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182-505-0240  <<  182-505-0250 >>   182-505-0300

PDFWAC 182-505-0250

Washington apple healthMAGI-based adult medical.

(1) Effective on or after January 1, 2014, a person is eligible for Washington apple health (WAH) modified adjusted gross income (MAGI)-based adult coverage when he or she meets the following requirements:
(a) Is age nineteen or older and under the age of sixty-five;
(b) Is not entitled to, or enrolled in, medicare benefits under Part A or B of Title XVIII of the Social Security Act;
(c) Is not otherwise eligible for and enrolled in mandatory coverage under one of the following programs:
(i) WAH SSI-related categorically needy (CN);
(ii) WAH foster care program; or
(iii) WAH adoption support program;
(d) Meets citizenship and immigration status requirements described in WAC 182-503-0535;
(e) Meets general eligibility requirements described in WAC 182-503-0505; and
(f) Has net countable income that is at or below one hundred thirty-three percent of the federal poverty level for a household of the applicable size.
(2) Parents or caretaker relatives of an eligible dependent child as described in WAC 182-503-0565 are first considered for WAH for families as described in WAC 182-505-0240. A person whose countable income exceeds the standard to qualify for family coverage is considered for coverage under this section.
(3) Persons who are eligible under this section are eligible for WAH alternative benefit plan as defined in WAC 182-500-0010 coverage. A person described in this section is not eligible for medically needy WAH.
(4) Other coverage options for adults not eligible under this section are described in WAC 182-508-0001.
[Statutory Authority: RCW 41.05.021, 41.05.160, Public Law 111-148, 42 C.F.R. § 431, 435, and 457, and 45 C.F.R. § 155. WSR 14-16-052, § 182-505-0250, filed 7/29/14, effective 8/29/14.]
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