Special free services for our members - Medicaid - Amerigroup
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Medicaid Special free services for our members
Educational and Pregnancy support
advocacy support Taking Care of Baby and Me®
Free GED testing program
For members 17 years of age and This program provides educational tools and
older, Amerigroup Washington, support during pregnancy and throughout
Inc. pays the four required the postpartum period. Additionally, the
modules of GED testing once per program offers incentives to pregnant
member lifetime. This benefit is members for attending healthy activities such
accessed through coordination as prenatal and postpartum visits.
with local community colleges. Amerigroup
works with the school to verify eligibility and My Advocate®
arrange payment. To help members learn This component of our pregnancy support provides
more, advise them to contact Member Services health education by phone, smartphone app, or web.
at 800-600-4441. Pregnant women who choose the phone program will
get to know Mary Beth, My Advocate’s automated
National disability advocacy personality. Members can complete an initial health
screening related to their pregnancy and then receive
organizations prenatal educational messages related to each stage of
Members with disabilities may enroll in an
pregnancy. Once the member delivers, education shifts
annual membership to one of four national
to postpartum and well-baby content. When members
disability advocacy organizations:
tell Mary Beth they have a problem, a prompt callback
■ Autistic Self Advocacy Network
is initiated by one of our case managers.
■ American Association of People
with Disabilities
■ National Council on Independent Living Prenatal ultrasounds
■ TASH We cover two routine prenatal
ultrasounds for fetal anatomic survey
per pregnancy (CPT® codes 76801 and
76805); no authorization is required.
Additional ultrasounds for CPT codes 76811, 76812,
76815, 76816, and 76817 for suspected maternal/
fetal abnormality or follow-up require an appropriate
diagnosis indicating medical necessity to be
reimbursed. Authorization is not required. These limits
do not apply to hospitals, maternal fetal medicine,
or radiology providers. Review our policy on prenatal
ultrasounds using our Quick Tools menu to access
medical coverage policies on our provider self-service
website at https://provider.amerigroup.com/WA.
Electric breast pumps
Moms may receive one electric breast pump per
pregnancy without need for prior authorization.
Providers simply submit the request form to our sole
source provider, Medline, denoting the member’s
choice pumpsfrom Medela, Ameda, Evenflo, Medline,
or Lansinoh brands.
Maternal meal program Allowable sick visits are limited to the following:
Members can receive customized meals to take the ■ A minor (for example, 10 minutes) new patient
stress off mom. Qualifying members can receive E&M visit
up to two meals per day for 14 days (28 meals per ■ A minor established patient E&M visit
member total). Various meal options are available ■ A minimal (for example, five minutes)
and include low-sodium, low-fat, diabetic-friendly, established patient E&M visit
gluten-free, renal-friendly, and pureed meals. When modifier 25 is not billed appropriately, the
sick visit is denied. Appropriate diagnosis codes
Maternal health support must also be billed for every visit. Same-day
Pregnant members and moms can choose wellness visits are not applicable to the After Hours
two of the following items to support with Care program; after-hours care is for sick visits only.
maternal health: Diapers, breastfeeding support
kit, breastfeeding pillow, microwave sterilizer, Boys & Girls Club free membership
microwave steam bags, baby car seat, preemie car This service is available in each of the state
seat, portable crib, highchair, safe sleep kit, baby locations for members ages 6 to 18.
monitor-video, and baby proof items (for example,
plug protectors, doorknob covers, cabinet and
drawer latches). Memberships for WA State 4-H
This benefit is available for members ages 5 to 18
to support with youth development statewide.
Just for kids
Newborn circumcisions YMCA membership
Members who qualify for the Y scholarship at
We pay for newborn circumcisions up to $150 for
Wenatchee and Cowlitz County up to 19 years old
members. Use CPT codes 54150, 54160, or 54161.
are eligible for this benefit.
Sports physicals Healthy Families program
We pay in-network primary care
We give families with children
providers for performing sports
ages 7 to 13 coaching and support
physicals once per year for our
on nutrition and physical activity.
members ages 7 to 18. Use current
CPT code 99212 with DX Z02.5 when
you bill. You can bill for both a wellness visit and Calm app
a sports physical on the same day by including This is an annual membership for members
modifier 25. up to 18 years old. The Calm app provides age
appropriate meditations and sleep aids to help
calm the mind and body.
Same-day well-child and sick visits
We pay for sick visits and complete
preventive well-child assessment TutorMe-online tutorial
visits on the same day. Use TutorMe is an online platform used to improve
evaluation and management student engagement and success by providing
(E&M) CPT codes for the level of easy access to detailed information on student’s
complexity combined with the age. Bill with the progress, hours spent, tutoring, and subject
age-appropriate Early and Periodic Screening, analytics. The maximum allowance is 24 hours
Diagnostic, and Treatment (EPSDT) service codes per member, per year. This benefit is available for
(99381-99385 and 99392-99395) using one of the members 8 to 17 years of age and at risk of failing
appropriate sick visit E&M codes with modifier 25. a grade or individual subject, or in the juvenile
justice system.
Adults — filling the gaps Transportation services
Members receive a nonmedical
Eyeglasses transportation benefit to help
Members ages 21 to 64 are covered them access services including
for one pair, once a year, up to $100. transportation to school, work,
This service is available through EyeQuest, our job interviews, transporting kids to daycare and
eye care vendor. other services.
Members should call the National Call Center, verify
Acupuncture mailing address and report the service they are
Amerigroup pays for seven acupuncture visits per
trying to access. An Orca card or gas card will be
calendar year, per member ages 18 years and older,
mailed to the member (18 years or older).
with contracted providers. Providers must use the
following codes:
■ 97810: Acupuncture, one or more needles,
One-time only benefit
without electrical stimulation, initial 15 minutes Members will receive one of the following:
■ $50 choice Uber/Lyft Card — once per year
of personal one-on-one contact with the patient;
■ $50 Gas card — once per year
Amerigroup fixed price of $30
■ $50 King County Orca Card
■ 97811: Each additional 15 minutes of personal
one-on-one contact with the patient, with
reinsertion of needles; Amerigroup fixed price of Tobacco cessation
$30 All members ages 18 years and
■ 97813: Acupuncture, one or more needles, older may enroll in Quit for Life, the
with electrical stimulation, initial 15 minutes of state’s tobacco cessation program.
personal one-on-one contact with the patient; Members enroll by phone at
Amerigroup fixed price of $50 866-QUIT-4-LIFE (866-784-8454) or
■ 97814: Each additional 15 minutes of personal online (https://quitnow.net). Amerigroup provides
one-on-one contact with the patient, with additional resource information and local tobacco
reinsertion of needles; Amerigroup fixed price of cessation program promotion via collaborative
$50 partnerships.
Effective January 1, 2022, Amerigroup covers the
Costco membership cost of the EX by Truth Initiative Program, a digital
Members can receive a one-year Costco Gold Star quit-tobacco program, for eligible members who
membership. This membership is a household smoke, vape, or chew. Nicotine patches, gum, or
card and valid at all Costco locations. Only one lozenges at no extra cost, as well as custom quit
membership per family is available. Members plans, and expert support.
should call the Member Services at 800-600-4441
to request, verify their address, and report the Amerigroup also pays PCPs for smoking cessation
benefit they are trying to access. The Costco Gold referral evaluations, smoking cessation prescription
Star membership card will then be mailed to evaluation, and face-to-face counseling for all
the member. members ages 18 years and older:
■ Intensive smoking cessation counseling
Flu Pandemic kit (procedure 99407 for greater than 10 minutes) is
Flu Pandemic kit benefit, helps members to remain limited to one per day.
prepared for the next flu season or pandemic. The ■ Two cessation counseling attempts (or up to
kit may include essential and preventive safety eight sessions) are allowed every 12 months.
items such as face masks, hand sanitizer, and wipes. An attempt is defined as up to four cessation
Limit one per member per year. counseling sessions.Staying fit Weight Watchers® Members can receive one Weight Watchers voucher good for sign-up fee and 13 weeks of classes and 14 weeks of Digital Tools. They must be over age 17 and get permission from their doctor. This is a one-time benefit. FitnessCoach Program Services include online exercise classes and online information on fitness and exercise topics, including information available to special needs populations. Light Box for seasonal affective disorder (SAD) Members must be diagnosed with depression or SAD to be eligible. This is available for members ages 19 years and older. No preauthorization is required; however, members with past or current eye problems, such as glaucoma, cataracts, or eye damage from diabetes, must get advice from their eye doctor before starting light therapy. Emotional well-being resources Learn ways to manage stress, anxiety, depression, substance use, and sleep issues that affect your emotional well-being through this online program and coaching support Life Transition Kit A Life Transition Kit includes: first-aid supplies such as bandages and ointment, toothpaste, travel toothbrush, mouthwash, dental floss, and a $15 Subway gift card. This benefit is intended to help members get back on their feet more quickly when transitioning out of an institutional setting or for anyone enrolled in supportive employment.
Peer-to-peer counselor benefit Employment and
Certified peer counselors work with
their peers (adults and youth) and education support
the parents of children receiving
mental health services. They
Internet essentials package
Receive up to a $300 allowance to help cover the
draw upon their experiences to
cost of internet services. Funds can be used for
help peers find hope and make progress toward
installation and set-up fees, to purchase modems,
recovery. Because of their own life experience,
routers, and any additional equipment that is
they are uniquely equipped to provide support,
essential to obtain (or strengthen) an internet
encouragement and resources to those with mental
connection, as well as to help cover monthly
health challenges.
service charges. This is a one-time benefit and
Washington state's Peer Support Program has applicable to members who have been previously
trained and qualified mental health consumers as incarcerated in the past 12 months.
certified peer counselors since 2005. A consumer
is someone who has applied for, is eligible for or Employment industry certification
who has received mental health services. This We will cover the cost of employment certifications
also includes parents and legal guardians when in fields such as early childhood education,
they have a child under the age of 13, or a child foundations of reading, business education,
13 years or older when they are involved in their computer science, technology education, English
treatment plan (Washington Administrative Code language arts, health, and marketing. This is a
388-865-0150). one-time benefit.
Members can contact Member Services to request
payment for the program. Member Services will Free laptop program
contact David Escame at the health plan, Members transitioning from incarceration will
david.escame@amerigroup.com: be able to receive a free laptop to help with
■ $90 initial registration fee
employment and educational pursuits.
■ $75 annual renewal fee
This is a one-time benefit and
■ $165 total unit cost
applicable to members who have
been previously incarcerated in the
past 12 months.
End of life
Vital decisions
This program provides telephonic healthcare
counseling service for members who are within
approximately 6 to 9 months from end of life.
The program consists of a series of telephone
counseling sessions with an individual counselor
to educate and coach members to become more
active participants in healthcare and end-of-life
decision making. Amerigroup identifies potential
participants through medical and pharmacy claims.
If providers wish to refer members to this optional
program, they may contact our case managers at
800-454-3730.Member incentives for Note: SafeLink Wireless® is a Lifeline-supported
service. Lifeline is a government benefit program.
healthy behaviors Only those who qualify may enroll in Lifeline;
it can’t be transferred and is limited to one per
Amerigroup partners with provider
household. Members may need to show proof
groups to tailor member incentives
of income or that they take part in the program
and outreach. Programs are
to enroll.
developed based on population
needs and priorities. Additionally, Amerigroup
offers eligible members incentives for important Amerigroup mobile ID card and app
preventive care visits identified below. Each Members may use this feature to safely access
incentive reward is limited to one per year, per ID cards, find a doctor, and increase access to
reward. Gift cards are not valid for alcohol, tobacco, health resources.
gift cards, stored-value cards, lottery tickets, or
other contest entries. Additional resources
Online and mobile resources First-aid kit and dental hygiene kit
These kits are available at no cost when a personal
Amerigroup On Call disaster plan is completed online.
Members may speak to a nurse about medical
questions or concerns, day or night, even on Disease management education
holidays. Translation services are available for more and support
than 150 languages. This support program is designed
Amerigroup On Call/24-hour Nurse HelpLine: to help manage difficult
866-864-2544. health conditions like asthma,
diabetes, and chronic obstructive
SafeLink® pulmonary disease.
Qualified members may secure a cellphone with up
to 350 free minutes of service each month, plus the
member may be eligible for the following:
■ 200 extra one-time bonus minutes when
the member chooses to receive free health Contact information
text messages To find out more about these special services,
■ Unlimited wellness text messages from please call your local Provider Experience
Amerigroup, plus reminders to renew benefits consultant or our Provider Services team at
on time 800-454-3730.
■ Unlimited minutes when calling our Member
Services department and Amerigroup On Call Members can call 800-600-4441 or TTY 711
■ Members enrolled in Case Management who to learn more about the benefits listed above.
access SafeLink receive an 8.5GB plan with
unlimited talk and text
EyeQuest is an independent company providing eye carevision benefit management services on behalf of Amerigroup, Washington, Inc.
Please note: This flier is intended for educational use to providers and community organizations. This is not for public distribution.https://providers.amerigroup.com/wa WAPEC-3233-21
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