We scoured the internet to bring you everything you need to know about Washington’s Medicaid Benefits.
Medicaid is a joint federal-state program that provides health insurance to low-income people who satisfy specific criteria, such as children, pregnant women, the elderly, and people with disabilities. It is simple to apply for Medicaid in person, by phone, or online.
This article will tell you all you need to know about Medicaid in Washington.
What is the Washington Medical Program?
Washington Medicaid is a service for adults and families that meet specific income and resource requirements. Within the confines of stated laws, resources broadly apply to the elderly, blind, or crippled population.
Who is eligible for the Washington Medical Program?
Through the Medicare Savings Plan, Washington Medicaid provides some financial assistance to select limited Medicare beneficiaries who are not eligible for the entire Medicaid benefit package.
- Expectant mothers
- People who are blind or disabled or who have a spouse who is blind or disabled;
- People whom someone adopts;
- People whom someone adopted;
- People who are blind or disabled or have a spouse who is disabled.
The Annual Household Income Limits (before taxes)
|Household Size*||Maximum Income Level (Per Year)|
*Add $9,440 per additional person for households with more than eight people..
How do I contact Medicaid in Washington?
Cherry Street Plaza, 626 8th Avenue SE
Olympia, WA 98501
What are the Medicaid plans in Washington?
Apple Health, a physical health managed care program, is run by five statewide managed care organizations under Section 1932(a) authority.
The majority of non-acute behavioral health services, as well as the full range of physical health services, are offered by the mandatory program, which also covers most pregnant women, kids, and parents.
Regional Support Networks
Under Section 1915(b) waiver authority, the state ran a mandatory managed care behavioral health program. Services are provided by eleven county-based Regional Support Networks (RSNs), which function as prepaid health plans.
Program of All-Inclusive Care for the Elderly
Additionally, under Section 1932(a) authority, the state runs a single Program of All-Inclusive Care for the Elderly in King County to provide all Medicare and Medicaid services to people over 55 who need a nursing home level of care, as well as a voluntary Primary Care Case Management (PCCM) program through fifteen Tribal Clinics and Urban Indian Centers.
For more details regarding Medicaid plans in Washington, visit here.
How do I apply for Washington Medicaid?
Call 1-800-200-1004 to enroll.
Apply in person at Washington State Health Care Authority
Online: Download and print the application.
Mail: To Cherry Street Plaza, 626 8th Avenue SE
Olympia, WA 98501
What is covered by Washington Medicaid?
Washington Medicaid covers the following services:
|Ambulatory surgery||Hospital stays|
|Audiology services||Laboratory tests|
|Behavioral health services||Vision care|
|Women’s health care||Non-emergency transportation|
|Dialysis||Orthotic and prosthetic devices|
|Doctor visits||Occupational therapy|
|Smoking cessation services||Pharmacy (medications)|
|Emergency care||Physical rehabilitation|
|Family planning services||Preventive care|
|Hearing aids||Hospital outpatient care|
|Home health care||X-rays and other radiology services|
Can I have both Washington Medicaid and Medicare?
Even if you have Medicare coverage, you might still be qualified for Washington Apple Health Classic Medicaid coverage. This coverage may include assistance with Medicare premium payments, Apple Health coverage, or long-term services and supports.
- Washington Mental Health Services
- Community Protection Waiver
- Core Waiver
- Basic Waiver
- Basic Plus Waiver
- New Freedom
- Medically Needy In-Home
- Washington Take Charge
They do not have to pay a copayment. When a member is
- under 21 years old;
- Held by the state
- Placed under government supervision
- Native American participants who qualify for Contract Health funding
- Services or Tribal Union of Indian Health Services
- The hospital (inpatient)
- A facility for skilled nursing
- A nursing home
What is not covered by Washington Medicaid?
In Washington, Medicaid is not required to provide in-home care or private nursing coverage. Bandages, adult diapers, and other disposable products, as well as cosmetic surgery and other elective operations, are routinely excluded from insurance coverage.
What is the highest income limit for Washington Medicaid?
Adults with incomes up to 138 percent of the federal poverty level are covered by Apple Health. That came to about $18,754 for a single person in April 2022 or $38,295 for a family of four.
What if a person’s income is too high to qualify for regular Medicaid benefits?
Even if your income is too high, thanks to the asset spend down option; you may still be qualified for Washington Medicaid.
What documents do I need to apply for Medicaid?
The following documents are required with the application:
- The Social Security Number;
- Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
- Evidence of all income sources, both legal and illegal
- Proof of origin
- Proof of residency
- Including the Medicare card, any insurance cards
- When non-parents apply for Medicaid on their behalf, they must provide evidence of their financial position.
What is the best Medicaid in Washington?
The Washington Apple Health Integrated Managed Care plan is what most people will prefer (IMC). The IMC plan offers memberships to the Boys & Girls Club, health education, translation services, tobacco cessation, and a rewards program, in addition to its extensive healthcare benefits.
Where do I find the letter showing the reason(s) for denial or discontinuance from Washington Medicaid?
By signing into your account at Portal, you can see the progress of your Washington Medicaid application.