Classic (non-MAGI) based programs manual

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Apple Health Family Planning Only

Revised Date: 
July 23, 2021

Purpose: To explain the Take Charge program.

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

Effective October 1, 2019

The purpose of the family planning only programs is to provide family planning services to:

  1. Improve access to family planning and family planning-related services;
  2. Reduce unintended pregnancies; and
  3. Promote healthy intervals between pregnancies and births.

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 November 9, 2020

To be eligible for one of the family planning only programs listed in this section, a client must meet the qualifications for that program. For the purposes of this section, "full-scope coverage" means coverage under either the categorically needy (CN) program, the broadest, most comprehensive scope of health care services covered or the alternative benefits plan (ABP), the same scope of care as CN, applicable to the apple health for adults 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 the Washington apple health for pregnant women program 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. Provide a valid Social Security number (SSN) or proof of application to receive an SSN, be exempt from the requirement to provide an SSN as provided in WAC 182-503-0515, or meet good cause criteria listed in WAC 182-503-0515(2);
      2. Be a Washington state resident, as described under WAC 182-503-0520;
      3. Have an income at or below two hundred sixty percent of the federal poverty level, as described under WAC 182-505-0100;
      4. Need family planning services; and
      5. Have been denied apple health coverage within the last thirty days, unless the applicant:
        1. Has made an informed choice to not apply for full-scope coverage, including family planning;
        2. Is age eighteen or younger and seeking services in confidence;
        3. Is a domestic violence victim who is seeking services in confidence; or
        4. 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)(v) 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 have the option to apply for the program through a family planing provider or by submitting their own family planning only application. All eligibility questions can be answered by contacting the Health Care Authority at 1-800-562-3022. This program is confidential and the information is only shared with the individual  receiving the services or their designated authorized representative. 

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 family planning only program.

The family planning only medical coverage type in ACES is P06. Participation in the family planning only program is confidential even when members of the same household are receiving the services.

Example: Members of the same family or household may not know that a spouse or minor is receiving family planning only  services. 

For more information on family planning services, visit HCA's family planning webpage. 

Family planning only individuals who inquire about their family planning services should contact their provider.

Worker responsibilities

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.