Who can apply for whom

Revised date
Purpose statement

To explain who can apply for Apple Health coverage and for whom.

WAC 182-503-0010 Washington apple health -- Who may apply.

WAC 182-503-0010 Washington apple health -- Who may apply.

Effective January 16, 2020.

  1. You may apply for Washington apple health for yourself.
  2. You may apply for apple health for another person if you are:
    1. A legal guardian;
    2. An authorized representative (as described in WAC 182-503-0130);
    3. A parent or caretaker relative of a child age eighteen or younger;
    4. A tax filer applying for a tax dependent;
    5. A spouse; or
    6. A person applying for someone who is unable to apply on their own due to a medical condition and who is in need of long-term care services.
  3. If you reside in an institution of mental diseases (as defined in WAC 182-500-0050(1)) or a public institution (as defined in WAC 182-500-0050(4)), including a Washington state department of corrections facility, city, tribal, or county jail, or secure community transition facility or total confinement facility (as defined in RCW 71.09.020), you, your representative, or the facility may apply for you to get the apple health coverage for which you are determined eligible.
  4. You are automatically enrolled in apple health and do not need to submit an application if you are a:
    1. Supplemental security income (SSI) recipient;
    2. Person deemed to be an SSI recipient under 1619(b) of the SSA;
    3. Newborn as described in WAC 182-505-0210; or
    4. Child in foster care placement as described in WAC 182-505-0211.
  5. You are the primary applicant on an application if you complete and sign the application on behalf of your household.
  6. If you are an SSI recipient, then you, your authorized representative as defined in WAC 182-500-0010, or another person applying on your behalf as described in subsection (2) of this section, must turn in a signed application to apply for long-term care services as described in WAC 182-513-1315. 

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Clarifying Information

Usually, individuals age 18 or younger apply for health coverage with their custodial parent(s) or guardian(s). But, they may be able to get health coverage on their own if they:

  • Live separately from their parents/guardians and are not claimed by them as a tax dependent;
  • Are homeless;
  • Are pregnant; or
  • Need birth control or sexually transmitted infection care.

If an individual age 18 or younger wishes to apply for Apple Health, he or she must call 855-WAFINDER (855-923-4633).

Who can apply when there is a custodial dispute of a dependent?

The primary custodial parent or guardian.

In cases where it is not clearly established who the custodial parent is, whether because the court orders establishes joint custody or there is no formal order, the custodial parent is the parent with whom the child spends the most nights.

If it is claimed the child spends an equal number of nights with each parent, but for purposes of establishing Apple Health eligibility for that dependent, the agency accepts the application for the custodial parent or guardian that applied first.

This action does not prevent the other custodial parent or guardian from including that dependent on their application and counted towards their medical assistance unit.

For more information on determining a person's medical assistance unit see Household composition.

Who can apply for a deceased individual?

  1. Their spouse;
  2. The parent or caretaker relative as described in WAC 182-500-0020;
  3. A relative, either through blood, marriage, or adoption;
  4. The Executor, Administrator, or Personal Representative of the deceased's estate;
  5. A court appointed guardian who was appointed after the applicant or recipient's death; or
  6. Anyone legally authorized by the courts or by state law to act on behalf of the deceased or his or her estate.

Who cannot apply for a deceased individual?

  1. An Authorized Representative (AREP) who was designated while the applicant or recipient was living unless they are one of the following:
    • Their spouse;
    • The parent or caretaker relative as described in WAC 182-500-0020;
    • A relative, either through blood, marriage, or adoption;
    • The Executor, Administrator, or Personal Representative of the deceased's estate; or
    • Anyone legally authorized by the courts or by state law to act on the behalf of the deceased or his or her estate
  2. An individual or organization assigned guardianship or Power of attorney (POA) while the applicant or recipient was living.
    Guardianship and POA assigned while the individual is living ends after the applicant or recipient is deceased.

Note: This information does not apply to long-term care applications that were received prior to the applicant's death. ALTSA will continue to work with the applicant's designee to approve or deny the request.

Power of Attorney defined:

A "power of attorney" (POA) is a legal document giving one person the legal power to act on behalf of someone else. A POA can grant someone a wide range of powers or a narrow range; it depends on what is written in the POA. The only way to know what powers are granted by a POA is to read the POA itself. A POA ends if:

  • The applicant or recipient dies;
  • The applicant or recipient becomes incompetent;
  • The person who granted the power revokes the POA;
  • The person who is given power by a POA terminates the POA; or
  • A court invalidates the POA.

Durable Power of Attorney defined:

A durable power of attorney (DPOA) is a power of attorney that stays in effect even if the person who signed it becomes incompetent or incapacitated. A DPOA can grant someone a wide range of powers or a narrow range; it depends on what is written in the DPOA. The only way to know what powers are granted by a DPOA is to read the POA itself. 

Note: A person who is already legally incompetent cannot create a valid DPOA.

A DPOA ends if:

  • The applicant or recipient dies
  • The person who granted the power revokes the DPOA;
  • The person who is given power by a DPOA terminates the POA.
  • The person who is given power by a DPOA cannot be found; or
  • A court invalidates the DPOA.

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