General eligibility requirements that apply to all Apple Health programs

Chart of requirements

Revised Date: 
May 30, 2018

Verification Requirements Chart - Apple Health

What to verify Verification needed for MAGI-Based Apple Health for Adults, Pregnant Women, and Children? Verification needed for SSI Related Apple Health (Aged, Blind and Disabled)? Verification needed for Long-Term Supports and Services Apple Health?
Child Support obligation No - Deduction not allowed No - Deduction not allowed Yes - Only if income is garnished
Citizenship (1) Yes Yes Yes
Dependent care expenses No - Deduction not allowed No - Deduction not allowed No - Deduction not allowed
Disability  Not applicable Yes Yes
Health insurance premiums other than Medicare No - Deduction not allowed  Yes - for spenddown Yes - for spenddown
Household composition Only if questionable Only if questionable Yes - For spousal and deeming cases only
Immigration and lawful presence (1) Yes Yes Yes
Income Yes (2) Yes Yes
Medical expenses No - Deduction not allowed  Yes - For spenddown only Yes
Pregnancy No - Self-attestation accepted No - Self-attestation accepted No - Self-attestation accepted
Residency Only if questionable Only if questionable Only if questionable
Resources Not Applicable Yes - Except HWD Yes
Shelter costs Not Applicable Not applicable Yes - Spousal and dependent deeming cases only
Social Security Number Yes (3)(4) Yes (4) Yes (4)
Tax filing status No Not applicable  Not applicable
Tribal status No - Self-attestation accepted No - Self-attestation accepted No - Self-attestation accepted 

1 - Citizenship, identity, and lawful presence is verified using the SSA citizenship data match, federal hub services, or SAVE. If citizenship or lawful presence is unverified, verification is requested.

2 - Income for MAGI-based health care coverage is verified in post-eligibility review when electronic verifications do not confirm attested income.

3 - A newborn born to a mom on Washington Apple Health (see WAC 182-505-0210 (2)) is eligible for Washington Apple Health without meeting the SSN requirement until his or her first birthday.

4 - A client needs to provide his or her SSN, or proof one has been applied for, unless claiming an exemption for religious or domestic violence reasons.