(1) A
pregnant person is eligible for Washington apple health pregnancy coverage if
the person:
(a) Meets citizenship or
immigration status under WAC
182-503-0535;
(b) Meets Social Security number requirements
under WAC
182-503-0115;
(d) Has countable income at or
below the limit described in:
(i) WAC
182-505-0100
to be eligible for categorically needy (CN) coverage; or
(ii) WAC
182-505-0100
to be eligible for medically needy (MN) coverage. MN coverage begins when the
pregnant person meets any required spenddown liability as described in WAC
182-519-0110.
(2) A noncitizen pregnant person who does not
meet the requirements in subsection (1)(a) or (b) of this section is eligible
for apple health pregnancy coverage if they meet countable income standards for
CN or MN coverage as described in subsection (1)(d) of this section.
(3) The assignment of medical support rights
as described in WAC
182-503-0540
does not apply to pregnant people.
(4) A person who was eligible for and covered
under any CN or MN scope of coverage apple health program on the last day of
pregnancy remains continuously eligible for after-pregnancy coverage for 12
months, beginning the month after their pregnancy ends. This includes people
who meet an MN spenddown liability with expenses incurred no later than the
date the pregnancy ends.
(5)
Pregnancy coverage has CN scope of care for all people except those enrolled
through the MN program who have MN scope of care. A person's after-pregnancy
coverage has the same scope of coverage as their pregnancy coverage.
(6) A person who does not meet the
requirements in subsection (4) of this section may qualify for after-pregnancy
coverage if they:
(a) Apply for and meet all
requirements of the apple health pregnancy coverage program other than
pregnancy; and
(b) Apply any time
during their 12-month postpartum period to receive ongoing medical coverage
until the end of the 12th month after their pregnancy ends.
Notes
Wash. Admin.
Code §
182-505-0115
Amended by
WSR
14-16-052, Filed 7/29/2014, effective
8/29/2014
Amended by
WSR
22-12-033, Filed 5/24/2022, effective
6/24/2022
12-13-056, recodified as WAC 182-505-0115, filed 6/15/12,
effective 7/1/12. Statutory Authority:
RCW
74.04.050,
74.04.057,
74.08.090,
74.09.500,
42 U.S.C.
9902(2). 05-07-032, §
388-462-0015, filed 3/9/05, effective 4/9/05. Statutory Authority:
RCW
74.08.090,
74.08A.100,
74.09.080, and 74.09.415.
02-17-030, § 388-462-0015, filed 8/12/02, effective 9/12/02. Statutory
Authority:
RCW
74.04.050,
74.04.055,
74.04.057 and
74.08.090. 98-16-044, §
388-462-0015, filed 7/31/98, effective 9/1/98. Formerly WAC 388-508-0820,
388-508-0830, 388-522-2230 and
388-508-0835.
