Family planning is a crucial aspect of healthcare, empowering individuals to make informed decisions about their reproductive health and prevent unintended pregnancies. For those seeking accessible and confidential family planning services, the Family Planning Only program offers a vital resource. And the best part? You can often start the process and get your questions answered simply by phone.
Understanding Family Planning Only Coverage
Family Planning Only is a program designed to provide individuals with comprehensive coverage for family planning services. This program helps people proactively manage their reproductive health and plan their families responsibly. It’s about giving you the tools and resources you need to take control of your life and future.
What Services Are Covered?
The Family Planning Only program encompasses a wide range of essential services, ensuring you receive the care you need. These services include:
- Annual Comprehensive Preventive Visit: You are entitled to one comprehensive preventive family planning visit every 365 days. This ensures regular check-ups and proactive care. Any necessary follow-up visits related to family planning are also covered.
- Counseling and Education: Access to counseling, education, and risk reduction strategies is a core component. This empowers you with knowledge to make informed choices.
- Contraceptive Education and Supplies: The program covers education and supplies for all FDA-approved contraceptives, including natural family planning methods and abstinence education. This comprehensive approach caters to individual preferences and needs.
- Permanent Methods: For those considering permanent solutions, tubal ligations (tubes tied), hysteroscopic sterilization, and vasectomies are covered.
- Pregnancy Testing and Cervical Cancer Screening: When clinically appropriate, pregnancy testing and cervical cancer screening are included in the covered services.
- STI Services: Screening, testing, and treatment for sexually transmitted infections (STIs) are covered when clinically appropriate, following nationally recognized guidelines, or when medically necessary for the safe and effective use of your chosen contraceptive method.
- Vaccinations: Human papillomavirus (HPV) and Hepatitis B vaccinations are also included, promoting preventative health measures.
It’s important to note that while Family Planning Only offers extensive family planning support, some services fall outside its scope.
Services Not Covered
Family Planning Only coverage is specifically focused on family planning and related services. Therefore, it does not cover:
- Most other vaccinations beyond HPV and Hepatitis B.
- Mammograms for breast cancer screening.
- Services unrelated to family planning, such as follow-up for abnormal Pap smears, pregnancy care, or the management of general health issues like diabetes, asthma, or high blood pressure. These broader healthcare needs require different coverage options.
Eligibility for Family Planning Only: Could You Qualify?
Eligibility for the Family Planning Only program is primarily based on income and insurance status. You may be eligible if you meet the following criteria:
- Income Limits: Your annual household income must be at or below the specified amounts. These income thresholds are updated annually every April, so it’s important to check the current guidelines.
- Insurance Status:
- You are uninsured and not eligible for Apple Health (Medicaid) coverage.
- Alternatively, you may be insured but seeking confidential family planning services that you prefer not to go through your primary insurance.
The income limits are structured to ensure that the program supports those who need it most. Here’s a table outlining the monthly income limits for different household sizes:
| Program | Single person | 2-person household | 3-person household | 4-person household | 5-person household | 6-person household | 7-person household | 8-person household |
|---|---|---|---|---|---|---|---|---|
| Family Planning Only | $3,326 monthly | $4,514 monthly | $5,702 monthly | $6,890 monthly | $8,078 monthly | $9,266 monthly | $10,454 monthly | $11,642 monthly |
*Income standards are subject to annual changes every April.
It’s also worth noting that even if you might be eligible for Apple Health (Medicaid), you can make an informed choice to waive your right to apply for it and still apply for Family Planning Only. This might be relevant if you specifically need confidential family planning services.
Applying for Family Planning Only: The Phone Option and Other Methods
Applying for Family Planning Only is designed to be straightforward. While online and mail-in options exist, applying by phone offers a direct and often quicker way to get started and ask questions.
Initial Steps: Online or Phone for Apple Health Check
Before applying specifically for Family Planning Only, it’s recommended to first check your eligibility for full health coverage through Apple Health or subsidized Qualified Health Plans. You can do this by:
- Visiting Washington Healthplanfinder: Go to https://www.wahealthplanfinder.org/ online.
- Calling by Phone: Call 1-855-923-4633.
These resources will help you determine if you qualify for broader coverage that includes family planning and much more.
Applying for Family Planning Only by Phone or Other Methods
If you are not eligible for Apple Health or prefer to apply directly for Family Planning Only (especially for confidential services), you have several application methods:
- Apply by Phone: Contact your Apple Health provider and apply for benefits over the phone or in person. You can also call the Health Care Authority (HCA) directly at 1-800-562-3022 ext. 12533. Translation services are available when you call this number, ensuring language is not a barrier to access.
- Apply Online: While not explicitly stated as a direct application method in the original text, exploring the Washington Healthplanfinder website may offer online application options.
- Apply by Fax: Fax your application to 1-866-841-2267.
- Apply by Email: Email your application to [email protected].
- Apply by Mail: Mail your application to HCA MEDS, PO Box 45531, Olympia, WA 98504-5531.
For assistance navigating the application process and understanding your options, numerous assisters are available across the state. You can learn how to find help with coverage by downloading the assisters fact sheet.
Remember, you can reapply for Family Planning Only coverage every 12 months as long as you continue to meet the eligibility requirements.
Confidential Services: Protecting Your Privacy
The Family Planning Only program understands the importance of privacy, especially when it comes to reproductive health. You have the option to apply for confidential services. Choosing this option provides you with protected status, ensuring:
- Preferred Mailing Address: You can designate a preferred mailing address to ensure sensitive information is sent to the correct and private location.
- No Explanation of Benefits (EOB) Mailed: EOBs, which detail healthcare services received, will not be mailed to you, further enhancing your privacy.
- Live Person Phone Contact: When you call in with questions or need assistance, you will be routed to a live person instead of an automated system, offering more personalized and discreet support.
This focus on confidentiality makes Family Planning Only a safe and trusted option for accessing reproductive healthcare.
Accessing Services and Finding Providers
Once enrolled in Family Planning Only, accessing services is straightforward.
Where to Get Services
You can receive services from any eligible Apple Health provider. To find a provider who accepts Apple Health, use the provider search tool at https://fortress.wa.gov/hca/p1findaprovider/. Your chosen provider can also assist you with filling prescriptions at the pharmacy of your choice.
Covered Contraceptive Methods
Family Planning Only covers a comprehensive range of contraception methods, often referred to as birth control. This includes all FDA-approved methods such as:
- Pills
- Patches
- Intrauterine Devices (IUDs), also known as Long-Acting Reversible Contraceptives (LARCs)
- And more
The program also reimburses for certain over-the-counter (OTC) family planning supplies without requiring a prescription. These OTC contraceptives include:
- Condoms (including female condoms)
- Spermicides (foam, gel, suppositories, and cream)
- Emergency contraception
- Over-the-counter oral contraception
For more details on accessing OTC contraceptives and other coverage specifics, you can read the FAQ on OTCs for Apple Health clients.
Emergency contraception is a covered benefit and readily available from any Apple Health provider, and also covered OTC from pharmacies without a prescription.
Hormonal contraception, both prescription and OTC, can be filled in 12-month supplies unless otherwise indicated by your healthcare provider or preferred by you. Supply availability may vary by pharmacy.
To access contraceptive supplies at the pharmacy, go to the pharmacy counter (not the retail counter) and present your Apple Health ProviderOne services card or use the mobile app.
For in-depth coverage details, you can also view the Family Planning billing guide.
Stay Informed: Family Planning Only Text Message Surveys
Clients enrolled in Family Planning Only coverage may receive text messages inviting them to participate in a short, confidential survey about their experiences with reproductive healthcare. This survey aims to improve services and your feedback is valuable.
Survey Text Messages: What to Expect
You might receive text messages like these:
- Message #1: “Health Care Authority: Message frequency varies. Message & data rates may apply. Reply STOP to opt-out. For help or to view T&Cs, visit hca.wa.gov/FPO-text.”
- Message #2: “You’re invited to share your experience receiving Family Planning Only services. Visit (survey link in text message) to take the brief survey.”
- Message #3: “Family planning services should work for you! This survey will take less than 1 minute. Make your voice heard: (survey link in text message).”
Participation in these surveys is entirely optional and will not impact your coverage in any way. Your responses are kept strictly confidential.
Frequently Asked Questions About Text Surveys
- Why am I getting this text message? If you are enrolled in Family Planning Only and provided your phone number, you may receive these survey invitations.
- What number is the text message coming from? The Health Care Authority sends these messages from 888-689-5016.
- What if I don’t have Family Planning Only coverage? If you received a text in error, you can simply ignore it or reply “STOP” to opt-out of future messages.
- How often will I get a text? You will typically receive one set of text messages per survey invitation, and possibly a follow-up set if response rates are low. Once you complete the survey, you will not receive further texts related to that survey.
- What if I don’t want any more texts? Reply “STOP” to opt-out at any time.
- Who do I contact with questions? For any questions about the survey or Family Planning Only in general, contact the Family Planning Only team at 1-800-562-3022 ext.12533 or email [email protected].
Conclusion: Family Planning Support is Just a Phone Call Away
The Family Planning Only program is a vital resource for individuals seeking confidential and affordable family planning services. With comprehensive coverage, various application methods including phone applications, and a commitment to privacy, accessing the support you need is easier than ever. Whether you have questions about eligibility, covered services, or how to apply, reaching out by phone is a great first step. Take charge of your reproductive health and explore the Family Planning Only program today. Call 1-800-562-3022 ext. 12533 to speak with the Family Planning Only team and get started.
