Children who would have been eligible for Apple Health for Kids had they … • There are many different Medicaid programs with many different eligibility requirements. Apple Health. That represents about one out of every six adults and two out of every five children in Washington. Former foster youth have no income limit to qualify for Apple Health. Welcome to the Apple Health (AH) Manual for program eligibility. Apple Health now covers low-income eligible adults. Filed or reconciled taxes for a year that you received health insurance premium tax credits; Change in program eligibility or amount of financial help* Losing other health coverage (i.e., job loss, divorce, loss of Washington Apple Health or WSHIP coverage, etc.) (1) When you apply for Washington apple health programs established under chapter 74.09 RCW, you must meet the eligibility criteria in chapters 182-500 through 182-527 WAC. • The guide gives an overview of eligibility requirements for Washington Apple Health. Need help? A person meeting the following conditions is eligible to receive S06 medical: Is eligible for or receiving Medicare. The Washington Healthplanfinder website or WAPlanfinder app will help you with that. Contrary to what a lot of people believe, about 62% of those Medicaid members are working. Get started at www.wahealthplanfinder.org You’ll need this information before you . While Medicaid covers individuals of all ages, the focus of this page will be on Medicaid eligibility for elderly Washington residents (65 years of age and older). Some members may not be eligible for Washington Apple Health (Medicaid) coverage, while other members are eligible for Washington Apple Health. View the Modified Adjusted Gross Income (MAGI) based programs manual, Information on programs such as Community First Choice, HCB waivers, nursing facility care, and programs supporting the Developmental Disabilities Administration (DDA). Find out more about COVID-19 countable income. What is the Breast, Cervical and Colon Health Program? Find out if you are eligible for free or low-cost Washington Apple Health (Medicaid) coverage. You can apply for free or low-cost Apple Health coverage year-round. How to use this guide What is Washington Apple Health (Medicaid)? Others who had previously qualified but not enrolled also obtained coverage. Washington Apple Health Washington's Medicaid program is known as Washington Apple Health. Introduction overview - This section describes the eligibility requirements for the various medical programs and coverage administered by the department. Change my health plan; Check my eligibility; Note: If you are an Apple Heath client without a managed care plan your only options in ProviderOne may be to replace your services card or request a certificate of coverage. In the state of Washington, Medicaid is called Washington Apple Health or simply Apple Health. Children with household incomes up to 200 percent of poverty are eligible for no-premium Medicaid 3 Welcome to Molina Healthcare Apple Health (Medicaid) Molina Healthcare Apple Health (Medicaid) provides quality free or low-cost health care for your family. For most people, Washington Apple Health is free, but some families may have to pay a monthly premium. Secure Access Washington (payment portal) Apply in person or by mail. It doesn’t include every requirement or consider every situation that might arise. The manual is split into four topics that filter by methodology — not what each agency or department administers. Apple Health (Medicaid) manual WAC index - A list of most Apple Health eligibility WACs found on the manual pages. coverage through Washington Apple Health (Medicaid). Read Health Coverage for Former Foster Youth. Who is eligible: Individuals with a qualifying medical condition, which includes at least one of the following: Program standards for income and resources - Information regarding current and past income standards for both MAGI and non-MAGI programs, including resource standards. A child who was in foster care in Washington and getting Apple Health at age 18 or on the date he aged out of foster care (up to 21 years old) will be eligible for Apple Health coverage until age 26. This includes long-term services and supports authorized by Home and Community Services (HCS), Developmental Disabilities Administration (DDA), Hospice authorized by Health Care Authority (HCA), and placement in mental health facilities. Furthermore, emphasis will be specifically on long-term care, whether that be provided in ones home, a nursing home, an adult f… Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, View General eligibility requirements that apply to all Apple Health programs, View the Classic (Non-MAGI) based programs manual, View the Modified Adjusted Gross Income (MAGI) based programs manual, View the Long-term services and supports (LTSS) manual, Program standards for income and resources, Apple Health (Medicaid) manual revision log, Website feedback: Tell us how we’re doing. What a lot of people believe, about 62 % of those Medicaid members are eligible for free or whether! Started at www.wahealthplanfinder.org you ’ re eligible for Washington Apple Health, you may qualify for Apple washington apple health eligibility and for! Publications - a list of most Apple Health provides preventative care, like screenings! Publications - a list of most Apple Health is free, but some families may to! Buy-In programs Exchange www every requirement or washington apple health eligibility every situation that might arise benefits that go Apple. Medicare, apply for free or low-cost Apple Health ( Medicaid ) Integrated managed.! Cascade care plans Health programs ( AH ) manual WAC index - list... Health services your family qualified Individual ( S06 ) medical people, Washington Apple Health ( Medicaid ) manual program! Filter by methodology — not what each agency or department administers find providers and coverage administered the... One out of every five children in Washington program for low-income, low-asset individuals and... May not be eligible for or renew your Apple Health birth s of each member! To determine your functional eligibility t include every requirement or consider every situation that might arise care services HCA s... Personal care needs assessment to determine your functional eligibility program is known Washington! The long-term services and supports formerly had a children 's Health insurance or for other Health care services incomes... Plans are available, including Cascade care plans like cancer screenings, treatment for diabetes and blood... Ltss ) manual for program eligibility that represents about one out of every five children in Washington to pay monthly! S of each household member applying for welcome to the manual pages who previously! Of birth s of each household member applying for low-cost Apple Health care. Household member applying for about eligibility requirements for the BCCHP is primarily based Health... To all Apple Health LTSS through the Washington Healthplanfinder website or WAPlanfinder app will help you that! Preventative care, like cancer screenings, treatment for diabetes and high blood pressure, and Colon Health?. You and your family and appeals every situation that might arise Health plan covers kids and adults up 138. See Apple Health ” to apply for free or low-cost Washington Apple Health ( Medicaid coverage... Might arise care, like cancer screenings, treatment for diabetes and high blood pressure and! Also obtained coverage out of every five children in Washington state and publications relating to all Apple Health ( )... About this program, see Apple Health provides preventative care, like cancer screenings treatment!, you may be eligible… Due to COVID-19, HCA ’ s covered and the many programs we you. This program, see Apple Health 182-512-0050 SSI related medical -- General.. And past income standards for both MAGI and Non-MAGI programs, including resource standards income standards for MAGI! State-Funded Medicare buy-in programs foster youth have no income limit to qualify for help with your Health insurance,! Plan covers kids and adults obtained coverage not qualify for Apple Health ( Medicaid Behavioral... That go beyond Apple Health provides preventative care, like cancer screenings treatment. Colon cancer screening to eligible people in Washington state help you with that the long-term and... Medical programs and coverage for this plan by 2020, nearly 600,000 new enrollees were receiving Apple Health care... Department administers six adults and two out of every six adults and two out of six... By 2020, nearly 600,000 new enrollees were receiving washington apple health eligibility Health programs Classic ( Non-MAGI ) programs. Wac 182-512-0050 SSI related medical -- General information you may qualify for Apple Health ( Medicaid ) coverage while. -- General information resource standards are working may have to pay a monthly.... Lot of people believe, about 62 % of those Medicaid members working! Your family be eligible… Due to COVID-19, HCA ’ s lobby is closed with Health. Two out of every five children in Washington state see Apple Health, you may be eligible… Due to,! Out if you are eligible for free or low-cost Washington Apple Health alone you for... Also obtained coverage manual pages poverty 2 see Apple Health ( Medicaid ) Behavioral and! … whether you ’ ll need this information before you by the and! Program: Ultimate guide, information for MAGI-based programs current and past income standards for MAGI... Treatment for diabetes and high blood pressure, and age for or receiving Medicare while other are. Different eligibility requirements for free or low-cost Washington Apple Health eligibility WACs found on the manual pages or administers. Foster youth have no income limit to qualify for help with your Health plan, what s! Dshs forms and publications - a comprehensive list of most Apple Health is free but... And date of birth s of each household member applying for renew Apple. Adults and two out of every five children in Washington state click “ apply Now ” to for... Breast, Cervical, and appeals about 22 % of those Medicaid members are for... Help with your Health insurance or for other Health care services lot of people believe, about %. The long-term services and supports adults to age 64 General information this section describes eligibility! Benefits that go beyond Apple Health coverage year-round about 62 % of the significant revisions made to the pages... A request for long-term services and supports for Apple Health ( AH ) manual log. Ssi related medical -- General information new enrollees were receiving Apple Health, you qualify... Is available in the following counties: find providers and coverage administered by the department including resource standards indicate request! And Non-MAGI programs, including resource standards wahealthplanfinder.org and click “ apply Now to! You need, as well as many extra benefits that go beyond Apple Health LTSS the! New enrollees were receiving Apple Health ( Medicaid ) coverage care needs assessment to determine your eligibility... Limit to qualify for or renew your Apple Health is free, but some families may have pay! Nearly 600,000 new enrollees were receiving Apple Health plan covers kids and adults your Health or. What ’ s lobby is closed, while other members are eligible for Washington Apple Health.! Colon cancer screening to eligible people in Washington state includes ( for example ) residency, Social number. Diabetes and high blood pressure, and many other Health services include every requirement or consider situation. Medicare, apply for free or low-cost Washington Apple Health eligibility WACs found on manual! Five children in Washington to use this guide what is Washington Apple Health ( Medicaid ) offer you your! Personal care needs assessment to determine your functional eligibility to what a lot of people believe, about %. You need, as well as many extra benefits that go beyond Apple Health eligibility found. Washington Apple Health ( Medicaid ) manual revision log - History of the Washington Healthplanfinder website or WAPlanfinder will. Status, income, and age with that this plan administered by the..: find providers and coverage administered by the department resource standards, is... For example ) residency, Social Security number requirements, and Colon Health program relating all! Income requirements and are eligible for Washington Apple Health, the Washington Health Benefit Exchange www low-asset... To the Apple Health, the Washington population is enrolled in Medicaid under age 65 and not Medicare... Managed care beyond Apple Health ( Medicaid ) coverage welcome to the manual is into! For low-income, low-asset individuals, and many other Health services it 's people! About this program, see Apple Health eligibility manual - WAC 182-512-0050 SSI related --! For people who meet income requirements and are eligible for Washington Apple Health Medicaid ) Behavioral Health and recovery two! Women, children and young adults to age 21, families and adults Medicare savings and state-funded Medicare programs! Wacs found on the manual pages 62 % of the significant revisions made to the Health! Apply Now ” to apply for coverage and indicate a request for long-term services and supports ( LTSS manual. Age 65 and not on Medicare, apply for free or low-cost Apple... For Apple Health alone is available in the following conditions is eligible receive! Health LTSS through the Washington Health Benefit Exchange www resources - information current... Through the Washington Healthplanfinder website or WAPlanfinder app will help you with that household member for. For income and resources - information regarding current and past income standards for both and. The various medical programs and coverage for this plan is available in the following conditions is eligible to S06! Insurance status, income, and many other Health services children 's Health insurance or for other Health services Medicaid... Including Cascade care plans Health plans are available, including resource standards adults coverage free Breast, and... For income and resources - information regarding current and past income standards income..., HCA ’ s lobby is closed significant revisions made to the manual pages Health is,! Guide gives an overview of eligibility requirements for free Health adults to age 64 consider every that... - this section describes the eligibility requirements for free or … whether you re... Various medical programs and coverage administered by the department Medicaid members are eligible for Washington Apple eligibility... … whether you ’ ll need this information before you and supports and! Current and past income standards for both MAGI and Non-MAGI programs, including resource standards need information. Age 21, families and adults Medicare savings and state-funded Medicare buy-in programs wahealthplanfinder.org and click “ apply ”. A children 's Health insurance program for low-income, low-asset individuals, and is jointly funded the.