Revised November 21, 2016
Purpose: Most Apple Health programs are limited to Washington residents. This chapter explains how the agency determines who meets the residency requirement.
A resident is someone who currently lives in Washington state AND:
- Intends to continue living in Washington permanently or for an open-ended period of time; OR
- Entered the state looking for a job; OR
- Entered the state with a job commitment.
Residency depends on a person's intent or purpose in coming to Washington state at the time of application and renewal.
A person is not considered a resident of Washington if he or she enters the state only for medical care. The only exception is for someone who is moving directly to a nursing facility in Washington.
Migrant/seasonal farmworkers working in Washington and maintaining a residence in another state are considered Washington state residents. The person meets Washington's residency requirements because they currently live in Washington and entered the state with a job commitment.
The Residency flowchart provides more information about how to determine a person's residency status.
Persons Who Are Temporarily in Washington
Persons visiting Washington are not considered residents of Washington. Examples of those who are NOT residents include:
- Person just moved to Washington without a job commitment and is not looking for work, but does not intend to stay.
- Person is attending a college in Washington state from out of state and intends to return home after completing school.
- Person is a temporary visa holder. Generally, a temporary visa holder is not a Washington State resident, unless he or she:
- Intends to reside in Washington after the visa expires,
- Entered the state with a job commitment (most typical with business visas), or
- Entered the state looking for a job.
Business visa holders who enter the state with a job commitment meet residency requirements because the visa holder has a job commitment, even if the visa is temporary.
Tourist/visitor visa holders may meet residency requirements if they declare intent to continue residing in Washington after the visa expires. When questionable, one way in which tourist/visitor visa holders may show they intend to reside in Washington is to apply for adjustment with the United States Citizenship and Immigration Services/Department of Homeland Security (USCIS). However, applying for adjustment with USCIS is not required.
Residency of Minors for Washington Apple Health
A minor (under age 18) is a resident of the state in which he or she is living (other than on a temporary basis) or the state in which the parent or caretaker is looking for or has a job. If a minor is living in Washington, the minor is considered a resident unless the parent/guardian or the minor declares that they plan to leave the state.
For a minor who is able to declare intent, such as minors age 13 and older, the minor can attest to their residency.
For a minor unable to declare intent, the minor’s residency follows the minor’s parent or guardian’s residency status.
Temporarily Out of State
A person may be temporarily out of state. There is no specified period before the person loses Washington State residency. However, they must demonstrate intent to continue to reside in Washington after purpose for leaving the state is completed. Intent can be shown by a current lease agreement or utility bill.
Special Exception for Nursing Facilities
Persons who come to Washington solely for medical care in a nursing facility may be considered residents of Washington. They can even maintain a residence in another state if they hope to return. However, if a person is placed in a nursing facility by another state, the person is considered a resident of the state that placed them.
Apple Health eligibility continues for a Washington resident who is absent temporarily and will return. For example, a person who goes from Washington State to a border facility for rehabilitation for 4 to 6 weeks and will return to Washington is considered a resident.
Receipt of Medicaid Coverage in Another State
When a person moves to Washington and is currently receiving Medicaid from the other state, HCA will provide Apple Health coverage to the new Washington resident. The person needs to contact the other state to report the move.
Access to Care Outside of Washington for Active Recipients
Active recipients who are temporarily out of state who need care should contact their managed care plan or Health Care Authority’s Medical Assistance Customer Service Center (MACSC) at 1-800-562-3022.
Example - Migrant Farm Worker
A person lives in Arizona, but comes to Washington State with his family for a 3-4 month crop season. They plan to return to Arizona when the season is over. Because they entered the state with a job commitment, they are residents.
Example - Temporarily Out of State to Care for Relative
A person receiving Apple Health coverage must stay with her ill grandmother in another state. She expects to be gone for several months. She is still a resident of Washington.
Example - Temporarily Out of State for Job
A person leaves Washington to take a temporary job in another state. She is planning to return to live with her parents when the job ends, which may be in about 3 to 6 months. She will be renting an apartment in the other state. She is still a resident of Washington State because she plans to return to Washington after her temporary job ends.
Example - Apple Health Coverage for SSI Recipients Who Move to Washington
When an SSI recipient moves to Washington and continues to receive their state supplemental payment (SSP) benefit from the other state, the state paying the benefit is considered to be the person’s state of residence. However, if the other state refuses to provide medical services in Washington, then the person can be approved for Apple Health. The person needs to contact the Social Security Administration at 1-800-772-1213 to change their address.
Example - Residency of Child Separate from Residency of Parents
Mom and dad are in the US on student visas, attending college. They have a teenage child who is in the country under her parents’ student visas. The child moves out of the parents' house and in with a friend and applies for Apple Health. The parents intend to return to their home country when they finish with school, but the child says that she is staying. Even though the parents do not intend to live in Washington, the child does intend to stay and is considered a resident.
Example - Applicant Temporarily in Washington on Student Visa
Dad and mom are in the US on student visas, attending college, and have one US-born child, age 2. The parents apply for Apple Health. When asked, they declare they intend to return to their home country with their child when they finish with school. Since the parents do not intend to live in Washington indefinitely, the parents and child are not considered residents.
Example - Applicant Who Entered Washington for Medical Care
A family came to Washington State from Montana for cancer treatment at a local children’s hospital and plans to return as soon as their child completes treatment. The family will be here for a minimum of six months and could possibly be longer depending on the progress the child makes from the treatment. Since the family entered the state for medical care and they plan to return home, they are not considered residents.
Example – Applicant Visiting the US Gives Birth
A woman enters the US from overseas with a tourist visa. She gives birth to a child and both return home after a two-week stay. Neither the mother nor child are considered residents.
A person’s residency may be questionable when other information does not match their attestation. For example, a person lists his address in another state, country, or housing at facilities for hospitalized patients. Determine whether they are residents by asking questions, such as:
- Temporary visa holders: what has changed in your circumstances to change your intent that you filed with their current visa?
No verification is needed -- document the intent and determine if the intent is reasonable.
- Other questionable circumstances: Is the person keeping a home, property or residence in the state/country that person left?
- If no, the person meets residency requirements with the declared intent.
- If yes, did the person enter Washington State with a job commitment or looking for a job? If yes, the person meets residency requirements.
- If the person is still maintaining his or her residence and the explanation is not reasonable, the person is not a Washington resident.
For Classic Medicaid programs, see the Client Details screen in ACES 3G.