Worker responsibilities

Every month Apple Health eligible individuals age 65 and older not already receiving Medicare are asked to provide proof of application for Medicare. The Medicare Buy-in unit in Olympia (call toll free 1-800-562-3022) manages this workload. The following process is followed:

Individuals are mailed a letter generated by barcode around the 20th of the month asking for proof of application for Medicare. The letter is provided in the individual's primary language and in English to the individual and to the individual's authorized representative. Only the English version is stored in DMS. All letters have a business reply postage paid return envelope addressed to the Medicare Buy-in Unit for returning the proof of Medicare application. Verification can be returned to any DSHS office or mailed to the DSHS Imaging Center.

Thirty days or more after the first letter is sent, the Medicare Buy-in Unit works the ticklers to review for proof of application for Medicare.

If no proof is received, a second letter is sent to the individual requesting proof of application for Medicare and again ticklers are set for the Medicare Buy-in Unit to review the case for proof.

If no proof is received from the second letter, the Medicare Buy-in Unit generates an action request to the worker of record asking that the individual be sent a termination of Medicaid notice under WAC 182-503-0505 General Eligibility and WAC 182-503-0540 Non Cooperation with Third Party Liability.

Proof Received After Termination – If the former recipient provides verification of application for Medicare their Medicaid case can be reactivated. If the verification comes in during the period of the original certification period the case should be opened with no further contact with the individual. If verification is received after the original certification period ends than a new application is necessary.