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      • Find Apple Health benefits & services
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      • Find Apple Health benefits & services
        • What are my basic covered services?
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        • What are my basic covered services?
        • How do I get dental care?
        • Can I get vision care?
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        • Enrollment next steps
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      • Manage my coverage
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        • Replace my services card
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        • Update my income or address
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        • Family initiated treatment (FIT)
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      • Prenatal, children & young adults
        • Behavioral health services for prenatal, children & young adults
        • Wraparound with Intensive Services (WISe)
        • Family initiated treatment (FIT)
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        • Wraparound with Intensive Services (WISe)
        • Family initiated treatment (FIT)
        • Early signs of psychosis
      • American Indians & Alaska Natives
        • Behavioral health services for American Indians & Alaska Natives (AI/AN)
        • Behavioral health services for American Indians & Alaska Natives (AI/AN)
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        • What is recovery support?
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      • Prevention
        • Substance use disorder prevention & mental health promotion
        • Substance use disorder prevention & mental health promotion
    • I help others apply for & access Apple Health
      • Apple Health Eligibility Manual
        • Apple Health eligibility manual overview
        • Introduction overview for general eligibility
        • General eligibility requirements that apply to all Apple Health programs
        • Classic (non-MAGI) based programs manual
        • Modified Adjusted Gross Income (MAGI) based programs manual
        • Long-term services & supports (LTSS) manual
        • Apple Health eligibility manual overview
        • Introduction overview for general eligibility
        • General eligibility requirements that apply to all Apple Health programs
        • Classic (non-MAGI) based programs manual
        • Modified Adjusted Gross Income (MAGI) based programs manual
        • Long-term services & supports (LTSS) manual
      • Additional tools
        • Apple Health manual WAC index
        • Apple Health manual revision log
        • Program standards for income & resources
        • Apple Health manual WAC index
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        • Medicaid suspension
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        • Community-based training
        • Reference guides
        • Webinars, videos & presentations
        • Apple Health outreach toolkit
        • COFA outreach toolkit
        • Apple Health Medicare Connect
        • Hospital Presumptive Eligibility
        • Medicaid suspension
      Quick links
      • Apply for or renew Apple Health coverage
      • Apple Health for you
      • Apple Health account logins
      • Find forms & publications
      • Get help paying for prescriptions
      • Behavioral health facilities complaints
      • Ombuds services
      • General eligibility introduction
      • ​Program standard for income & resources
      • Voices of Apple Health
      • Voices of behavioral health & recovery
      MM - Footer
      • Contact Apple Health (Medicaid)
      • News
      • Apple Health Eligibility Manual
        • Apple Health eligibility manual overview
        • Introduction overview for general eligibility
        • General eligibility requirements that apply to all Apple Health programs
        • Classic (non-MAGI) based programs manual
        • Modified Adjusted Gross Income (MAGI) based programs manual
        • Long-term services & supports (LTSS) manual
        • Apple Health eligibility manual overview
        • Introduction overview for general eligibility
        • General eligibility requirements that apply to all Apple Health programs
        • Classic (non-MAGI) based programs manual
        • Modified Adjusted Gross Income (MAGI) based programs manual
        • Long-term services & supports (LTSS) manual
      • Additional tools
        • Apple Health manual WAC index
        • Apple Health manual revision log
        • Program standards for income & resources
        • Apple Health manual WAC index
        • Apple Health manual revision log
        • Program standards for income & resources
      • Stakeholder training & education
        • Training & education overview
        • Community-based training
        • Reference guides
        • Webinars, videos & presentations
        • Apple Health outreach toolkit
        • COFA outreach toolkit
        • Apple Health Medicare Connect
        • Hospital Presumptive Eligibility
        • Medicaid suspension
        • Training & education overview
        • Community-based training
        • Reference guides
        • Webinars, videos & presentations
        • Apple Health outreach toolkit
        • COFA outreach toolkit
        • Apple Health Medicare Connect
        • Hospital Presumptive Eligibility
        • Medicaid suspension
    • I need medical, dental, or vision care
      • Find Apple Health benefits & services
        • What are my basic covered services?
        • How do I get dental care?
        • Can I get vision care?
        • Other benefits & services
        • What are my basic covered services?
        • How do I get dental care?
        • Can I get vision care?
        • Other benefits & services
      • Other Apple Health programs
        • Noncitizens
        • Apple Health Expansion
        • Apple Health Medicare Connect
        • Apple Health for Workers with Disabilities (HWD)
        • Family Planning Only (FPO)
        • Medically Intensive Children's Program (MICP)
        • Medicare Savings Program
        • Veterans & family members
        • Noncitizens
        • Apple Health Expansion
        • Apple Health Medicare Connect
        • Apple Health for Workers with Disabilities (HWD)
        • Family Planning Only (FPO)
        • Medically Intensive Children's Program (MICP)
        • Medicare Savings Program
        • Veterans & family members
      • Am I eligible?
        • Eligibility overview
        • Individual adults
        • Parents & caretakers
        • Pregnant individuals
        • Children
        • Age 65 & older, or Medicare eligible
        • Aged, blind, or disabled
        • Long-term care & hospice
        • Foster care
        • Eligibility overview
        • Individual adults
        • Parents & caretakers
        • Pregnant individuals
        • Children
        • Age 65 & older, or Medicare eligible
        • Aged, blind, or disabled
        • Long-term care & hospice
        • Foster care
      • Learn about my coverage
        • Coverage with managed care
        • Coverage without managed care
        • American Indians & Alaska Natives
        • Coordination of benefits
        • Premium payment program
        • Patient review & coordination
        • Client rights
        • Coverage with managed care
        • Coverage without managed care
        • American Indians & Alaska Natives
        • Coordination of benefits
        • Premium payment program
        • Patient review & coordination
        • Client rights
      • Use my coverage
        • How do I use my coverage?
        • Enrollment next steps
        • Make my first appointment
        • Transportation services (nonemergency)
        • Apple Health client booklets
        • How do I use my coverage?
        • Enrollment next steps
        • Make my first appointment
        • Transportation services (nonemergency)
        • Apple Health client booklets
      • Manage my coverage
        • Update my income or address
        • Submit my verification
        • Log into my Apple Health accounts
        • Replace my services card
        • Change my health plan
        • Pay my Apple Health premium
        • Cancel my coverage
        • Update my income or address
        • Submit my verification
        • Log into my Apple Health accounts
        • Replace my services card
        • Change my health plan
        • Pay my Apple Health premium
        • Cancel my coverage
      Quick links
      • Apply for or renew Apple Health coverage
      • Apple Health for you
      • Apple Health account logins
      • Find forms & publications
      • Get help paying for prescriptions
      • Behavioral health facilities complaints
      • Ombuds services
      • General eligibility introduction
      • ​Program standard for income & resources
      • Voices of Apple Health
      • Voices of behavioral health & recovery
      MM - Footer
      • Contact Apple Health (Medicaid)
      • News
      • Find Apple Health benefits & services
        • What are my basic covered services?
        • How do I get dental care?
        • Can I get vision care?
        • Other benefits & services
        • What are my basic covered services?
        • How do I get dental care?
        • Can I get vision care?
        • Other benefits & services
      • Other Apple Health programs
        • Noncitizens
        • Apple Health Expansion
        • Apple Health Medicare Connect
        • Apple Health for Workers with Disabilities (HWD)
        • Family Planning Only (FPO)
        • Medically Intensive Children's Program (MICP)
        • Medicare Savings Program
        • Veterans & family members
        • Noncitizens
        • Apple Health Expansion
        • Apple Health Medicare Connect
        • Apple Health for Workers with Disabilities (HWD)
        • Family Planning Only (FPO)
        • Medically Intensive Children's Program (MICP)
        • Medicare Savings Program
        • Veterans & family members
      • Am I eligible?
        • Eligibility overview
        • Individual adults
        • Parents & caretakers
        • Pregnant individuals
        • Children
        • Age 65 & older, or Medicare eligible
        • Aged, blind, or disabled
        • Long-term care & hospice
        • Foster care
        • Eligibility overview
        • Individual adults
        • Parents & caretakers
        • Pregnant individuals
        • Children
        • Age 65 & older, or Medicare eligible
        • Aged, blind, or disabled
        • Long-term care & hospice
        • Foster care
      • Learn about my coverage
        • Coverage with managed care
        • Coverage without managed care
        • American Indians & Alaska Natives
        • Coordination of benefits
        • Premium payment program
        • Patient review & coordination
        • Client rights
        • Coverage with managed care
        • Coverage without managed care
        • American Indians & Alaska Natives
        • Coordination of benefits
        • Premium payment program
        • Patient review & coordination
        • Client rights
      • Use my coverage
        • How do I use my coverage?
        • Enrollment next steps
        • Make my first appointment
        • Transportation services (nonemergency)
        • Apple Health client booklets
        • How do I use my coverage?
        • Enrollment next steps
        • Make my first appointment
        • Transportation services (nonemergency)
        • Apple Health client booklets
      • Manage my coverage
        • Update my income or address
        • Submit my verification
        • Log into my Apple Health accounts
        • Replace my services card
        • Change my health plan
        • Pay my Apple Health premium
        • Cancel my coverage
        • Update my income or address
        • Submit my verification
        • Log into my Apple Health accounts
        • Replace my services card
        • Change my health plan
        • Pay my Apple Health premium
        • Cancel my coverage
    • I need behavioral health support
      • Mental health
        • Mental health crisis lines
        • Mental health services
        • Acute mental health care
        • Problem gambling
        • Mental health advance directives
        • Mental health crisis lines
        • Mental health services
        • Acute mental health care
        • Problem gambling
        • Mental health advance directives
      • Substance use
        • Substance use treatment
        • Alcohol use treatment
        • Opioid use treatment
        • Substance use treatment
        • Alcohol use treatment
        • Opioid use treatment
      • Prenatal, children & young adults
        • Behavioral health services for prenatal, children & young adults
        • Wraparound with Intensive Services (WISe)
        • Family initiated treatment (FIT)
        • Early signs of psychosis
        • Behavioral health services for prenatal, children & young adults
        • Wraparound with Intensive Services (WISe)
        • Family initiated treatment (FIT)
        • Early signs of psychosis
      • American Indians & Alaska Natives
        • Behavioral health services for American Indians & Alaska Natives (AI/AN)
        • Behavioral health services for American Indians & Alaska Natives (AI/AN)
      • Recovery support services
        • What is recovery support?
        • Peer support & counseling
        • Recovery housing
        • What is recovery support?
        • Peer support & counseling
        • Recovery housing
      • Prevention
        • Substance use disorder prevention & mental health promotion
        • Substance use disorder prevention & mental health promotion
      Quick links
      • Apply for or renew Apple Health coverage
      • Apple Health for you
      • Apple Health account logins
      • Find forms & publications
      • Get help paying for prescriptions
      • Behavioral health facilities complaints
      • Ombuds services
      • General eligibility introduction
      • ​Program standard for income & resources
      • Voices of Apple Health
      • Voices of behavioral health & recovery
      MM - Footer
      • Contact Apple Health (Medicaid)
      • News
      • Mental health
        • Mental health crisis lines
        • Mental health services
        • Acute mental health care
        • Problem gambling
        • Mental health advance directives
        • Mental health crisis lines
        • Mental health services
        • Acute mental health care
        • Problem gambling
        • Mental health advance directives
      • Substance use
        • Substance use treatment
        • Alcohol use treatment
        • Opioid use treatment
        • Substance use treatment
        • Alcohol use treatment
        • Opioid use treatment
      • Prenatal, children & young adults
        • Behavioral health services for prenatal, children & young adults
        • Wraparound with Intensive Services (WISe)
        • Family initiated treatment (FIT)
        • Early signs of psychosis
        • Behavioral health services for prenatal, children & young adults
        • Wraparound with Intensive Services (WISe)
        • Family initiated treatment (FIT)
        • Early signs of psychosis
      • American Indians & Alaska Natives
        • Behavioral health services for American Indians & Alaska Natives (AI/AN)
        • Behavioral health services for American Indians & Alaska Natives (AI/AN)
      • Recovery support services
        • What is recovery support?
        • Peer support & counseling
        • Recovery housing
        • What is recovery support?
        • Peer support & counseling
        • Recovery housing
      • Prevention
        • Substance use disorder prevention & mental health promotion
        • Substance use disorder prevention & mental health promotion
    • I help others apply for & access Apple Health
      • Apple Health Eligibility Manual
        • Apple Health eligibility manual overview
        • Introduction overview for general eligibility
        • General eligibility requirements that apply to all Apple Health programs
        • Classic (non-MAGI) based programs manual
        • Modified Adjusted Gross Income (MAGI) based programs manual
        • Long-term services & supports (LTSS) manual
        • Apple Health eligibility manual overview
        • Introduction overview for general eligibility
        • General eligibility requirements that apply to all Apple Health programs
        • Classic (non-MAGI) based programs manual
        • Modified Adjusted Gross Income (MAGI) based programs manual
        • Long-term services & supports (LTSS) manual
      • Additional tools
        • Apple Health manual WAC index
        • Apple Health manual revision log
        • Program standards for income & resources
        • Apple Health manual WAC index
        • Apple Health manual revision log
        • Program standards for income & resources
      • Stakeholder training & education
        • Training & education overview
        • Community-based training
        • Reference guides
        • Webinars, videos & presentations
        • Apple Health outreach toolkit
        • COFA outreach toolkit
        • Apple Health Medicare Connect
        • Hospital Presumptive Eligibility
        • Medicaid suspension
        • Training & education overview
        • Community-based training
        • Reference guides
        • Webinars, videos & presentations
        • Apple Health outreach toolkit
        • COFA outreach toolkit
        • Apple Health Medicare Connect
        • Hospital Presumptive Eligibility
        • Medicaid suspension
      Quick links
      • Apply for or renew Apple Health coverage
      • Apple Health for you
      • Apple Health account logins
      • Find forms & publications
      • Get help paying for prescriptions
      • Behavioral health facilities complaints
      • Ombuds services
      • General eligibility introduction
      • ​Program standard for income & resources
      • Voices of Apple Health
      • Voices of behavioral health & recovery
      MM - Footer
      • Contact Apple Health (Medicaid)
      • News
      • Apple Health Eligibility Manual
        • Apple Health eligibility manual overview
        • Introduction overview for general eligibility
        • General eligibility requirements that apply to all Apple Health programs
        • Classic (non-MAGI) based programs manual
        • Modified Adjusted Gross Income (MAGI) based programs manual
        • Long-term services & supports (LTSS) manual
        • Apple Health eligibility manual overview
        • Introduction overview for general eligibility
        • General eligibility requirements that apply to all Apple Health programs
        • Classic (non-MAGI) based programs manual
        • Modified Adjusted Gross Income (MAGI) based programs manual
        • Long-term services & supports (LTSS) manual
      • Additional tools
        • Apple Health manual WAC index
        • Apple Health manual revision log
        • Program standards for income & resources
        • Apple Health manual WAC index
        • Apple Health manual revision log
        • Program standards for income & resources
      • Stakeholder training & education
        • Training & education overview
        • Community-based training
        • Reference guides
        • Webinars, videos & presentations
        • Apple Health outreach toolkit
        • COFA outreach toolkit
        • Apple Health Medicare Connect
        • Hospital Presumptive Eligibility
        • Medicaid suspension
        • Training & education overview
        • Community-based training
        • Reference guides
        • Webinars, videos & presentations
        • Apple Health outreach toolkit
        • COFA outreach toolkit
        • Apple Health Medicare Connect
        • Hospital Presumptive Eligibility
        • Medicaid suspension
  • Employee & retiree benefits
    • Public employees
      • Find benefits
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      • Manage benefits
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        • Change my coverage
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      • Get help
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        • PEBB wellness programs
        • Medicare & PEBB benefits while employed
        • Medical plans & benefits
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        • Vision plans & benefits
        • Benefits while traveling
        • Find a PEBB plan provider
        • Life, home, auto, AD&D, LTD, FSA, & DCAP benefits
        • PEBB wellness programs
        • Medicare & PEBB benefits while employed
      • Explore costs
        • Medical plan premiums
        • Life insurance premiums
        • Long-term disability insurance premiums
        • Surcharges
        • Paying for benefits
        • Medical plan premiums
        • Life insurance premiums
        • Long-term disability insurance premiums
        • Surcharges
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        • Am I eligible?
        • Are my dependents eligible?
        • Are my survivors eligible?
      • Learn how to enroll
        • For newly eligible employees
        • Verify & enroll my dependents
        • Waive my medical coverage
        • For newly eligible employees
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      • Manage benefits
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      • Explore costs
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        • Enroll as a survivor
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        • Enroll as a survivor
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      • Manage benefits
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      • Explore costs
        • Medical, dental & vision plan premiums
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        • Am I eligible?
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      • Learn how to enroll
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        • Verify & enroll my dependents
      • For survivors
        • Enroll as a survivor
        • Defer as a survivor
        • How do I notify SEBB that my loved one has passed away?
        • Enroll as a survivor
        • Defer as a survivor
        • How do I notify SEBB that my loved one has passed away?
      • Manage benefits
        • What is special open enrollment?
        • Change my coverage
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        • What is special open enrollment?
        • Change my coverage
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      • Get help
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      Quick links
      • Benefits 24/7
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      • Contact us
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      • Find benefits
        • Medical plans & benefits
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        • Medical plans & benefits
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        • Vision plans & benefits
        • Benefits while traveling
        • Find a SEBB plan provider
        • Life & FSA benefits
        • SEBB wellness programs
      • Explore costs
        • Medical, dental & vision plan premiums
        • Life insurance premiums
        • Surcharges
        • Paying for benefits
        • Medical, dental & vision plan premiums
        • Life insurance premiums
        • Surcharges
        • Paying for benefits
      • Determine eligibility
        • Am I eligible?
        • Are my dependents eligible?
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        • Am I eligible?
        • Are my dependents eligible?
        • Are my survivors eligible?
      • Learn how to enroll
        • For newly eligible members
        • Verify & enroll my dependents
        • For newly eligible members
        • Verify & enroll my dependents
      • For survivors
        • Enroll as a survivor
        • Defer as a survivor
        • How do I notify SEBB that my loved one has passed away?
        • Enroll as a survivor
        • Defer as a survivor
        • How do I notify SEBB that my loved one has passed away?
      • Manage benefits
        • What is special open enrollment?
        • Change my coverage
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        • Cancel my coverage
        • What is special open enrollment?
        • Change my coverage
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      • Get help
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  • Billers, providers & partners
    • Prior authorization, claims & billing
      • Getting started
        • For new providers
        • Overview of prior authorization (PA), claims & billing
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      • Submit prior authorization (PA)
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      Quick links
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      • Submit prior authorization (PA)
        • Step-by-step guide for prior authorization (PA)
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      • Programs: A-E
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        • Applied Behavior Analysis therapy
        • Child & youth behavioral health services
        • Community behavioral support services
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        • Designated crisis responders
        • Doulas
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      • Programs: F-H
        • Family Planning Only
        • First Steps (maternity support & infant care)
        • Foster care & adoption support
        • Foundational Community Supports
        • Global leasing
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        • Health Home
        • Home health care services: electronic visit verification
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        • First Steps (maternity support & infant care)
        • Foster care & adoption support
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        • Global leasing
        • Ground emergency medical transportation
        • Health Home
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      • Programs: I-N
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        • Medicaid Administrative Claiming
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      • Programs: O-P
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      • Programs: Q-Z
        • Resources for behavioral health providers
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        • Washington Integrated Care Assessment
        • Resources for behavioral health providers
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        • Suicide prevention resources
        • Transhealth program
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        • Washington Integrated Care Assessment
      Quick links
      • Log into ProviderOne
      • Find billing guides & fee schedules
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      • Contact us
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      • Getting started
        • Program benefit packages & scope of services
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        • Program benefit packages & scope of services
        • Patient review & coordination
      • Programs: A-E
        • 340B Drug Pricing Program
        • 90- & 180-day civil commitment beds
        • Applied Behavior Analysis therapy
        • Child & youth behavioral health services
        • Community behavioral support services
        • Dental services
        • Designated crisis responders
        • Doulas
        • Early Periodic Screening, Diagnosis & Treatment
        • 340B Drug Pricing Program
        • 90- & 180-day civil commitment beds
        • Applied Behavior Analysis therapy
        • Child & youth behavioral health services
        • Community behavioral support services
        • Dental services
        • Designated crisis responders
        • Doulas
        • Early Periodic Screening, Diagnosis & Treatment
      • Programs: F-H
        • Family Planning Only
        • First Steps (maternity support & infant care)
        • Foster care & adoption support
        • Foundational Community Supports
        • Global leasing
        • Ground emergency medical transportation
        • Health Home
        • Home health care services: electronic visit verification
        • Family Planning Only
        • First Steps (maternity support & infant care)
        • Foster care & adoption support
        • Foundational Community Supports
        • Global leasing
        • Ground emergency medical transportation
        • Health Home
        • Home health care services: electronic visit verification
      • Programs: I-N
        • Immunization services
        • Indian health programs
        • Intensive behavioral health treatment facilities
        • Intensive residential treatment teams
        • Interpreter services
        • Kidney Disease Program
        • Managed care
        • Medicaid Administrative Claiming
        • Medical equipment and supplies
        • Mobile Crisis Response Endorsement Program
        • Immunization services
        • Indian health programs
        • Intensive behavioral health treatment facilities
        • Intensive residential treatment teams
        • Interpreter services
        • Kidney Disease Program
        • Managed care
        • Medicaid Administrative Claiming
        • Medical equipment and supplies
        • Mobile Crisis Response Endorsement Program
      • Programs: O-P
        • Partnership Access Lines
        • Peer support
        • Pharmacy services
        • Preadmission screening & resident review
        • Prescription drug discount card
        • Primary Care Practice Recognition
        • Program of Assertive Community Treatment
        • Partnership Access Lines
        • Peer support
        • Pharmacy services
        • Preadmission screening & resident review
        • Prescription drug discount card
        • Primary Care Practice Recognition
        • Program of Assertive Community Treatment
      • Programs: Q-Z
        • Resources for behavioral health providers
        • School-based services
        • Substance use disorder
        • Suicide prevention resources
        • Transhealth program
        • Transportation services (nonemergency)
        • Washington Integrated Care Assessment
        • Resources for behavioral health providers
        • School-based services
        • Substance use disorder
        • Suicide prevention resources
        • Transhealth program
        • Transportation services (nonemergency)
        • Washington Integrated Care Assessment
    • Become an Apple Health provider
      • Learn how to enroll
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        • Enroll as a billing provider
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        • Enroll as a nonbilling provider
        • Enroll as a billing agent or clearinghouse
      • What's next
        • Track my application
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      Quick links
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      • Contact us
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      • Learn how to enroll
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        • Enroll as a billing provider
        • Enroll as a health care professional practicing under a group or facility
        • Enroll as a nonbilling provider
        • Enroll as a billing agent or clearinghouse
        • Enrollment overview
        • Eligible provider types & requirements
        • Become a behavioral health provider
        • Become a Community Behavioral Health Support (CBHS) provider
        • Enroll as a billing provider
        • Enroll as a health care professional practicing under a group or facility
        • Enroll as a nonbilling provider
        • Enroll as a billing agent or clearinghouse
      • What's next
        • Track my application
        • Find next steps for new Medicaid providers
        • Track my application
        • Find next steps for new Medicaid providers
      • For existing medicaid providers
        • Update my provider information
        • Revalidation
        • Update my provider information
        • Revalidation
    • Learn ProviderOne
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      Quick links
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      • Contact us
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        • How do I access ProviderOne?
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    • Prior authorization, claims & billing
      • Getting started
        • For new providers
        • Overview of prior authorization (PA), claims & billing
        • Document submission cover sheets
        • HIPAA Electronic Data Interchange (EDI)
        • Audit & program integrity
        • For new providers
        • Overview of prior authorization (PA), claims & billing
        • Document submission cover sheets
        • HIPAA Electronic Data Interchange (EDI)
        • Audit & program integrity
      • Submit prior authorization (PA)
        • Step-by-step guide for prior authorization (PA)
        • Pharmacy prior authorization
        • Step-by-step guide for prior authorization (PA)
        • Pharmacy prior authorization
      • Submit claims
        • Provider billing guides & fee schedules
        • Hospital rates & reimbursement
        • Provider billing guides & fee schedules
        • Hospital rates & reimbursement
      Quick links
      • Log into ProviderOne
      • Find billing guides & fee schedules
      • Find forms & publications
      • Sign up for Provider Alerts
      • ProviderOne Billing & Resource Guide
      • ProviderOne Discovery Log
      • ProviderOne maintenance
      • Termination & exclusion list
      MM - Footer
      • Contact us
      • News
      • Getting started
        • For new providers
        • Overview of prior authorization (PA), claims & billing
        • Document submission cover sheets
        • HIPAA Electronic Data Interchange (EDI)
        • Audit & program integrity
        • For new providers
        • Overview of prior authorization (PA), claims & billing
        • Document submission cover sheets
        • HIPAA Electronic Data Interchange (EDI)
        • Audit & program integrity
      • Submit prior authorization (PA)
        • Step-by-step guide for prior authorization (PA)
        • Pharmacy prior authorization
        • Step-by-step guide for prior authorization (PA)
        • Pharmacy prior authorization
      • Submit claims
        • Provider billing guides & fee schedules
        • Hospital rates & reimbursement
        • Provider billing guides & fee schedules
        • Hospital rates & reimbursement
    • Program information for providers
      • Getting started
        • Program benefit packages & scope of services
        • Patient review & coordination
        • Program benefit packages & scope of services
        • Patient review & coordination
      • Programs: A-E
        • 340B Drug Pricing Program
        • 90- & 180-day civil commitment beds
        • Applied Behavior Analysis therapy
        • Child & youth behavioral health services
        • Community behavioral support services
        • Dental services
        • Designated crisis responders
        • Doulas
        • Early Periodic Screening, Diagnosis & Treatment
        • 340B Drug Pricing Program
        • 90- & 180-day civil commitment beds
        • Applied Behavior Analysis therapy
        • Child & youth behavioral health services
        • Community behavioral support services
        • Dental services
        • Designated crisis responders
        • Doulas
        • Early Periodic Screening, Diagnosis & Treatment
      • Programs: F-H
        • Family Planning Only
        • First Steps (maternity support & infant care)
        • Foster care & adoption support
        • Foundational Community Supports
        • Global leasing
        • Ground emergency medical transportation
        • Health Home
        • Home health care services: electronic visit verification
        • Family Planning Only
        • First Steps (maternity support & infant care)
        • Foster care & adoption support
        • Foundational Community Supports
        • Global leasing
        • Ground emergency medical transportation
        • Health Home
        • Home health care services: electronic visit verification
      • Programs: I-N
        • Immunization services
        • Indian health programs
        • Intensive behavioral health treatment facilities
        • Intensive residential treatment teams
        • Interpreter services
        • Kidney Disease Program
        • Managed care
        • Medicaid Administrative Claiming
        • Medical equipment and supplies
        • Mobile Crisis Response Endorsement Program
        • Immunization services
        • Indian health programs
        • Intensive behavioral health treatment facilities
        • Intensive residential treatment teams
        • Interpreter services
        • Kidney Disease Program
        • Managed care
        • Medicaid Administrative Claiming
        • Medical equipment and supplies
        • Mobile Crisis Response Endorsement Program
      • Programs: O-P
        • Partnership Access Lines
        • Peer support
        • Pharmacy services
        • Preadmission screening & resident review
        • Prescription drug discount card
        • Primary Care Practice Recognition
        • Program of Assertive Community Treatment
        • Partnership Access Lines
        • Peer support
        • Pharmacy services
        • Preadmission screening & resident review
        • Prescription drug discount card
        • Primary Care Practice Recognition
        • Program of Assertive Community Treatment
      • Programs: Q-Z
        • Resources for behavioral health providers
        • School-based services
        • Substance use disorder
        • Suicide prevention resources
        • Transhealth program
        • Transportation services (nonemergency)
        • Washington Integrated Care Assessment
        • Resources for behavioral health providers
        • School-based services
        • Substance use disorder
        • Suicide prevention resources
        • Transhealth program
        • Transportation services (nonemergency)
        • Washington Integrated Care Assessment
      Quick links
      • Log into ProviderOne
      • Find billing guides & fee schedules
      • Find forms & publications
      • Sign up for Provider Alerts
      • ProviderOne Billing & Resource Guide
      • ProviderOne Discovery Log
      • ProviderOne maintenance
      • Termination & exclusion list
      MM - Footer
      • Contact us
      • News
      • Getting started
        • Program benefit packages & scope of services
        • Patient review & coordination
        • Program benefit packages & scope of services
        • Patient review & coordination
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  1. Home
  2. PEBB benefits administrators
  3. PEBB participating employer groups
  4. Loss of eligibility or retirement
  5. Retiring & PEBB Retiree Insurance

We’re stabilizing Benefits 24/7

See the updates on Benefits 24/7 stabilization efforts.

Retiring and PEBB Retiree Insurance

Information for employers with employees who are seeking insurance coverage in retirement.

On this page

  • Employer process
  • Who determines eligibility for retirement and PEBB retiree insurance?
  • Procedural requirements
  • Retiree life insurance options

PEBB retiree coverage is available to employees who meet procedural and substantive eligibility requirements described in WAC 182-12-171. Coverage is also available to:

  • Elected and full-time appointed officials of the legislative and executive branches of state government who voluntarily or involuntarily leave public office and meet the procedural requirements.
  • The surviving spouse, state-registered domestic partner, or dependent children of a deceased eligible employee or retiree.
  • The surviving spouse, state-registered domestic partner, or dependent children of an emergency service employee killed in the line of duty.
  • When enrolling in retiree coverage, an employee may change the medical plan they had while employed. If eligible dependents are enrolling, they must be covered under the same medical, dental and vision plan as the retiree with the exceptions specified for Medicare Supplement Plan F.

To enroll or defer retiree coverage, PEBB must receive the Retiree Enrollment form (form A) no later than 60 days after the employer-paid coverage, COBRA coverage, or continuation of coverage ends.

Retirees may choose to enroll in:

  • Medical, or
  • Medical and/or dental, and/or vision, and/or
  • Retiree term life insurance (if eligible)

Retirees and permanently disabled employees of employer groups who discontinue participation with PEBB may be eligible for PEBB Extension of Coverage on a self-pay basis for up to 18 months.

Employer process

Complete the appropriate C-series worksheet and provide the PEBB Retiree Health Insurance Checklist to employees who are:

  • Leaving employment due to retirement who may be eligible for PEBB retiree insurance coverage.
  • Retirees who returned to work and are retiring again.
  • Applying for disability retirement who may be eligible for PEBB retiree insurance coverage.

The worksheets are located on the Eligibility worksheets page for state agencies and institutions of higher education or the Notification requirements page for employer groups.

Who determines eligibility for retirement and PEBB retiree insurance?

Eligibility for retirement is determined by the Department of Retirement Systems (DRS) and eligibility for PEBB retiree insurance is determined by the PEBB program.

Eligibility for PEBB retiree insurance

The PEBB Program determines eligibility based on when an application is received and PEBB rules.

In general, employees must be eligible to retire under a Washington State-sponsored retirement plan when the employee’s employer-paid coverage or COBRA coverage ends.

  • DRS plan 1 and 2 members (see exception below) must immediately receive a monthly retirement plan payment or lump sum payment as allowed by the plan.
  • DRS PERS, TRS, and SERS plan 2 members who are retiring or separating from employment on or after January 1, 2024, and are at least age 55 with at least 20 years of service are not required to immediately receive a retirement plan payment.
  • DRS Plan 3 members are not required to receive a retirement plan or lump sum payment but must be at least age 55 and have at least 10 years of service under Plan 3.
  • Employees who are members of a Washington higher education retirement plan (i.e., TIAA-CREF) are eligible if they immediately begin to receive a monthly retirement plan payment, meet their plan’s retirement eligibility criteria, or are at least age 55 with 10 years of service.
  • Employees not retiring under a Washington State-sponsored retirement plan must meet the same age and years of service had the person been a member of either PERS Plan 1 or 2 for the same period of employment.

Employers should direct employees to contact the PEBB Program and DRS directly.

The PEBB Program

  • Phone: 1-800-200-1004 (this number is for retiree, COBRA and Unpaid Leave subscribers only.).
  • PEBB Retirees website
  • Send a secure message: HCA Support

Department of Retirement Systems (DRS) (if applicable)

  • Phone: 1-800-547-6657
  • DRS website

Procedural requirements

Procedural requirements include:

  • The employee must submit the Retiree Enrollment form (form A) to enroll or defer. The PEBB program must receive the form no later than 60 days after the employer-paid coverage, COBRA coverage, or continuation of coverage ends.
  • Employees not entitled to Medicare Part A and Part B, and wanting to enroll dependents, must provide verification documents.
  • If eligible, the subscriber and/or dependents must enroll and maintain enrollment in both Medicare Part A and Part B to qualify for PEBB retiree coverage.
  • PEBB will not enroll subscribers until it receives the first premium payment unless they choose to have their premiums deducted from their monthly pension check.

Retiree life insurance options

PEBB provides life insurance through the Metropolitan Life Insurance Company (MetLife). PEBB retirees may be eligible to purchase the following life insurance options:

  • Portability provision
  • Conversion of life insurance provision
  • Retiree term life insurance

Portability provision

Employees may apply to continue their PEBB employee basic life and optional life insurance until age 100 if certain conditions are met.

Coverage may be decreased but cannot be increased.

The minimum an employee can continue under the portability provision is $5,000. The approved amount will not exceed $2,000,000.

Dependent basic life and any spouse or state-registered domestic partner optional life insurance can be continued, but only if the employee continues their life insurance.

Conversion of life insurance provision

Retiring employees and their dependents may be entitled to convert their life insurance to an individual policy without evidence of insurability (proof of good health).

The amount of the individual policy will be equal to (or at the employee's option, less than) the amount of coverage as of the termination date of the policy being converted.

MetLife will send information and an application to employees eligible for portability or conversion due to termination or other reasons. Employees can contact MetLife directly at 1-877-275-6387 with any questions about the portability and/or conversion provisions.

Retiree term life insurance

This insurance is only available to those who meet the PEBB Program’s retiree eligibility requirements and had life insurance through the PEBB Program as an employee.

Enrolling requires PEBB receive the Retiree Enrollment form (form A) no later than 60 days after the employer-paid coverage ends.

Dependents are not eligible for retiree term life insurance.

Retiree term life coverage is not available to those who:

  • Enroll in COBRA
  • Have a break in life insurance coverage

For more information concerning retiree life insurance options with MetLife please refer to the Certificates of Coverage (COC) for Washington and non-Washington residents.

Related rules and policies
  • WAC 182-12-171: When is a retiring employee or a retiring school employee eligible to enroll in PEBB retiree insurance coverage?
  • WAC 182-12-146: When is an enrollee eligible to continue PEBB benefits under COBRA?
  • WAC 182-12-200: May a retiring employee, a retiring school employee, or a retiree enrolled as a dependent in a health plan sponsored by PEBB, a Washington state educational service district, or SEBB defer enrollment under PEBB retiree insurance coverage?
  • WAC 182-12-205: May a retiree or a survivor defer enrollment or voluntarily terminate enrollment under PEBB retiree insurance coverage?

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  • Free or low-cost health care
    • I need medical, dental, or vision care
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    • I help others apply for & access Apple Health
      • Apple Health Eligibility Manual
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  • Employee & retiree benefits
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    • Contact us
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  • Billers, providers & partners
    • Prior authorization, claims & billing
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    • Become an Apple Health provider
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      • What's next
        • Track my application
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