WAC 182-508-0005 Eligibility for Washington apple health medical care services eligibility and scope of coverage.
Effective August 24, 2014
- A person is eligible for state-funded Washington apple health (WAH) medical care services (MCS) coverage to the extent of available funds if the person is:
- Determined by the department of social and health services to be eligible for benefits under either the aged, blind, or disabled program as described in WAC 388-400-0060 or the housing and essential needs referral program as described in WAC 388-400-0070; and
- 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) WAH program.
- If an enrollment cap exists under WAC 182-508-0150, a waiting list of persons may be established.
- A person's period of eligibility for MCS is the same as either the person's period of eligibility for the aged, blind, or disabled program as described in WAC 388-449-0150 or the person's incapacity authorization period for the housing and essential needs referral program as described in WAC 388-447-0110.
- The MCS program covers only the medically necessary services defined in WAC 182-501-0060.
- 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.