For the purposes of this section, "full-scope coverage"
means coverage under either the categorically needy (CN) program, the broadest,
most comprehensive scope of health care services covered or the alternative
benefits plan (ABP), the same scope of care as CN, applicable to the apple
health for adults program.
(1) To be
eligible for family planning only services, as defined in WAC
182-532-001, a
client must:
(a) Provide a valid Social
Security number (SSN) or proof of application to receive an SSN, be exempt from
the requirement to provide an SSN as provided in WAC
182-503-0515, or meet good
cause criteria listed in WAC
182-503-0515(2);
(b) Be a Washington state resident, as
described under WAC
182-503-0520;
(c) Have an income at or below 260 percent of
the federal poverty level, as described under WAC
182-505-0100;
(d) Need family planning services;
and
(e) Have been denied apple
health coverage within the last 30 days, unless the applicant:
(i) Has made an informed choice to not apply
for full-scope coverage as described in WAC
182-500-0035 and
182-501-0060,
including family planning;
(ii) Is
age 18 or younger and seeking services in confidence;
(iii) Is a domestic violence victim who is
seeking services in confidence; or
(iv) Has an income of 150 percent to 260
percent of the federal poverty level, as described in WAC
182-505-0100.
(2) A client is not eligible for family
planning only medical if the client is:
(a)
Pregnant;
(b) Sterilized;
(c) Covered under another apple health
program that includes family planning services; or
(d) Covered by concurrent creditable
coverage, as defined in RCW 48.66.020, unless they meet criteria in subsection
(1)(e) of this section.
(3) The agency does not limit the number of
times a client may reapply for coverage.
Notes
Wash. Admin. Code §
182-532-510
Amended by
WSR
19-18-024, Filed 8/28/2019, effective
10/1/2019
Amended by
WSR
20-21-024, Filed 10/9/2020, effective
11/9/2020
Amended by
WSR
25-06-057, Filed 2/28/2025, effective
3/31/2025
WSR 11-14-075, recodified as §182-532-510, filed 6/30/11,
effective 7/1/11. Statutory Authority:
RCW
74.08.090,
74.09.520, and
74.09.800. WSR 05-24-032, §
388-532-510, filed 11/30/05, effective 12/31/05; WSR 04-05-011, § 388-532-510,
filed 2/6/04, effective 3/8/04.
