Apple Health Medical Extension for Families and Caretaker Relatives

Revised September 19, 2014

Purpose: This category describes the Health Care Extension (N02) available to parenting/caretaker (N01) adults when their N01 coverage ends due to increased earnings or collection of spousal support.

WAC 182-523-0100 Washington apple health--Medical extension

WAC 182-523-0100 Washington apple health--Medical extension.

Effective October 1, 2017

A parent or caretaker relative who was eligible for and who received coverage under Washington apple health for parents and caretaker relatives, described in WAC 182-505-0240, in any three of the last six months is eligible, along with all dependent children living in the household, for twelve months' extended health care coverage if the person becomes ineligible for his or her current coverage due to increased earnings or hours of employment.
A person remains eligible for apple health medical extension unless:
1. The person:
  1. Moves out of state;
  2. Dies;
  3. Becomes an inmate of a public institution; or
  4. Leaves the household.
2. The family:
  1. Moves out of state;
  2. Loses contact with the agency or its designee or the whereabouts of the family are unknown; or
  3. No longer includes an eligible dependent child as defined in WAC 182-503-0565(2).
When a person or family is determined ineligible for apple health coverage under subsection (2)(a)(i) through (iii) or (b)(i) or (ii) of this section during the medical extension period, the agency or its designee redetermines eligibility for the remaining household members as described in WAC 182-504-0125 and sends written notice as described in chapter 182-518 WAC before apple health medical extension is terminated.

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.

Clarifying Information

Health Care Extension

Health Care Extension (N02) is CN coverage given only to parent/caretaker adults who become ineligible for Washington Apple Health Family (N01) coverage because of an increase in earned income or spousal support.
To qualify the adult must be eligible for Washington Apple Health Family (N01) coverage in three of the preceding six months.
Health Care Extension (N02) coverage is certified for twelve months. However, eligibility is not continuous. Changes in household circumstances may effect eligibility.
There is no renewal of the Health Care Extension (N02).

WAC 182-523-0130 Medical extension--Redetermination.

Effective August 24, 2014

When the agency or its designee determines the family or an individual family member is ineligible during the medical extension period, the agency or its designee must determine if they are eligible for another medical program.
Children are eligible for twelve month continuous eligibility beginning with the first month of the medical extension period.
When a family reports a reduction of income, the family may be eligible for the Washington apple health for parents and caretaker relatives program (described in WAC 182-505-0240) instead of medical extension benefits.
When a medical extension period is ending, the family is required to complete a renewal of eligibility as described in WAC 182-504-0035.
Postpartum and family planning extensions are described in WAC 182-505-0115.

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.

Clarifying Information

The individual receives a review at the end of the Health Care Extension certification period. Adults aren't eligible for consecutive N02 certifications.

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