Enrollment
Coverage
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Billing
Pharmacy
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Enrollment
How do I apply for a health plan?
You can get a quote and apply online for individual and family plans. To apply by mail, complete the following forms:
What can I do if my application has been denied?
You may be eligible for coverage through the Washington State Health Insurance Pool (WSHIP), created by the Washington State Legislature. It provides health coverage to Washington residents who cannot find adequate commercial health coverage due to their health conditions, or because they reside in a county where commercial individual coverage is not offered.
Can I change my plan during a plan year?
Yes, but you may need to complete the Standard Health Questionnaire if you are changing to the richer plan.
Coverage
Consult the provider directory or call us at 800-592-6804.
Am I covered outside the state of Washington?
Benefits are provided at a constant 50% for services received outside the state of Washington, except for medical emergencies or accidental injuries. Outside the U.S., benefits are not provided for treatment or drugs considered experimental or investigational by U.S. medical standards.
Am I covered for immunizations?
If you’re a WiseChoices or WiseSavings plan member, you’re fully covered for physician-recommended, routine immunizations given by in-network providers. There is no immunization benefit for WiseEssentials plan members.
How do I file a claim?
Healthcare providers normally bill LifeWise directly for services to you and your enrolled dependents. If you need to submit a claim to LifeWise you can follow these instructions.
Complete and sign a claim form:
LifeWise Health Plan of Washington
P.O. Box 91059
Seattle, WA 98111
How do I file a complaint or appeal a claim?
You may appeal any LifeWise decision you find unacceptable. And you may file an appeal related to a complaint that was not resolved to your satisfaction. Here’s how: Mail us a letter stating your intention to appeal a LifeWise decision. Describe the circumstances of your situation with as much relevant detail as possible. Please provide us with your name, member identification number, current address, and telephone numbers where we may contact you during business hours.
Mail your letter to:
Customer Service
LifeWise Health Plan of Washington
P.O. Box 91102
Seattle, WA 98111-9202
Billing
How do I make a payment to my plan?
You can make payments by mail with a check or money order made out to LifeWise Health Plan of Washington. Please include your member identification number (located on your card) on your check or money order.
Mail payments to:
LifeWise Health Plan of Washington
P.O. Box 91060
Seattle, WA 98111-9160
You can avoid the time and expense of mailing payments through the use of monthly automatic fund transfers. Funds are transferred on the first day of each month. Get details, or sign up, by downloading an Automatic Fund Transfer Authorization request.
Payment is due on the 1st of every month. You have a 10-day grace period to make your payment per the contract.
If my plan is cancelled due to nonpayment can I get reinstated?
You have a one-time reinstatement. To be eligible, you must bring your account to current within 30 days of the final bill. To check for your reinstatement eligibility, please call Customer Service at 800-592-6804.
How do I cancel a plan?
You may cancel your LifeWise plan by notifying us of your intentions in a letter or by a telephone call. We’ll need to know the names and member identification numbers of plan members in your family, your current address and telephone number.
Mail cancellation requests to:
Customer Service
LifeWise Health Plan of Washington
P.O. Box 91120
Seattle, WA 98111-9220
Contact us by telephone at 800-592-6804.
Pharmacy
What is the difference between pharmacy benefits and pharmacy discount programs?
If you are a member of a LifeWise plan that offers pharmacy benefits, you receive coverage for a portion of the cost of prescriptions. If your plan does not offer a pharmacy benefit, you can trim your prescription expenses through the Pharmacy Discount Program. Participating pharmacies offer you cost savings of up to 50 percent. To take advantage of this program, you must show your LifeWise member identification card at a participating pharmacy when you fill a prescription.
Can I get my prescription by mail?
Yes. You have access to a comprehensive, nationwide network of retail pharmacies and to a convenient mail order pharmacy, Medco By Mail. You can also order specialty drugs for the treatment of complex or rare conditions through our specialty pharmacies: Caremark or Accredo Health Group (a Medco company).
Which prescription drugs are not covered?
The Preferred Drug List Search allows you to search for a drug by name or drug class to find out whether it is covered. LifeWise's Preferred Drug List applies to members who have the 3-Tier Pharmacy Benefit.
To find out whether you have a 3-Tier Pharmacy Benefit, please check your benefit booklet or contact Customer Service.
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