How we work

Apple Health (Medicaid) Program

The Apple Health (Medicaid) Program aids clients and providers by developing enrollment and eligibility policy, determining a client's eligibility for health coverage, and improving public awareness of programs and services offered by the Health Care Authority (HCA).

Support services

Medical Assistance Customer Service Center (MACSC)

The Apple Health Medical Assistance Customer Service Center (MACSC) is the front-line support available to over 2 million clients and 140,000 providers. MACSC helps customers with a wide range of program issues, including managed care enrollment, ProviderOne client services card questions, benefit coverage, and billing/claims. Contact MACSC by phone, email or via web portal.

Provider Relations Unit (PRU)

The Apple Health Provider Relations Unit provides information, training, and consultation to providers to help them more efficiently deliver services and support to Apple Health clients. Contact PRU via provider web portal.

Medical Eligibility Determination Services (MEDS)

Apple Health Medical Eligibility Determination Services (MEDS) offers support for Modified Adjusted Gross Income (MAGI) programs covering a wide range of Apple Health clients, including children, pregnant individuals, families, and adults. MEDS is responsible for all MAGI post-enrollment functions. Contact MEDS by phone, email, or web portal.

Eligibility specialists

Community-based eligibility specialists are located in each county across the state to help applicants, enrollees and community partners to answer questions related to eligibility rules for the family, children, pregnant individuals and individual adult Apple Health programs. 

Office of Medicaid Eligibility and Policy (OMEP)

The Office of Medicaid Eligibility and Policy (OMEP) transforms Medicaid policy into practical approaches for improving health. It does this through a wide range of activities, including the development of eligibility and policy for Apple Health. In partnership with other state agencies, OMEP provides training and education for eligibility staff and community partners about the Apple Health program.

Other efforts include outreach to the stakeholder community with public presentations, webinar trainings, forms/publications,and online resources.

For questions or more information, contact your local HCA area representative by phone or email.