WAC 182-508-0005 Washington apple health medical care services - eligibility and scope of coverage.

WAC 182-508-0005 Eligibility for Washington apple health medical care services eligibility and scope of coverage.

Effective February 1, 2022

  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:
    1. Determined by the department of social and health services to be eligible for benefits under:
      1. The aged, blind, or disabled program as described in WAC 388-400-0060;
      2. The housing and essential needs referral program as described in WAC 388-400-0070; or
      3. 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; and
    2. 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.
  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:
    1. The aged, blind, or disabled program as described in WAC 388-449-0150;
    2. The person's incapacity authorization period for the housing and essential needs referral program as described in WAC 388-447-0110;
    3. 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.

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.