WSR 18-11-071
PERMANENT RULES
HEALTH CARE AUTHORITY
[Filed May 15, 2018, 1:01 p.m., effective June 15, 2018]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The agency is amending these rules to include tailed [tailored] supports for older adults (TSOA) in subsection (5). The agency is also amending the rules to clarify both who may apply and language regarding the application process for these programs, and to update a web site. In addition, the agency added a new subsection (11) to make it clear that authorized representatives may apply on the applicant's behalf.
Citation of Rules Affected by this Order: Amending WAC 182-503-0005.
Statutory Authority for Adoption: RCW 41.05.021, 41.05.160.
Adopted under notice filed as WSR 18-07-060 on March 15, 2018.
Changes Other than Editing from Proposed to Adopted Version:
Proposed/
Adopted
WAC Subsection
Reason
WAC 182-503-0005 Washington apple healthHow to apply
Proposed
(3)(b) By completing the application for aged, blind, disabled/long-term care coverage (HCA 18-005) and mailing or faxing to DSHS; or
Removed "or" following subsection (b), as subsection (c) had been the last subsection under (3).
Adopted
(3)(b) By completing the application for aged, blind, disabled/long-term care coverage (HCA 18-005) and mailing or faxing to DSHS; or
Proposed
(3)(c) In person at a local DSHS CSO or home and community services (HCS) office.
Added "or" following subsection (c) because a new subsection (d) now follows.
Adopted
(3)(c) In person at a local DSHS CSO or home and community services (HCS) office.; or
Adopted
(3)(d) As specified in subsection (2) of this section, if you are a child, pregnant, a parent or caretaker relative, or an adult age sixty-four and under without medicare.
New subsection clarifies that persons under age sixty-five with disabilities may apply through Washington Healthplanfinder.
Proposed
(4) You may receive help filing an application:
(a) For household containing people described in subsection (2) of this section: …
Housekeeping corrections.
Adopted
(4) You may receive help filing an application:.
(a) For households containing people described in subsection (2) of this section: …
Proposed
(7) For the confidential pregnant minor program under WAC 182-505-0117 and for minors living independently, you must complete a separate application directly with us (the medicaid agency).
(8) More information on how to give us an application may be found at the agency's web site: www.hca.wa.gov/free-or-low-cost-health-care.
Combining subsections (7) and (8) helps clarify that the provision applies to teens. Adding the parenthetical "search for teen" will help readers locate this information.
Adopted
(7) For the confidential pregnant minor program under WAC 182-505-0117 and for minors living independently, you must complete a separate application directly with us (the medicaid agency).
(8) More information on how to give us an application may be found at the agency's web site: www.hca.wa.gov/free-or-low-cost-health-care (search for "teen").
Proposed
(12) We help you with your application or renewal for apple health in a manner that is accessible to you if you:
(a) Are a person with disabilities, impairments, or other limitations and choose equal access services as described in WAC 182-503-0120; or
(b) Have limited-English proficiency as described in WAC 182-503-0110;
These revisions clarify that the equal access (EA) services offered are as specified in WAC 182-503-0120 and identifies the ways in which a person receives EA services.
Adopted
(12) We help you with your application or renewal for apple health in a manner that is accessible to you. We provide equal access (EA) services as described in WAC 182-503-0120 if you:
(a) Are a person with disabilities, impairments, or other limitations and choose equal access services as described in WAC 182-503-0120 Ask for EA services, you apply for or receive long-term services and supports, or we determine that you would benefit from EA services; or
(b) Have limited-English proficiency as described in WAC 182-503-0110.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: May 15, 2018.
Wendy Barcus
Rules Coordinator
AMENDATORY SECTION (Amending WSR 17-15-061, filed 7/13/17, effective 8/13/17)
WAC 182-503-0005 Washington apple healthHow to apply.
(1) You may apply for Washington apple health at any time.
(2) For apple health programs for children, pregnant people, parents and caretaker relatives, and adults age sixty-four and under without medicare((, parents and caretaker relatives (modified adjusted gross income (MAGI)):
(a))) (including people who have a disability or are blind), you may apply:
(((i))) (a) Online via the Washington Healthplanfinder at ((http://www.wahealthplanfinder.org)) www.wahealthplanfinder.org;
(((ii))) (b) By calling the Washington Healthplanfinder customer support center ((number)) and completing an application by telephone;
(((iii))) (c) By completing the application for health care coverage (HCA 18-001P), and mailing or faxing to Washington Healthplanfinder; or
(((iv) Through)) (d) At a department of social and health services (DSHS) community services office (CSO).
(((b) If you need help filing a MAGI-based apple health application, you may:
(i) Contact the Washington Healthplanfinder customer support center number listed on the application for health care coverage form (HCA 18-001P); or
(ii) Contact a navigator, health care authority community assistor, or broker.))
(3) If you seek apple health ((and have a disability or are blind, age sixty-five or older, eligible for medicare, or need long-term services and supports (non-MAGI))) coverage and are age sixty-five or older, have a disability, are blind, need assistance with medicare costs, or seek coverage of long-term services and supports, you may apply:
(a) Online via Washington Connection at ((http://www.WashingtonConnection.org)) www.WashingtonConnection.org;
(b) By completing the application for aged, blind, disabled/long-term care coverage (HCA 18-005) and mailing or faxing to DSHS; ((or))
(c) In person at a local DSHS CSO or home and community services (HCS) office; or
(d) As specified in subsection (2) of this section, if you are a child, pregnant, a parent or caretaker relative, or an adult age sixty-four and under without medicare.
(4) ((For apple health that is not based on MAGI, you may apply if you are:
(a) Age sixty-five or older;
(b) Eligible for medicare;
(c) Applying for health care based on blindness or disability;
(d) Applying for long-term services
and supports; or
(e) Applying for assistance with medicare premiums.
(5))) You may receive help filing an application ((by:
(a) Visiting)).
(a) For households containing people described in subsection (2) of this section:
(i) Call the Washington Healthplanfinder customer support center number listed on the application for health care coverage form (HCA 18-001P); or
(ii) Contact a navigator, health care authority volunteer assistor, or broker.
(b) For people described in subsection (3) of this section who are not applying with a household containing people described in subsection (2) of this section:
(i) Call or visit a local DSHS CSO or HCS office; or
(((b) Calling)) (ii) Call the DSHS community services customer service contact center number listed on the medicaid application form.
(5) To apply for tailored supports for older adults (TSOA), see WAC 182-513-1625.
(6) You must apply directly with the service provider for the following programs:
(a) The breast and cervical cancer treatment program under WAC 182-505-0120;
(b) The TAKE CHARGE program under chapter 182-532 WAC; and
(c) The kidney disease program under chapter 182-540 WAC.
(7) For the confidential pregnant minor program under WAC 182-505-0117 and for minors living independently, you must complete a separate application directly with us (the medicaid agency).
More information on how to give us an application may be found at the agency's web site: ((http://www.hca.wa.gov)) www.hca.wa.gov/free-or-low-cost-health-care (search for "teen").
(8) As the primary applicant or head of household, you may start an application for apple health by((:
(a))) providing your:
(((i))) (a) Full name;
(((ii))) (b) Date of birth; ((and
(iii))) (c) Physical address, and mailing addresses (if different)((.
(b) Signing the application)); and
(d) Signature.
(9) To complete an application for apple health, you must also give us all of the other information requested on the application.
(10) You may have an authorized representative apply on your behalf as described in WAC 182-503-0130.
(11) We help you with your application or renewal for apple health in a manner that is accessible to you. We provide equal access (EA) services as described in WAC 182-503-0120 if you:
(a) ((Are a person with disabilities, impairments, or other limitations and may need equal access services as described in WAC 182-503-0120)) Ask for EA services, you apply for or receive long-term services and supports, or we determine that you would benefit from EA services; or
(b) Have limited-English proficiency as described in WAC 182-503-0110.