Classic (non-MAGI) based programs manual

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Medical Care Services (MCS) program

Revised Date: 
February 1, 2022

Purpose: The Medical Care Services (MCS) Program provides health care coverage to lawfully present recipients of Aged, Blind, or Disabled (ABD) cash assistance and the Housing and Essential Needs (HEN) Referral program who are unable to access other Washington Apple Health (Medicaid) programs due to their citizenship / immigration status.

Beginning February 1, 2022, MCS provides health care coverage to recipients of the State Family Assistance (SFA) for Survivors of Certain Crimes cash program who are unable to access other health care coverage due to their citizenship/immigration status.

WAC 182-508-0005 Eligibility for Washington apple health medical care services eligibility and scope of coverage.

Effective February 1, 2022

  1. A person is eligible for state-funded Washington apple health medical care services (MCS) coverage to the extent of available funds if the person is:
    1. Determined by the department of social and health services to be eligible for benefits under:
      1. The aged, blind, or disabled program as described in WAC 388-400-0060;
      2. The housing and essential needs referral program as described in WAC 388-400-0070; or
      3. The survivors of certain crimes (SCC) program, as described in WAC 388-424-0035, which includes victims of human trafficking as described in RCW 74.04.005; and
    2. Not eligible for another federally funded categorically needy (CN) (as defined in WAC 182-500-0020) or alternative benefits plan (ABP) (as defined in WAC 182-500-0010) Washington apple health program.
  2. If an enrollment cap exists under WAC 182-508-0150, a waiting list of people may be established.
  3. A person's period of eligibility for MCS is the same as the person's period of eligibility for:
    1. The aged, blind, or disabled program as described in WAC 388-449-0150;
    2. The person's incapacity authorization period for the housing and essential needs referral program as described in WAC 388-447-0110;
    3. The person's period of eligiblity for the SCC program as described in WAC 388-424-0035.
  4. The MCS program covers only the medically necessary services defined in WAC 182-501-0060.
  5. The MCS program does not cover medical services received outside the state of Washington unless the medical services are provided in a border city listed in WAC 182-501-0175.

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 cannot apply for Medical Care Services (MCS); they access MCS by submitting an application for cash assistance online through Washington Connection, in person at their local DSHS Community Services Office, or over the phone at 877-501-2233.

In order to receive Medical Care Services (MCS), an individual must meet eligibility, income and resource requirements for either ABD cash assistance, Housing and Essential Needs (HEN) Referral or SFA for Survivors of Certain Crimes programs. 

MCS eligibility begins when ABD cash eligibility begins; HEN Referral eligibility begins; or SFA for Survivors of Certain Crimes cash program eligibility begins.
MCS eligibility ends when ABD cash eligibility ends; or HEN Referral eligibility ends; or SFA for Survivors of Certain Crimes cash program eligibility ends.

Cash assistance requirements

In order to receive Medical Care Services (MCS) an individual must meet:

  1. ABD cash assistance eligibility requirements as described in WAC 388-400-0060; or
  2. HEN Referral requirements eligibility requirements as described in WAC  388-400-0070; or
  3. SFA for Survivors of Certain Crimes cash program eligibility requirements as described in WAC 388-400-0010. 

Income and resource requirements outlined in Chapter 388-450 WAC and the citizenship and immigration requirements outlined in WAC 388-424-0015; and for SFA for survivors of Certain Crimes as described in WAC 388-424-0001(4)(5).

ABD cash disability requirements outlined in WAC 388-449-0001 or HEN Referral incapacity requirements outlined in WAC 388-447-0001; Or for SFA for Survivors of Certain Crimes Workfirst mandatory participant requirements described in WAC 388-310-0400.

The monthly income limits for:

  • ABD cash and HEN Referrals are described in WAC 388-478-0090.
  • SFA for Survivors of Certain Crimes is described in WAC 388-450-0162.

The ABD cash program provides SSI Facilitation services and a maximum cash grant of $197 for a one person assistance unit, or $248 for a two person assistance unit, as described in WAC 388-478-0033.

Note: Because ABD cash maximum income limits are higher than the program payment standard, an individual may be eligible for ABD cash without receiving cash grant. These individuals may be eligible for MCS if they are not eligible for a federally funded CN or ABP WAH program.

The HEN Referral program does not provide a cash grant. HEN Referral recipients are eligible for essential needs items (e.g. hygiene and cleaning supplies) and potential housing assistance from the Department of Commerce through its network of local providers.

ABD cash and HEN Referral recipients are subject to both financial eligibility and disability/incapacity reviews. Financial eligibility reviews are conducted every 6 to 12 months as required by WAC 388-434-0005. ABD cash disability reviews are conducted at least every 24 months as required by WAC 388-449-0150. A HEN Referral incapacity review is conducted at least every 12 months as required by WAC 388-447-0110.

SFA for Survivors of Certain Crimes recipients are subject to financial eligibility reviews every 6 to 12 months as required by WAC 388-434-0005 and WAC 388-418-0011.

There is a potential enrollment cap for MCS outlined in WAC 182-508-0150. Since the enrollment cap was put into law, the agency has not implemented any limits or disenrollment actions because there has been adequate funding to serve the enrolled population.

Worker Responsibilities

Worker Responsibilities are carried out by CSD staff

  1. When an individual is approved for ABD cash assistance, HEN Referral, or SFA for Survivors of Certain Crimes, review the case to determine if they are Federally Qualified to receive Medicaid.
  2. If the individual is not Federally Qualified to receive Medicaid, screen in an A-track Assistance Unit (AU) and approve MCS for the same certification period as ABD cash assistance, HEN Referral, or SFA for Survivors of Certain Crimes.
  3. At the time of Mid-Certification Review, Eligibility Review, or Disability / Incapacity Review, extend MCS eligibility if the individual remains eligible for ABD cash assistance, HEN Referral, or SFA for Survivors of Certain Crimes.
  4. Terminate MCS when eligibility for ABD cash assistance, HEN Referral, or SFA for Survivors of Certain Crimes ends.