Apple Health eligibility manual

Apple Health (Medicaid) manual revision log

Apple Health (Medicaid) manual WAC index

Overview

Introduction overview

Health care for adults

Health care for pregnant women

Health care for children

Health care for the aged, blind, or disabled

Long-Term Care

Other programs

Scope of Care

Applications

Applications overview

Who can apply for whom

Information needed

Filing

Time to process

Denials

General Eligibility Requirements

Social Security Number

Residency

Citizenship and Immigration Status

Program standard for income and resources

Application for Medicare

Modified Adjusted Gross Income (MAGI) Program Requirements

MAGI Eligibility Requirements

Program Specific Eligibility Requirements

Classic (Non-MAGI) Medicaid Program Requirements

Apple Health for Supplemental Security Income (SSI) Recipients

Apple Health for SSI-Related Individuals

Apple Health for Workers with Disabilities

Apple Health Medicare Savings Programs

Apple Health for the Medically Needy and Spenddown

Non-Grant Medical Assistance (NGMA) Overview

Medical Care Services (MCS) program

Long-Term Care Program Requirements

Long-Term Care index

Overview- Long-term Services and Supports chart

Adult Abuse and Neglect Reporting - Adult Protective Services (APS)

Applications for LTC

AREP Screens for Long-Term Care cases

LTC Change of Circumstances

Definitions - Long-Term Services and Supports

Eligibility requirements index

Equal Access - Necessary Supplemental Accommodation (NSA) and Long-Term Care

DSHS and HCA forms, WACs, rule-making, and useful LTC links

Home and Community Based (HCB) waivers and programs using HCB waiver rules

Income requirements index

Institutions

Long-term services and supports authorized under Apple Health

Modified Adjusted Gross Income (MAGI) - based Institutional Care

Managed Care and Long-Term Care

Medicare and Long-Term Care

Post-eligibility index

Renewals

Resource eligibility index

State-funded Long-term care for non-citizens

Standards – LTC

Third Party resources and LTC insurance

Verification requirements

Working clients on Long-Term Care programs (Waiver, Residing in a Medical Institution, or MPC)

Hospice

Hospice index

Hospice overview

Contact us - HCS or CSO

Eligibility for hospice as a service

Eligibility for the Hospice program following institutional Medicaid rules

DSHS agency and individuals electing hospice services

Applications - individuals determined eligible for non-institutional CNP coverage

Applications - individuals not otherwise eligible for a non-institutional CNP program

Hospice change of circumstances

Hospice and ALTSA programs

Special circumstances

Hospice agency contacts

Trusts, Annuities and Life Estates

How trusts affect eligibility

How annuities affect eligibility

How life estates affect eligibility

Other Programs

Apple Health Alien Medical programs

Apple Health Kidney Disease Program (KDP)

Apple Health Prescription Drug Assistance Program (PDAP)

Care Delivery

Care Delivery - managed care

Patient Review and Coordination

Miscellaneous

Administrative Hearings

Authorized representatives

Certification periods

Changes of Circumstance

Civil rights and complaints

Confidentiality

Confidentiality data sharing

Confidentiality definitions

Equal Access services

Estate recovery

Justice Involved Individuals

Letters

Limited English Proficiency (LEP) services

Program codes

Quality assurance

Re-determination

Scope of Care

Service Cards

Third Party Liability

Verification