Apple Health Family Planning Only

Revised date
Purpose statement

To explain the Family Planning Only (FPO) program.

Clarifying information

Individuals have the option to apply for FPO through a family planning provider or by submitting their own application. All eligibility questions can be answered by contacting the Health Care Authority at 1-800-562-3022 ext. 12533 (translation services available). This program is confidential and information is only shared with the individual receiving the services or their designated authorized representative.

Example

Mary Sue is covered under Apple Health for Pregnant individuals. She has her baby and reports this in Healthplanfinder and is approved for After Pregnancy Coverage (APC) for 12 months following the end of her pregnancy. After her APC coverage ends, she does not qualify for other Apple Health programs because her income is too high (above 210% of FPL). She is potentially eligible for the FPO program.

The FPO program code in ACES is P06. Participation in the Family Planning Only program is confidential even when members of the same household are receiving the services.

For more information on FPO services, visit HCA's Family Planning Only webpage.

Worker responsibilities

Staff do not need to take any action to close AUs for Apple Health for Pregnant Individuals. If an individual applies for Family Planning Only and is on an AU for pregnancy or after pregnancy coverage staff will deny the P06 as those programs offer full coverage and cover FPO services.   

WAC 182-532-500 Family Planning only program - Purpose

WAC 182-532-500  Family Planning only program - Purpose.

Effective October 1, 2019

The purpose of the family planning only programs is to provide family planning services to:

  1. Improve access to family planning and family planning-related services;
  2. Reduce unintended pregnancies; and
  3. Promote healthy intervals between pregnancies and births.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

WAC 182-532-510 Family Planning only program - Client eligibility

WAC 182-532-510 Family planning only program—Client eligibility

Effective October 6, 2025

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:
    1. 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);
    2. Be a Washington state resident, as described under WAC 182-503-0520;
    3. Have an income at or below two hundred sixty percent of the federal poverty level, as described under WAC 182-505-0100;
    4. Need family planning services; and
    5. Have been denied apple health coverage within the last 30 days, unless the applicant:
      1. 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;
      2. Is age 26 or younger and seeking services in confidence;
      3. Is a domestic violence victim who is seeking services in confidence; or
      4. 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:
    1. Pregnant;
    2. Sterilized;
    3. Covered under another apple health program that includes family planning services; or
    4. Covered by concurrent creditable coverage, as defined in RCW 48.66.020, unless they meet criteria in (1) (e) (ii) or (iii) of this section.
  3. The agency does not limit the number of times a client may reapply for coverage.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

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