WAC 182-508-0005 Washington apple health medical care services - eligibility and scope of coverage.

WAC 182-508-0005 Washington apple health medical care services - eligibility and scope of coverage.

Effective February 12, 2023

1. A person is eligible for state-funded Washington apple health medical care services (MCS) coverage to the extent of available funds if the person is:
   1. Determined by the department of social and health services to be eligible for benefits under:
      1. The aged, blind, or disabled program as described in WAC 388-400-0060;
      2. The housing and essential needs referral program as described in WAC 388-400-0070; or
      3. The survivors of certain crimes (SCC) program, as described in WAC 388-424-0035, which includes victims of human trafficking as described in RCW 74.04.005;
   2. Not eligible for another federally funded categorically needy (CN) (as defined in WAC 182-500-0020) or alternative benefits plan (ABP) (as defined in WAC 182-500-0010) Washington apple health program and
   3. Not residing in a public institution as defined in WAC 182-500-0050.
2. If an enrollment cap exists under WAC 182-508-0150, a waiting list of people may be established.
3. A person's period of eligibility for MCS is the same as the person's period of eligibility for:
   1. The aged, blind, or disabled program as described in WAC 388-449-0150;
   2. The person's incapacity authorization period for the housing and essential needs referral program as described in WAC 388-447-0110;
   3. The person's period of eligibility for the SCC program as described in WAC 388-424-0035.
4. The MCS program covers only the medically necessary services defined in WAC 182-501-0060.
5. The MCS program does not cover medical services received outside the state of Washington unless the medical services are provided in a border city listed in WAC 182-501-0175.