also has a data privacy law adding further protection for people seeking reproductive health care.10Guttmacher Institute. Abortion Policies – Washington
Coverage After the Pregnancy Ends
Apple Health continues for 12 months after a pregnancy ends, including a pregnancy ended by abortion.7Northwest Health Law Advocates. Coverage for Adults If you were enrolled during the pregnancy, this extended coverage starts the first day of the month after the pregnancy ends. If you weren’t enrolled, you can still apply, and if eligible, coverage starts the month you apply.13King County Department of Public Health. Eligibility Qualifications The extended coverage includes hospitalization, prescriptions, and preventive and wellness care.
If You Don’t Qualify for Apple Health
If you’re uninsured, underinsured, or can’t safely use your insurance for privacy reasons, help is available. The Washington Department of Health’s How to Pay for Abortion Care page lists clinics and abortion funds to contact.14Washington State Department of Health. How to Pay for Abortion Care The Northwest Abortion Access Fund serves Washington, Oregon, Idaho, and Alaska, paying clinics directly and helping with travel and lodging costs.15Northwest Abortion Access Fund. About NWAAF The National Abortion Federation hotline and the National Network of Abortion Funds list additional funds nationwide.
If you have private insurance with a high deductible, you may face out-of-pocket costs even when the plan covers abortion. Check with your insurer about your remaining deductible, and tell the clinic if the cost is a barrier so staff can help you look at other payment options.14Washington State Department of Health. How to Pay for Abortion Care