(1) A
certification period is the period of time we determine that you are eligible
for a categorically needy (CN) Washington apple health program. Unless
otherwise stated in this section, the certification period begins on the first
day of the month of application and continues through the end of the last month
of the certification period.
(2)
Newborn coverage begins on the child's date of birth and continues through the
end of the month of the child's first birthday.
(3) If you are eligible for apple health
based on pregnancy, the certification period continues through the last day of
the month the pregnancy ends. After-pregnancy coverage begins the first day of
the month, following the end of the pregnancy, and ends the last day of the
12th month from the time after-pregnancy coverage began.
(4) If you are newly eligible for apple
health coverage and had a pregnancy end within the last 12 months, your
certification period for after-pregnancy coverage:
(a) Begins the first day of the month you are
eligible; and
(b) Ends the last day
of the 12th month following the end of your pregnancy.
(5) If you are eligible for the refugee
program, the certification period ends at the end of the 12th month following
your date of entry to the United States.
(6) If you are a child under age six
receiving apple health for kids without a premium, your certification period
ends the last day of the month of your sixth birthday.
(7) If you are eligible for newborn coverage,
your coverage continues through the last day of the month of your first
birthday. Apple health for kids coverage begins automatically on the first day
of the month after your newborn coverage ends and the certification period ends
the last day of the month of your sixth birthday.
(8) For all other CN coverage, the
certification period is 12 months.
(9) If you are a child, eligibility is
continuous throughout the certification period regardless of a change in
circumstances, unless a required premium (described in WAC
182-505-0225) is not paid for
three consecutive months, or you:
(a) Turn age
19;
(b) Move out-of-state;
or
(c) Die.
(10) When you turn 19, the certification
period ends after the redetermination process described in WAC
182-504-0125 is completed, even
if the 12-month period is not over, unless:
(a) You are receiving inpatient services
(described in WAC
182-514-0230) on the last day of
the month you turn 19;
(b) The
inpatient stay continues into the following month or months; and
(c) You remain eligible except for turning
age 19.
(11) A
retroactive certification period is described in WAC
182-504-0005.
(12) Coverage under premium-based programs
included in apple health for kids as described in chapter
182-505 WAC begins no
sooner than the month after creditable coverage ends.
Notes
Wash. Admin.
Code §
182-504-0015
Amended by
WSR
14-16-052, Filed 7/29/2014, effective
8/29/2014
Amended by
WSR
17-12-017, Filed 5/30/2017, effective
6/30/2017
Amended by
WSR
22-12-033, Filed 5/24/2022, effective
6/24/2022
Amended by
WSR
22-21-072, Filed 10/13/2022, effective
11/13/2022
Amended by
WSR
23-23-057, Filed 11/8/2023, effective
12/9/2023
11-24-018, recodified as WAC
182-504-0015, filed 11/29/11,
effective 12/1/11. Statutory Authority:
RCW
74.04.050,
74.04.057, and
74.08.090, and Apple Health for
Kids Act (ESHB 2128); 42
U.S.C. 1305;
Public Law
111-3 (Children's Health Insurance Program
Reauthorization Act of 2009). 11-03-001, § 388-416-0015, filed 1/5/11,
effective 2/5/11. Statutory Authority:
RCW
74.04.050,
74.04.057,
74.08.090,
74.09.402,
74.09.470, and 2008 session law.
09-07-086, § 388-416-0015, filed 3/17/09, effective 4/17/09. Statutory
Authority:
RCW
74.04.050,
74.04.057,
74.08.090,
74.09.530,
74.09.700, and 2007 c 5.
08-05-018, § 388-416-0015, filed 2/12/08, effective 3/14/08. Statutory
Authority:
RCW
74.04.050,
74.08.090,
74.09.530, and
74.09.700. 06-24-036, §
388-416-0015, filed 11/30/06, effective 1/1/07. Statutory Authority:
RCW
74.08.090,
74.09.530, and 74.09.415.
05-19-031, § 388-416-0015, filed 9/12/05, effective 10/13/05. Statutory
Authority:
RCW
74.04.050,
74.04.055,
74.04.057,
74.04.510, and 2004 c 54.
04-21-064, § 388-416-0015, filed 10/18/04, effective 11/18/04. Statutory
Authority:
RCW
74.08.090,
74.09.530, and 2003 c 10.
04-03-019, § 388-416-0015, filed 1/12/04, effective 2/12/04. Statutory
Authority:
RCW
74.04.050,
74.04.055,
74.04.057,
74.08.090 and 74.09.450.
00-08-002, § 388-416-0015, filed 3/22/00, effective 5/1/00. Statutory
Authority:
RCW
74.04.050,
74.04.055,
74.04.057 and
74.08.090. 98-16-044, §
388-416-0015, filed 7/31/98, effective 9/1/98. Formerly 388-509-0970,
388-521-2105, 388-522-2210 and
388-522-2230.
