Apple Health for Kids

Newborn Medical (N10): See WAC 182-505-0210 (2). Newborns are automatically entitled to receive this CN Medicaid program through the end of month of their first birthday as long as: Their birthparent was eligible for medical (Apple Health or CHIP) on the day of delivery, including any retroactive eligibility determination. For MN spenddown pending on the day of delivery, spenddown was met with the labor and delivery expenses, and The newborn is a Washington State resident. It is important that a ProviderOne ID be obtained as soon as possible after the day of delivery to ensure there are no interruptions in coverage. Until the baby has their own ProviderOne ID: Birthparent is on fee-for-service: The newborn is covered under the birthparent's ProviderOne ID through the month that includes the baby's 60th day of life or until they are assigned their own ProviderOne ID. Birthparent is on managed care: The newborn is covered under the birthparent's ProviderOne ID through the month in which the 21st day of life occurs. If the newborn's eligibility begins in a month other than the month of birth, the eligibility worker may need to use the retro medical process to approve missing months of eligibility.

Apple Health for Kids CN coverage (N11/N31): See WAC 182-505-0210 (3). These children receive federal or state-funded CN Medicaid. Federally-funded children are enrolled in a managed care plan while state funded children remain fee-for-service.

Apple Health for Kids with Premiums CN Coverage (N13/N33): See WAC 182-505-0210 (4). These children receive federal or state funded CN medical, but are required to pay a premium see WAC 182-505-0225 . Federally-funded children are enrolled in managed care, while state-funded children remain fee-for-service.

Apple Health for Kids (MN) Medically Needy coverage (F99, S99, K99): See WAC 182-505-0210 (4). These children receive slightly less coverage than CN Medicaid and do not enroll in managed care. They must meet a spenddown before any services are paid. See Spenddown for more information.

Children's Institutional coverage (K01, K95, K99): See WAC 182-505-0210 (3) WAC 182-514-0230 through WAC 182-514-0265: These children are approved for medical assistance based on institutional rules once they reside or are expected to reside in an institution for 30 days or longer.

Children's Alien Medical Program (AMP) coverage (F99): See WAC 182-505-0210 (5): These alien children are eligible for MN coverage for emergency medical services only. Their coverage under F99 does not require an acute and emergent medical need to set up the spenddown.

Nonqualified children eligibility

Nonqualified children under age 19 with family income under 312% FPL are related to and approved for the appropriate Apple Health for Kids program not AMP.