The purpose of this chapter is to establish criteria for state residents for participation in medicare supplemental coverage available through the HCA.

Unless otherwise specifically provided, the definitions contained in this section apply throughout this chapter.

(1) "HCA" means the Washington state health care authority.

(2) "Health plan," or "plan" means any individual or group: Policy, agreement, or other contract providing coverage for medical, surgical, hospital, or emergency care services, whether issued, or issued for delivery, in Washington or any other state. "Health Plan" or "plan" also includes any group health plan that is maintained by any state and governed by the Public Health Services Act in 42 U.S.C. Chapter 6A, self-insured coverage governed by the federal Employee Retirement Income Security Act of 1974, coverage through the Washington state health insurance pool as described in chapter 48.41 RCW, coverage through the medicaid program as described in Title 74 RCW, and coverage through the Washington state health benefit exchange as described in chapter 43.71 RCW. "Health plan" or "plan" does not mean or include: Hospital confinement indemnity coverage as described in WAC 284-50-345; disability income protection coverage as described in WAC 284-50-355; accident only coverage as described in WAC 284-50-360; specified disease and specified accident coverage as described in WAC 284-50-365; limited benefit health insurance coverage as described in WAC 284-50-370; long-term care benefits as described in chapter 48.84 RCW; or limited health care coverage (e.g., dental only).

(3) "Lapse in coverage" means a period of time greater than sixty-three continuous days without coverage by a health plan.

(4) "Resident" means a person who demonstrates that they live in the state of Washington by providing evidence of residency.

A resident is eligible to apply for medicare supplemental coverage available through the HCA provided the resident is:

(1) Enrolled in Parts A and B of medicare; and

(2) Not eligible to purchase coverage as a retired or disabled employee under RCW 41.05.195.

Residents meeting eligibility requirements may apply for medicare supplemental coverage available through the HCA:

(1) No earlier than thirty days before they are enrolled in both Parts A and B of medicare;

(2) Within sixty-three days after becoming a resident of Washington state;

(3) During any open enrollment period established by federal or state law;

(4) During any open enrollment period established by the HCA subsequent to the initial open enrollment period provided that the applicant is replacing a health plan with no lapse in coverage; or

(5) When replacing coverage as described in RCW 48.66.045 or when enrolling during a guaranteed issue period as described in RCW 48.66.055.