Classic (non-MAGI) based programs manual

Important: Stay covered! Are you enrolled in Apple Health (Medicaid) coverage? Make sure your address and phone number are up to date so you can stay enrolled. Report a change.

HCA’s lobby is temporarily closed for walk-in customer service. Learn about customer service options.

Apple Health for Refugees

Revised Date: 
September 30, 2021

Purpose: To describe the program rules for the refugee medical program.

WAC 182-507-0130 Refugee medical assistance (RMA).

Effective November 8, 2020

  1. You are eligible for refugee medical assistance (RMA) if all the following conditions are met.  You:
    1. Meet immigration status requirements of WAC 182-507-0135;
    2. Have countable resources below one thousand dollars on the date of application;
    3. Have countable income equal to or below two hundred percent of the federal poverty level (FPL) on the date of application. The following income is not considered when determining eligibility for RMA:
      1. Resettlement cash payments made by the voluntary agency (VOLAG);
      2. Income of a sponsor is not counted unless the sponsor is al-so part of your assistance unit; and
      3. Income received after the date of application.
    4. Provide the name of the VOLAG which helped bring you to the United States so that the department of social and health services (DSHS) can promptly notify the VOLAG (or sponsor) about the medical application.
  2. If you receive refugee cash assistance (RCA) you are eligible for RMA as long as you are not otherwise eligible for medicaid or a children's health care program as described in WAC 182-505-0210. You do not have to apply for or receive RCA in order to qualify for RMA.
  3. You are not eligible to receive RMA if you are:
    1. Already eligible for medicaid or a children's health care program as described in WAC 182-505-0210;
    2. A full-time student in an institution of higher education un-less the educational activity is part of a DSHS-approved individual responsibility plan (IRP); or
    3. A nonrefugee spouse of a refugee.
  4. If approved for RMA, the agency or its designee issues an approval letter in both English and your primary language. The agency or its designee also sends a notice every time there are any changes or actions taken which affect your eligibility for RMA.
  5. You may be eligible for RMA coverage of medical expenses incurred during the three months prior to the first day of the month of the application. Eligibility determination will be made according to medicaid rules.
  6. If you are a victim of human trafficking you must provide the following documentation and meet the eligibility requirements in sub-sections (1) and (2) of this section to be eligible for RMA:
    1. Adults, eighteen years of age or older, must provide the original certification letter from the United States Department of Health and Human Services (DHHS). No other documentation is needed. The eight-month eligibility period will be determined based on the en-try date on ((the individual's)) your certification letter;
    2. A child victim under the age of eighteen does not need to be certified. DHHS issues a special letter for children. Children also have to meet income eligibility requirements;
    3. A family member of a certified victim of human trafficking must have a T-2, T-3, T-4, or T-5 visa (derivative T-Visas), and the family member must meet eligibility requirements in subsections (1) and (2) of this section.
  7. The entry date for an asylee is the date that asylum status is granted. For example, you entered the United States on December 1, 1999, as a tourist, then applied for asylum on April 1, 2000, interviewed with the asylum office on July 1, 2000, and were granted asylum on September 1, 2000. The date of entry is September 1, 2000, and that is the date used to establish eligibility for RMA.
  8. RMA ends on the last day of the eighth month from the month you entered the United States. For example, if you entered the United States on May 28, 2011, you are eligible through the end of December 2011. You may receive RMA benefits for more months if you are in a category of persons for whom the federal Office of Refugee Resettlement has extended the eligibility period.
  9. If you are approved for RMA you are continuously eligible through the end of the eighth month after your entry to the United States, regardless of an increase in income.
  10. The agency, or its designee, determines eligibility for medicaid and other medical programs for your spouse when the spouse arrives in the United States. If the spouse is not eligible for medicaid due to your countable income, the spouse is still eligible for RMA for eight months following the spouse's entry into the United States.
  11. If you disagree with a decision or action taken on the case by the agency, or its designee, you have the right to request a review of the case action(s) or request an administrative hearing (see chapter 182-526 WAC). The request must be received by the agency, or its designee, within ninety days of the date of the decision or action.

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 182-507-0135 Immigration status requirement for refugee medical assistance (RMA).

Effective March 29, 2022

  1. An individual is eligible for refugee medical assistance (RMA) if the individual provides documentation issued by the United States Citizenship and Immigration Services (USCIS) to show that the individual is:
    1. Admitted as a refugee under section 207 of the Immigration and Nationalities Act (INA);
    2. Paroled into the United States as a refugee or asylee under section 212 (d)(5) of the INA;
    3. Granted conditional entry under section 203 (a)(7) of the INA;
    4. Granted asylum under section 208 of the INA;
    5. Admitted as an Amerasian immigrant from Vietnam through the orderly departure program, under section 584 of the Foreign Operations Appropriations Act, incorporated in the FY88 continuing resolution P.L. 100-212;
    6. A Cuban-Haitian entrant who was admitted as a public interest parolee under section 212 (d)(5) of the INA;
    7. Certified as a victim of human trafficking by the federal Office of Refugee Resettlement (ORR);
    8. An eligible family member of a victim of human trafficking certified by ORR who has a T-2, T-3, T-4, or T-5 visa; or
    9. Admitted as special immigrant from Iraq or Afghanistan under one of the following:
      1. Special immigrant status under section 101 (a) (27) of the INA;
      2. Special immigrant conditional permanent resident; or 
      3. Parole under section 602 (b) (1) of the Afghan Allies Protection Act of 2009 or section 1059 (a) of the National Defense Authorization Act of 2006.
    10. An Afghan granted humanitarian parole between July 31, 2021, and September 30, 2022, their spouse or child, or a parent or guardian of an unaccompanied minor who is granted parole after September 30, 2022 under section 2502 of the Extending Government Funding and Delivering Emergency Assistance Act of 2021.
  2. A permanent resident alien meets the immigration status requirements for RCA and RMA if the individual was previously in one of the statuses described in subsection (1)(a) through (i) of this section.

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

  1. Recipients of Refugee Cash Assistance (RCA) are automatically eligible for RMA. A person who is eligible for RCA may choose not to receive cash assistance and still receive RMA.
  2. RMA eligibility is established as follows on the basis of an applicant's income (and resources for those ages 65 and over) on the date of the application, rather than averaging income over the application processing period.
  3. A student enrolled in an institution of higher education and carrying a full-time academic workload is considered a full-time student. A full time student is eligible for RMA only if educational activity is a part of his or her personal employment plan.
  4. An applicant who is not eligible for RCA because of income may be eligible for RMA. Applicants must meet monthly income standards up to 200% of FPL in the month of application.

Note: Individuals from Iraq or Afghanistan who were granted Special Immigrant status under section 101 (a)(27) of the INA, their spouses and unmarried children under 21 are qualified aliens and eligible for federally funded benefits to the same extent and for the same time period as refugees. Their eligibility period starts from the date of entry into the United States or, if it occurred after the US entry, the date the Special Immigrant status was granted as indicated on the I-551 (green card).

For more information on documentation, Immigration Status codes, benefit eligibility and step-by-step process, please see Desk Aid Iraqi and Afghan Special Immigrants Benefits.

Worker responsibilities

For clients under age 65 who are refugees or have other eligible immigration statuses, HCA determines eligibility for modified adjusted gross income (MAGI)-based Apple Health programs first.

  1. Applications for medical assistance should be submitted through Healthplanfinder. If you experience an issue when submitting the application, complete a paper application and fax to HCA at 360-725-1158, to the attention VOLAG or emailed​ and include:
    • Primary applicant name
    • Healthplanfinder app ID
    • Managed care organization (MCO) plan selection (optional)
    • Error code (if any)
  2. If applicant is ineligible for MAGI-based Apple Health, they should be referred to DSHS for screening for Classic Medicaid or Refugee Medical Assistance (RMA) program. For clients over age 65 who are refugees or have other eligible immigration statuses, DSHS determines eligibility.
  3. For Refugee/Asylee (defined as a Refugee, Asylee, Amerasian, and Cuban Haitian Entrants, Special Immigrants Visa holders from Iraq and Afghanistan, and Victims of Trafficking) who are under 65 years old or aged, blind and/or disabled - completed applications for medical assistance should be faxed to HCA at 360-725-1158, to the attention of VOLAG or emailed to
  4. Refugee and other eligible immigration status applicants who are over 65 years or older, blind, or disabled do not need to be denied MAGI-based Apple Health. These applicants should be referred directly to DSHS for screening for Classic Medicaid. Applications can be completed in person at a local CSO, online at Washington Connection, or faxed to CSD at 1-888-338-7410 to be screened for Classic Medicaid.

Appendix 1. - List of resettlement Agencies (VOLAG) in Washington State.