Business Details
34 Years
experience
Washington State Healthcare Coverage Experts
Community Health Plan of Washington (CHPW) was founded in 1992 by Washington's community health centers. We are a locally rooted organization committed to providing comprehensive healthcare solutions tailored to the needs of Washington residents. Our mission is to serve as a trusted partner in health, offering accessible and equitable care through Medicaid (Apple Health), Medicare Advantage, and dual eligible plans. With over three decades of experience, we prioritize community engagement, preventive care, and innovative health management programs. Our team of healthcare professionals and administrators brings extensive expertise in public health, behavioral care, and chronic disease management. We maintain authoritativeness through rigorous quality standards, partnerships with 21 community health centers, and a focus on culturally competent services.Transparency in eligibility processes, multilingual support, and member-centric policies underscore our commitment to trustworthiness. Our services span telehealth, dental care coordination, alternative treatments, and specialized programs for maternal-child wellness. By integrating clinical care with social services, we address holistic health needs while ensuring compliance with state and federal regulations. Our emergency response infrastructure, including 24/7 nurse advice lines, demonstrates our readiness to serve critical healthcare demands across diverse populations.
Services
Apple Health Plans
Medicare Advantage
Member Rewards Program
Virtual Care Visits
Behavioral Health Services
Dental Coverage Coordination
Chronic Disease Management
Maternal-Child Health Programs
Alternative Treatments
Care Coordination
Details
- Year established: 1992
Highlights and features
- We offer 24/7 nurse advice line with free medical guidance
- Our members receive zero-cost preventive care programs
- Multi-language support available for all services
- Specialized care coordination for chronic conditions
- Community-focused network with 190+ clinic locations
Services
Apple Health Plans
Washington State Medicaid plans with zero-cost coverage for eligible residents. Includes preventive care, prescription drugs, behavioral health services, and specialized medical treatments. Designed for individuals and families meeting income requirements through state-federal partnership.
Medicare Advantage
Comprehensive Medicare plans for seniors and qualifying individuals. Combines hospital, medical, and prescription coverage with additional benefits like dental and vision. Offers coordinated care through network providers across Washington State.
Member Rewards Program
Preventive care incentive system for Apple Health members. Provides gift cards for completing wellness visits, screenings, and maternity care. Encourages regular healthcare engagement through tangible health rewards.
Virtual Care Visits
24/7 remote medical consultations via phone or video. Connects members with licensed healthcare providers for non-emergency conditions. Enhances accessibility for rural residents and urgent care needs after office hours.
Care Coordination
Personalized health planning for members with complex needs. Focuses on chronic disease management, medication synchronization, and behavioral health integration. Uses interdisciplinary teams to ensure comprehensive treatment continuity.
Questions
What are CHPW's eligibility requirements for Apple Health plans?
Eligibility follows Washington State Medicaid standards based on income, household size, and residency. Income limits adjust annually, with additional criteria for seniors and disabled individuals.
Does CHPW offer dental coverage?
Provides coordination for accidental dental injuries and access to discounted dental services through DentistLink network for Apple Health members.
What behavioral health services are available?
Offers depression screening programs, substance use disorder support, and mental health counseling through network providers across Washington State.
How does the MemberFirst Rewards program work?
Members earn gift cards for completing preventive screenings, postpartum visits, and well-child checkups by submitting required documentation for verification.
What telehealth options exist for urgent care needs?
CHPW Virtual Care provides 24/7 access to medical consultations via phone or video chat for non-emergency conditions requiring immediate attention.
Are alternative treatments covered?
Apple Health members receive up to 20 annual visits for acupuncture, chiropractic care, and therapeutic massage through licensed Washington State providers.
Videos
Reviews (6)
Halibut FightingHalibut
Jun 20, 2022
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NOT LGBT friendly. They cover some gender affirming care they're legally obligated to, but if there's any wiggle room for them they will absolutely refuse to cover medication and treatment for transgender women and men.
Matt Lynch
May 18, 2022
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CHPW repeatedly denies legitimate claims, it took me 3 calls and literally months to initiate the appeals to get my appointments paid for. Their network of providers is small and apparently hate them because even though a provider is in network and contracted they will refuse to let you make an appointment. I am on month 3 trying to make an appointment with a dermatologist in their network. CHPW says they will sort it out, then they don't. 5 calls to them and 4 separate representatives including the supervisor, each time they promise to sort it out.
They never do. After describing the many issues with WA health exchange they are opening up enrollment for me to switch insurance. I have spent 10-15 hours on the phone with CHPW dealing with problems and empty promises to address them. What do your premiums pay for at this company? It certainly doesn't pay for your health expenses. It pays for their employees to create dysfunction for their customers and providers. CHPW is the worst health insurance I ever had.
They never do. After describing the many issues with WA health exchange they are opening up enrollment for me to switch insurance. I have spent 10-15 hours on the phone with CHPW dealing with problems and empty promises to address them. What do your premiums pay for at this company? It certainly doesn't pay for your health expenses. It pays for their employees to create dysfunction for their customers and providers. CHPW is the worst health insurance I ever had.
Margaret Cohen
Mar 06, 2021
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I don't understand how this health plan can have such low reviews. I'm so glad I chose CHPW. The representatives are always helpful, especially Debbie! She went above and beyond! Thank you for caring for your customers :
Ammar Almaliki
Feb 16, 2021
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Can anyone save me from this company? Several diseases are deprived of sleep, afflicted with diabetes, blood pressure, intolerable pain, and other diseases. And fake sanitary cover. Wait for my death. It is not always acceptable. All because of this company. It is my destiny to live with the pain and disease of cancer with Community Health Care
Lisa S.
Jul 18, 2019
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Having just watched CBS news regarding United Healthcare. I am so grateful and proud to have been a part of this team previously. Mental health is a huge priority for CHPW as is community support. I know intimately how hard CHPW makes this a priority.
B. Shute
Apr 17, 2018
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As a healthcare provider and in my honest opinion I cannot recommend the Community Health Plan of Washington. Despite our good faith efforts and the quality care provided to their subscribers (our patients), they deny claims seemingly without merit. The result is that subscribers think that they have coverage and they do not. I have found the Quality Department and their Provider Services departments to be fruitless and a waste of time. Bottom line, patients received quality care from us and CHPW didn't pay us for the bona fide services we provided. Regretfully, we refuse to deal with them at all now.
