Source: https://app.leg.wa.gov/WAC/default.aspx?cite=182-503-0510
Timestamp: 2019-12-14 16:10:05
Document Index: 342167531

Matched Legal Cases: ['§ 213', '§ 431', '§ 182', '§ 431', '§ 155', '§ 182', '§ 182', '§ 182', '§ 388', '§ 388', '§ 388', '§ 388']

WAC 182-503-0510:
WACs > Title 182 > Chapter 182-503 > Section 182-503-0510
182-503-0505 << 182-503-0510 >> 182-503-0515
PDFWAC 182-503-0510
Washington apple health—Program summary.
(1) The agency categorizes Washington apple health programs into three groups based on the income methodology used to determine eligibility:
(a) Those that use a modified adjusted gross income (MAGI)-based methodology described in WAC 182-509-0300, called MAGI-based apple health programs;
(b) Those that use an income methodology other than MAGI, called non-MAGI-based apple health programs, which include:
(i) Supplemental security income (SSI)-related apple health programs;
(ii) Temporary assistance for needy families (TANF)-related apple health programs; and
(iii) Other apple health programs not based on MAGI, SSI, or TANF methodologies.
(c) Those that provide coverage based on a specific status or entitlement in federal rule and not on countable income, called deemed eligible apple health programs.
(2) MAGI-based apple health programs include the following:
(a) Apple health parent and caretaker relative program described in WAC 182-505-0240;
(b) MAGI-based apple health adult medical program described in WAC 182-505-0250, for which the scope of coverage is called the alternative benefits plan (ABP) described in WAC 182-500-0010;
(c) Apple health for pregnant women program described in WAC 182-505-0115;
(d) Apple health for kids program described in WAC 182-505-0210 (3)(a);
(e) Premium-based apple health for kids described in WAC 182-505-0215;
(f) Apple health long-term care for children and adults described in chapter 182-514 WAC; and
(g) Apple health alien emergency medical program described in WAC 182-507-0110 through 182-507-0125 when the person is eligible based on criteria for a MAGI-based apple health program.
(3) Non-MAGI-based apple health programs include the following:
(i) Apple health for workers with disabilities (HWD) described in chapter 182-511 WAC;
(ii) Apple health SSI-related programs described in chapters 182-512 and 182-519 WAC;
(iii) Apple health long-term care and hospice programs described in chapters 182-513 and 182-515 WAC;
(iv) Apple health medicare savings programs described in chapter 182-517 WAC; and
(v) Apple health alien emergency medical (AEM) programs described in WAC 182-507-0110 and 182-507-0125 when the person meets the age, blindness or disability criteria specified in WAC 182-512-0050.
(i) Refugee medical assistance (RMA) program described in WAC 182-507-0130; and
(ii) Apple health medically needy (MN) coverage for pregnant women and children who do not meet SSI-related criteria.
(i) Breast and cervical cancer program described in WAC 182-505-0120;
(ii) take charge program described in WAC 182-532-0720;
(iii) Medical care services described in WAC 182-508-0005;
(iv) Apple health for pregnant minors described in WAC 182-505-0117;
(v) Kidney disease program described in chapter 182-540 WAC; and
(vi) Tailored supports for older adults described in WAC 182-513-1610.
(4) Deemed eligible apple health programs include:
(a) Apple health SSI medical program described in chapter 182-510 WAC, or a person who meets the medicaid eligibility criteria in 1619b of the Social Security Act;
(b) Newborn medical program described in WAC 182-505-0210(2);
(c) Foster care program described in WAC 182-505-0211;
(d) Medical extension program described in WAC 182-523-0100; and
(e) Family planning extension described in WAC 182-505-0115(5).
(8) A person who is eligible for the apple health MAGI-based adult program listed in subsection (2)(b) of this section is eligible for ABP health care coverage as defined in WAC 182-500-0010. Such a person may apply for more comprehensive coverage through another apple health program at any time.
(9) For the other specific program requirements a person must meet to qualify for apple health, see chapters 182-503 through 182-527 WAC.
[Statutory Authority: RCW 41.05.021, 41.05.160, 2016 1st sp.s. c 36 § 213 (1)(e), section 1115 of the Social Security Act, and 42 C.F.R. §§ 431.400 through 431.428. WSR 17-12-019, § 182-503-0510, filed 5/30/17, effective 7/1/17. Statutory Authority: RCW 41.05.021 and Patient Protection and Affordable Care Act (P.L. 111-148), 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155. WSR 14-06-068, § 182-503-0510, filed 2/28/14, effective 3/31/14. WSR 12-13-056, recodified as § 182-503-0510, filed 6/15/12, effective 7/1/12. WSR 12-02-034, recodified as § 182-505-0510, filed 12/29/11, effective 1/1/12. Statutory Authority: RCW 34.05.353 (2)(d), 74.08.090, and chapters 74.09, 74.04 RCW. WSR 08-11-047, § 388-503-0510, filed 5/15/08, effective 6/15/08. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.530. WSR 05-07-097, § 388-503-0510, filed 3/17/05, effective 4/17/05. Statutory Authority: RCW 74.08.090, 74.08A.100, 74.09.080, and 74.09.415. WSR 02-17-030, § 388-503-0510, filed 8/12/02, effective 9/12/02. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. WSR 98-16-044, § 388-503-0510, filed 7/31/98, effective 9/1/98.]