Incomplete and late reviews

If an administrative review for a renewal cannot be completed and no review has been completed over the phone or in-person, then the household is ineligible for coverage. No review form is needed if the review is completed on or before the eligibility review end date or within the first 30 days after termination for Classic cases or 90 days for MAGI.

Equal Access Plan

If a household does not return a review form or returns it late, check the household record for an Equal Access Plan.

If you initiate a review for CN coverage, ACES keeps Apple Health open even if the individual does not return the required proof. When pending a review, set an alert to check the case and determine if the individual returned the required proof.

If someone does not provide the proof you asked for, close the medical AU with advance and adequate notice (see WAC 182-518-0025 ).

If you receive information to establish eligibility: For Classic Apple Health, within 30 days after the month the review was due, reopen coverage. For MAGI Apple Health, within 90 days after the month the review was due, Washington Healthplanfinder reopens coverage back to the first of the month following termination of coverage.