Apple Health eligibility manual

Apple Health (Medicaid) manual revision log

Apple Health (Medicaid) manual WAC index


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 overview

Who can apply for whom

Information needed


Time to process


General Eligibility Requirements

Social Security number


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 long term services and supports (LTSS)

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 services and supports

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


Long-term services and supports authorized under Apple Health

Modified Adjusted Gross Income (MAGI) - based Institutional Apple Health

Managed Care and Long-Term Care

Medicare and Long-Term Care

Post-eligibility index


Resource eligibility index

State-funded Long-term care for noncitizens

Standards - Long Term Care (LTC) Long Term Services and Supports (LTSS)

Third party resources and long term care insurance

Verification requirements

Working clients on long-term services and supports


Hospice index

Hospice overview

Contact hospice program eligibility

Eligibility for hospice as a service

Hospice eligibility (with institutional Medicaid rules)

Electing hospice services - DSHS agency and client

Hospice applications - clients eligible for categorically needy (CN) coverage

Hospice applications - clients not eligible for a non-institutional CN program

Hospice changes or death reported

Hospice and Long-term Services and Supports (LTSS) programs

Hospice special circumstances

Hospice agency contacts

Trusts, Annuities and Life Estates


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


Administrative Hearings

Authorized representatives

Certification periods

Changes of Circumstance

Civil rights and complaints


Confidentiality data sharing

Confidentiality definitions

Equal Access services

Estate recovery

Justice Involved Individuals


Limited English Proficiency (LEP) services

Automated Client Eligibility (ACES) program codes

Quality assurance


Scope of Care

Service Cards

Third Party Liability