WA residents soon must apply to keep Medicaid coverage. Expert shares advice for preparing
On Jan. 30, the Biden administration announced it intends to end the public health emergency that’s been in effect since the beginning of the COVID-19 pandemic. The resolution is set to expire May 11, three years since order was first put in place by former President Trump on March 13, 2020.
In late December 2022, President Biden signed the Consolidated Appropriations Act, 2023, which removed the ongoing Medicaid enrollment from the public health emergency. As a result, the Washington State Health Care Authority, which oversees Apple Health — the state’s Medicaid program — announced it will be returning to normal operations April 1. For the first time in three years, around 300,000 Washingtonians must fill out an application to renew their eligibility for Medicaid coverage, according to Caitlin Duffy, director of business development and sales at Community Health Plan of Washington, a nonprofit organization that provides Apple Health, Medicare Advantage and individual and family health plans.
Duffy explained to The News Tribune what residents need to know about getting re-certified for Apple Health, the state’s Medicaid program.
What is Apple Health?
Medicaid is a government health insurance program that provides comprehensive medical benefits to residents with limited income. Every state defines its own benefits, but federal law requires each one to provide mandatory benefits while adding optional ones. Some mandatory benefits include:
Inpatient hospital services
Nursing facility services
Physician services
Rural health clinic services
Family planning services
In Washington, there are five Apple Health plans. These plans offer different kinds of benefits in addition to the mandatory ones. For instance, Duffy says CHPW offers benefits such as:
Chiropractic services
Acupuncture services
Massage therapy
Vision care and glasses for adults
To view even more services, check out Washington State Health Care Authority’s website.
Who is eligible for Apple Health?
In Washington, you may be eligible for Medicaid if you meet the following requirements:
Between the ages of 19 to 64
U.S. citizen or meet Medicaid immigration requirements
Not entitled to Medicare
Eligibility is also contingent on a person’s income, and these standards change annually. You may be eligible if your household monthly income is at or below these figures:
Single person: $1,563
Two people: $2,106
Three people: $2,649
Four people: $3,192
Five people: $3,735
Six people: $4,277
Seven people: $4,820
You may also be eligible for coverage if you’re a parent or caretaker, are pregnant, are a noncitizen, are blind or disabled, or a dependent child. These have slightly different eligibility requirements for household income than those listed above. You can check them on the CHPW website or check on the health care authority’s website.
Apple Health renewal process
If you haven’t gone through the process of renewing your Medicaid eligibility, Duffy has some tips to make the process easier and less stressful:
Washington state will start mailing notices to residents beginning April 1.
If you receive a notice, complete the renewal before the end of May. These notices to renew eligibility will continue on a monthly basis for 12 months depending on what time of the year you first enrolled.
Update your contact information on your Washington Healthplanfinder account. When it’s your time to renew, you will receive a notification on your account.
Check your mail or email for a notice. You will also receive a phone call.
If you need assistance completing the form and have questions concerning coverage for single adults, pregnant individuals, parents, caretakers or children, you can call Washington Healthplanfinder’s customer support at 1-855-923-4633. To speak with someone in person, you can find a facility near you on the Healthplanfinder website.
If you have questions concerning coverage for those who are aged, blind or have a disability, contact the Department of Social and Health Services at 1-877-501-2233 or visit a local community services office. You can find a facility at the department’s website.
Duffy encourages residents to contact Community Health Plan of Washington. The organization is open from 8 a.m. to 5:30 p.m. Monday through Friday. You can reach CHPW with any additional questions at 1-866-907-1904.
This story was originally published February 9, 2023 at 1:39 PM.
