Washington State Health Care Authority Forms

The Washington State Health Care Authority is responsible for managing and administering the state's healthcare programs. They ensure that eligible residents have access to affordable and high-quality medical, dental, and behavioral health services. The authority administers various healthcare programs, including Medicaid, Apple Health for Kids, and other state-funded health coverage options for low-income individuals and families. They also work to implement healthcare reforms, promote health equity, and improve the overall health and well-being of Washington residents.

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Documents:

351

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This form is used for recording information about teeth on a dental chart in Washington. It helps to track dental health and treatment.

This Form is used for submitting a fax or written request for basic information in the state of Washington. It is known as Form HCA13-756.

This Form is used for requesting Xolair (Omalizumab) J2357 in the state of Washington.

This form is used for requesting the medication Cimzia (Certolizumab Pegol. Inj.) under the J0717 code in Washington.

This form is used for requesting Stelara (Ustekinumab Injection) J3357 in the state of Washington.

This document is used for submitting Pa Pend forms in the state of Washington. It serves as a cover sheet for the submission process.

This document is used for submitting supporting documents for pharmacy prior authorization in Washington state. It serves as a cover sheet to facilitate the submission process.

This document is used for submitting claim attachments in the state of Washington. It serves as a cover sheet for attaching supporting documents to insurance claims.

This form is used for applying for health care coverage for pregnant teens under the age of 19 in Washington state.

This form is used for applying for family planning only services in the state of Washington.

This Form is used for requesting an administrative hearing in Washington state.

This form is used for requesting an administrative hearing in Washington state. It is available in the Amharic language.

This form is used for requesting an administrative hearing in Washington state. It is available in Punjabi language.

This document is used for requesting an administrative hearing in Washington State in Korean language.

This document is a request form for an administrative hearing in Washington State. It is primarily used by individuals who are seeking to contest or challenge a decision made by a government agency or department. The form is available in Lao language to accommodate Lao-speaking individuals.

This document is used to request an administrative hearing in Washington for Russian-speaking individuals.

This type of document is used for requesting an administrative hearing in Washington state.

This Form is used for requesting an administrative hearing in the state of Washington.

This form is used for filing a request for an administrative hearing in Washington State. It is specifically designed for individuals who prefer to have the form translated into Lao.

This form is used to request an administrative hearing in Washington, but it is available in Korean language.

This type of document is a Form HCA12-511 used to request an administrative hearing in Washington state. It is written in Spanish.

This form is used for requesting an administrative hearing in Washington. It is available in Tagalog language.

This form is used for withdrawing a request for an administrative hearing in Washington state.

This form is used for requesting the cancellation of an administrative hearing in Washington.

This form is used for withdrawing an administrative hearing request in Washington for Marshallese residents.

This Form is used for applying for Washington Apple Health for elderly, blind, disabled individuals/Long-term services and supports in Washington.

This form is used for applying for health care coverage in Washington state for individuals who speak Lao.

This form is used for non-citizens in Washington to apply for family planning services.

This document is an application form for pregnant teenagers under the age of 19 to apply for health care coverage in Washington state. It is available in the Burmese language.

This type of document is a medical coverage application form specifically for pregnant teenage girls under the age of 19 in Washington state.

This Form is used for applying for Tailored Supports for Older Adults (TSOA) in Washington state.

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