Wash. Admin. Code § 182-508-0005 - Washington apple health medical care services-Eligibility and scope of coverage

(1) A person is eligible for state-funded Washington apple health medical care services (MCS) coverage to the extent of available funds if the person is:

(a) Determined by the department of social and health services to be eligible for benefits under:

(i) The aged, blind, or disabled program as described in WAC 388-400-0060;

(ii) The housing and essential needs referral program as described in WAC 388-400-0070; or

(iii) The survivors of certain crimes (SCC) program, as described in WAC 388-424-0035, which includes victims of human trafficking as described in RCW 74.04.005;

(b) Not eligible for another federally funded categorically needy (CN) (as defined in WAC 182-500-0020) or alternative benefits plan (ABP) (as defined in WAC 182-500-0010) Washington apple health program; and

(c) Not residing in a public institution as defined in WAC 182-500-0050.

(2) If an enrollment cap exists under WAC 182-508-0150, a waiting list of people may be established.

(3) A person's period of eligibility for MCS is the same as the person's period of eligibility for:

(a) The aged, blind, or disabled program as described in WAC 388-449-0150;

(b) The person's incapacity authorization period for the housing and essential needs referral program as described in WAC 388-447-0110; or

(c) The person's period of eligibility for the SCC program as described in WAC 388-424-0035.

(4) The MCS program covers only the medically necessary services defined in WAC 182-501-0060.

(5) The MCS program does not cover medical services received outside the state of Washington unless the medical services are provided in a border city listed in WAC 182-501-0175.

Notes

Wash. Admin. Code § 182-508-0005

Amended by WSR 14-16-019, Filed 7/24/2014, effective 8/24/2014 Amended by WSR 22-02-034, Filed 12/29/2021, effective 2/1/2022 Amended by WSR 23-03-064, Filed 1/12/2023, effective 2/12/2023

Statutory Authority: RCW 41.05.021, 74.09.035, and 2011 1st sp.s. c 36 . 12-19-051, §182-508-0005, filed 9/13/12, effective 10/14/12.