Clarifying information

How to report changes of circumstance and the effects of reported changes MAGI-Based Apple Health and Apple Health for Parents and Caretaker Relatives Classic Medicaid (aged, blind, disabled [SSI-related] and long-term care) Individuals can report changes: Log into their Healthplanfinder account, under Quick Links, select "Report a Change in Income or Household," and follow the prompts to report the change. Call the Healthplanfinder Customer Support Center (HPF CSC) at 1-855-923-4633 (toll free). The HPF CSC worker will go into the client's HPF account to enter the changes. Call the HCA Medical Eligibility Determination Services (MEDS) toll free at 1-800-562-3022. By mail to PO Box 946, Olympia, WA 98507. By fax to 360-841-7620 Individuals can report changes: Report the change in Washington Connection, either by logging into their account or clicking on the "Report a Change" link and following the prompts. Call the Community Service Division Customer Service Center toll free at 1-877-501-2233. By mail to DSHS, CSD-Customer Service Center, PO Box 11699, Tacoma, WA 98411-6699. By fax to 1-888-338-7410. Taking action on changes: When information about someone's circumstances becomes known: determine the impact on the person's benefits. This may include contacting them, contacting other parties, or asking for proof of their circumstances. Individual Reports: Take action based on changes the person reports by entering the changes into the Healthplanfinder. Third Party Reports: If we receive information from a third party, follow-up to decide how the information affects the person's/household's health care coverage. This may include contacting the person, contacting other parties, or asking for proof of their circumstances under WAC 182-503-0050 Verification Requirements for Apple Health. Taking action on changes: When information about someone's circumstances becomes known: determine the impact on the person's benefits. This may include contacting them, contacting other parties, or asking for proof of their circumstances. Individual Reports: Take action based on changes the person reports by entering the changes into the Healthplanfinder. Third Party Reports: If we receive information from a third party, follow-up to decide how the information affects the person's/household's health care coverage. This may include contacting the person, contacting other parties, or asking for proof of their circumstances under WAC 182-503-0050 Verification Requirements for Apple Health. When a change happens: The date of the change is normally the date a change occurs, such as when someone gets married, a newborn comes home from the hospital, someone moves to a new home. However, the date of a change in income is the date someone receives the newly reported income, such as a first paycheck that reflects a wage increase or a first paycheck for a new job. When a change happens: The date of the change is normally the date a change occurs, such as when someone gets married, a newborn comes home from the hospital, someone moves to a new home. However, the date of a change in income is the date someone receives the newly reported income, such as a first paycheck that reflects a wage increase or a first paycheck for a new job. Effect of a reported change: If a reported change results in a change in coverage, the change takes place on the first of the month following the month in which the change is reported, after advance and adequate notice has been given. Unlike in ACES, Healthplanfinder does not have the functionality to enter a change into a specific month. If an individual reports a change early, the worker should keep in mind that the change should not be entered into Healthplanfinder before the month in which the change takes place. Effect of a reported change: If a reported change results in a change in coverage, the change takes place on the first of the month following the month in which the change is reported, after advance and adequate notice has been given. In ACES, the worker can enter a change in the month that the change is reported to take place, including a future month. Changes reported via Apple Health medical application, renewal or redetermination: The worker can use an application or renewal at any time to update the certification period. AU member moves out of Washington State: Individuals must be residents of the state in order to be eligible for health care coverage under any Apple Health programs. If one or more members of the household (but not the entire household) leave the state, they may still be eligible for Apple Health. Refer to WAC 182-503-0520 Residency Requirements, to determine eligibility for the people who left the state.

Example

Sandy is hired for a new job on May 31st, begins work on June 10th, and receives her first paycheck on July 5th. As this is an income change, the date of Sandy's first paycheck, July 5th, is the date of the change. Sandy must report this change by August 5th based on WAC 182-504-0105 Reporting Requirements. If Sandy reports this change earlier (other than her reporting the change in Healthplanfinder), the worker should make sure the effective date of the change is when her first check is expected.

Pregnant individuals and children found eligible for a CN medical program are continuously eligible through the end of their certification period. The only exceptions are aging out of the program, moving out of state, failing to pay a required premium, incarceration, or death. See WAC 182-504-0015 .

Newborns approved for SSI

Newborns approved for SSI receive continuous CN for 12 months from the date of the SSI medical opening even if they are no longer under the SSI program.

If mail is returned, see if a forwarding address is provided.

If one is provided, update the address. No further action is necessary.

If one is not provided, terminate the assistance for loss of contact/whereabouts unknown. Advance notice is not necessary.

If the individual provides an updated Washington address at any time during the original certification period, the assistance unit is reinstated from the month of termination through the end of the original certification period. A new application is not necessary.

When a pregnancy ends, regardless of the reason, medical coverage continues through the end of the month containing the sixtieth day from the day pregnancy ends.

Pregnant individual pending spenddown

If the pregnant individual is pending spenddown when the baby is born and meets spenddown with the birth of the baby, she is eligible for 60 days postpartum MN extension.

See Medical Extensions for:

Medical Extension Report; or

A change resulting in eligibility for a medical extension.

If changes in income increase the spenddown liability, the change is effective the first of the month after the change. An increase in resources may affect MN eligibility.