Washington Administrative Code › Title 182 - Health Care Authority › WASHINGTON APPLE HEALTH › Chapter 182-504 - Certification periods and change of circumstance › Section 182-504-0125 - Washington apple health-Effect of reported changes

Current through Register Vol. 24-14, July 15, 2024
(1) If you report a change required under WAC
				182-504-0105 during a
				certification period, you continue to be eligible for Washington apple health
				coverage until we decide if you can keep getting apple health coverage under
				your current apple health program or a different apple health
				program.
(2) If your apple health
				categorically needy (CN) coverage ends due to a reported change and you meet
				all the eligibility requirements for a different apple health CN program, we
				will approve your coverage under the new apple health CN program. If you are
				not eligible for coverage under any apple health CN program but you meet the
				eligibility requirements for either apple health alternative benefits plan
				(ABP) coverage or apple health medically needy (MN) coverage, we will approve
				your coverage under the program you are eligible for. If you are not eligible
				for coverage under any apple health CN program but you meet the eligibility
				requirements for both apple health ABP coverage and apple health MN coverage,
				we will approve the apple health ABP coverage unless you notify us that you
				prefer apple health MN coverage.
(3) If your apple health coverage ends and
				you are not eligible for a different apple health program, we stop your apple
				health coverage after giving you advance and adequate notice unless the
				exception in subsection (4) of this section applies to you.
(4) If you claim to have a disability and
				that is the only basis for you to be potentially eligible for apple health
				coverage, then we refer you to the division of disability determination
				services (within the department of social and health services) for a disability
				determination. Pending the outcome of the disability determination, we also
				determine if you are eligible for apple health coverage under the SSI-related
				medical program described in chapter 182-512 WAC. If you have countable income
				in excess of the SSI-related categorically needy income level (CNIL), then we
				look to see if you can get coverage under apple health MN with spenddown as
				described in chapter 182-519 WAC pending the final outcome of the disability
				determination.
(5) If you are
				eligible for and receive coverage under the apple health parent and caretaker
				relative program described in WAC
				182-505-0240, you may be eligible
				for the apple health medical extension program described in WAC
				182-523-0100, if your coverage
				ends as a result of an increase in your earned income.
(6) Changes in income during a certification
				period do not affect eligibility for the following programs:
(a) Apple health for pregnant
				women;
(b) Apple health for
				children, except as specified in subsection (7) of this section;
(c) Apple health for SSI
				recipients;
(d) Apple health
				refugee program; and
(e) Apple
				health medical extension program.