Classic (non-MAGI) based programs manual

As of Wednesday, March 18, HCA’s lobby will be closed. In-person customer services for Apple Health and the PEBB and SEBB Programs will not be available. Learn more.

Apple Health Take-Charge (Family Planning)

Revised Date: 
July 25, 2014

Purpose: To explain the Take Charge program.

WAC 182-532-500  Family Planning only program - Purpose.

Effective September 1, 2013

  1. The purpose of the family planning only program is to provide family planning services to:
    1. Increase the healthy intervals between pregnancies; and
    2. Reduce unintended pregnancies in women who received medical assistance coverage while pregnant.
  2. Women receive these services automatically, regardless of how or when the pregnancy ends. This ten-month coverage follows the medicaid agency's sixty-day postpregnancy coverage.
  3. Men are not eligible for the family planning only program.

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 182-532-510 Family planning only program—Client eligibility

Effective October, 01, 2019

To be eligible for one of the family planning only programs listed in this section, a client must meet the qualifications for the program.

  1. Family planning only - Pregnancy related program.
    1. To be eligible for family planning only - Pregnancy related services, as defined in WAC 182-532-001, a client must be determined eligible for Washington apple health for pregnant clients during the pregnancy, or determined eligible for a retroactive period covering the end of a pregnancy. See WAC 182-505-0115.
    2. A client is automatically eligible for the family planning only - Pregnancy related program when the client's pregnancy ends.
    3. A client may apply for the family planning only program in subsection (2) of this section up to sixty days before the expiration of the family planning only - Pregnancy related program.
  2. Family planning only program.
    1. To be eligible for family planning only services, as defined in WAC 182-532-001, a client must:
      1. Be a United States citizen, U.S. National, or "qualified alien" as described under WAC 182-503-0535;
      2. Provide a valid Social Security number (SSN) or meet good cause criteria listed in WAC 182-503-0515(2);
      3. Be a Washington state resident, as described under WAC 182-503-0520;
      4. Have an income at or below two hundred sixty percent of the federal poverty level, as described under WAC 182-505-0100;
      5. Need family planning services; and
      6. Have been denied apple health coverage within the last thirty days, unless the applicant:
        1. Is age eighteen and younger and seeking services in confidence;
        2. Is a domestic violence victim who is seeking services in confidence; or
        3. Has an income of one hundred fifty percent to two hundred sixty percent of the federal poverty level, as described in WAC 182-505-0100.
    2. A client is not eligible for family planning only medical if the client is:
      1. Pregnant;
      2. Sterilized;
      3. Covered under another apple health program that includes family planning services; or
      4. Covered by concurrent creditable coverage, as defined in RCW 48.66.020, unless they meet criteria in (a)(vi) of this subsection.
    3. A client may reapply for coverage under the family planning only program up to sixty days before the expiration of the twelve-month coverage period. The agency does not limit the number of times a client may reapply for coverage.

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

Individuals must apply for the program through a Take Charge family planning provider. Family planning providers send completed applications for Take Charge to MEDS at HCA. All eligibility and service questions posed by Take Charge individuals should be referred to the Take Charge provider where they enrolled.

Example: Mary Sue is covered under Apple Health for Pregnant Women. She has her baby and reports this in Healthplanfinder. After she has her baby, she does not qualify for other Apple Health programs because her income is too high. She is potentially eligible for the Apple Health Take Charge program.

The Take Charge medical coverage type in ACES is P06. Participation in the Take Charge program is confidential even when members of the same household are receiving Take Charge.

Example: Members of the same family or household may not know that a spouse or minor is receiving Take Charge. Staff must not reveal who in the household is receiving Take Charge.

Worker Responsibilities

For a list of providers, visit HCA’s Take Charge (Family Planning non-Medicaid) webpage.

Take Charge individuals who inquire about their Family Planning coverage should be informed to contact their Take Charge provider.

Workers may contact the Take Charge Unit at 1-800-562-3022.

Note: Staff do not need to take any action to close AUs for Apple Health for Pregnant Women. ACES will automatically terminate these AUs when individuals become active in another medical program or when the certification period ends.