Family planning only programs—Eligibility.
To be eligible for one of the family planning only programs listed in this section, a client must meet the qualifications for that program.
(1) Family planning only - Pregnancy related program.
(a) To be eligible for family planning only - Pregnancy related services, as defined in WAC
182-532-001, a client must be determined eligible for Washington apple health for pregnant clients during the pregnancy, or determined eligible for a retroactive period covering the end of a pregnancy. See WAC
182-505-0115.
(b) A client is automatically eligible for the family planning only - Pregnancy related program when the client's pregnancy ends.
(c) A client may apply for the family planning only program in subsection (2) of this section up to sixty days before the expiration of the family planning only - Pregnancy related program.
(2) Family planning only program.
(a) To be eligible for family planning only services, as defined in WAC
182-532-001, a client must:
(i) Be a United States citizen, U.S. National, or "qualified alien" as described under WAC
182-503-0535;
(ii) Provide a valid Social Security number (SSN) or meet good cause criteria listed in WAC
182-503-0515(2);
(iii) Be a Washington state resident, as described under WAC
182-503-0520;
(iv) Have an income at or below two hundred sixty percent of the federal poverty level, as described under WAC
182-505-0100;
(v) Need family planning services; and
(vi) Have been denied apple health coverage within the last thirty days, unless the applicant:
(A) Is age eighteen and younger and seeking services in confidence;
(B) Is a domestic violence victim who is seeking services in confidence; or
(C) Has an income of one hundred fifty percent to two hundred sixty percent of the federal poverty level, as described in WAC
182-505-0100.
(b) A client is not eligible for family planning only medical if the client is:
(i) Pregnant;
(ii) Sterilized;
(iii) Covered under another apple health program that includes family planning services; or
(iv) Covered by concurrent creditable coverage, as defined in RCW
48.66.020, unless they meet criteria in (a)(vi) of this subsection.
(c) A client may reapply for coverage under the family planning only program up to sixty days before the expiration of the twelve-month coverage period. The agency does not limit the number of times a client may reapply for coverage.
[Statutory Authority: RCW
41.05.021,
41.05.160 and section 1115(a) of the Social Security Act. WSR 19-18-024, § 182-532-510, filed 8/28/19, effective 10/1/19. Statutory Authority: RCW
41.05.021,
74.09.520,
74.09.657,
74.09.659, and
74.09.800. WSR 13-16-008, § 182-532-510, filed 7/25/13, effective 9/1/13. WSR 11-14-075, recodified as § 182-532-510, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW
74.08.090,
74.09.520, and
74.09.800. WSR 05-24-032, § 388-532-510, filed 11/30/05, effective 12/31/05; WSR 04-05-011, § 388-532-510, filed 2/6/04, effective 3/8/04.]
