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PDFWAC 182-521-0200

Coverage after the public health emergency (PHE) ends.

(1) In response to the coronavirus (COVID-19) public health emergency (PHE) declared by the Secretary of the U.S. Department of Health and Human Services (HHS) and in response to Section 6008 of the Families First Coronavirus Response Act (Public Law 116-127), the medicaid agency:
(a) Continues your Washington apple health coverage until the end of the PHE unless your eligibility determination was made incorrectly, or you:
(i) Are deceased;
(ii) Move out-of-state;
(iii) Request termination of your coverage; or
(iv) No longer meet citizenship or immigration requirements as described in WAC 182-503-0535.
(b) Waives and suspends the collection of premiums through the last day of the calendar quarter in which the PHE ends for:
(i) Apple health for kids with premiums (CHIP), as described in WAC 182-505-0215; and
(ii) Health care for workers with disabilities (HWD) program, as described in WAC 182-511-1250.
(c) Excludes, for the duration of the PHE and a period of 12 months after the PHE ends, resources accumulated from participation that did not increase in response to Section 6008(b) of the Families First Coronavirus Response Act (FFCRA), as described in WAC 182-512-0550(24).
(2) If you receive continued apple health due to the suspension of certain eligibility rules during the PHE, the agency, after the PHE ends:
(a) Redetermines your eligibility for ongoing coverage using the process and timelines described in WAC 182-504-0035 and notifies you as required under chapter 182-518 WAC. You may update any information needed to complete a redetermination of eligibility, as described in WAC 182-504-0035.
(i) If you are no longer eligible for apple health, or you do not respond to our renewal request notice, you will receive 10 calendar days' advance notice before your coverage is terminated, as described in WAC 182-518-0025.
(ii) If your modified adjusted gross income (MAGI)-based coverage ends because you did not renew it, you have 90 calendar days from the termination date to complete your renewal. If you are still eligible for apple health, your benefits will be restored without a gap in coverage.
(iii) If your coverage is terminated, you have a right to an administrative hearing, as described in chapter 182-526 WAC.
(b) Begins collecting premiums for CHIP and HWD clients prospectively, beginning with the month following the quarter in which the PHE ends, based upon reported circumstances, and without collecting arrears.
(c) Resumes eligibility verification based on the factors described in WAC 182-503-0050.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 22-12-004, ยง 182-521-0200, filed 5/19/22, effective 7/1/22.]
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