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

Effective August 24, 2014

  1. 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:
    1. 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
    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) WAH program.
  2. If an enrollment cap exists under WAC 182-508-0150, a waiting list of persons may be established.
  3. 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.
  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.