Welcome
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Questions
Please hold questions until the end of the presentation.
Submit questions into the Q&A feature. We will do our best to answer during the Q&A.
Any questions not addressed during the webinar will be compiled and made available in a
frequently asked questions document posted on the Apple Health Expansion webpage.
Presentation slides and the recording will be available on the Apple Health Expansion webpage.
Based on previous requests, translated slides will be available in Amharic, Arabic, Cambodian,
Chinese, Russian, Spanish, Tagalog, Ukrainian, and Vietnamese.
All mentioned resources and links are available at the end of the presentation.
Apple Health Expansion
Enrollment (Part 2)
May 2024
Topics
Review of current Apple Health programs
Apple Health Expansion
Policy & eligibility
Immigration statuses
Application pathways
Managing Apple Health Expansion
When to apply
Getting ready to apply
Current Apple Health Programs
Apple Health programs today
Individuals who do not qualify for federally
subsidized health care coverage because of their
immigration status may continue to qualify for
other Apple Health programs such as:
Medical Care Services (MCS)
Alien Emergency Medical (AEM)
Apple Health for Pregnant Individuals
After-Pregnancy Coverage (APC)
Apple Health for Kids
Apple Health Expansion
Program policies
Where possible, Health Care Authority (HCA) will use
the same procedures as Apple Health, including:
Eligibility,
Enrollment,
Redetermination and renewals.
Enrollees be able to choose one of these four
managed care programs:
Molina Healthcare of Washington
UnitedHealthcare Community Plan
Community Health Plan of Washington
Coordinated Care
Program policies
No retroactive eligibility for Apple Health
Expansion.
Clients may get retroactive coverage under:
Alien Emergency Medical if they had a qualifying
condition in the retroactive months.
After-Pregnancy Coverage if they were within 12-
months of a pregnancy ending.
No resource/asset limit.
Long-term services and supports will not be a
covered service.
Who is eligible
Washington residents who are age 19 years and older.
Income at or below 138% of the federal poverty level.
Not eligible for:
Other Apple Health programs based on immigration
status.
Qualified health plans with advance premium tax credits
or federally funded medical programs.
*Source: hca.wa.gov/assets/free-or-low-cost/income-standards.pdf
Immigration Status
Immigration status
Applicants for Asylum*
Applicants for Withholding
of Deportation/Removal*
Registry Applicants*
Order of supervision*
Applicant for Cancellation
of Removal/Suspension of
Deportation*
Lawfully admitted with
expired or revoked
immigration status
No immigration status
Deferred Action for
Childhood Arrivals (DACA)**
Individuals with the following immigration statuses may
be eligible for Apple Health Expansion if they are not
“employment authorized”:
* If not employment authorized.
** Effective November 1, 2024, DACA recipients will be included in the definition of
“lawfully present” and will be eligible for Advance Premium Tax Credits and purchase
a plan through the Health Benefit Exchange. This change is under review to
determine impacts to DACA applicants and eligibility for Apple Health Expansion.
Applicants for Asylum
Applicants for Withholding of Deportation/Removal
Registry Applicants
Applicants for Special Immigrant Juvenile Status
Order of supervision
Applicant for Cancellation of Removal/Suspension of
Deportation
Immigration status – continued
Individuals with the following immigration statuses
are not eligible for Apple Health Expansion if
employment is authorized:
Immigration Status Eligible for
Apple Health and Tax Credits
Apple Health eligible statuses
U.S Citizens/Nationals
Lawful Permanent
Resident within their 5-
year bar
COFA (Citizens of
Micronesia, Marshall
Islands, Palau)
Asylee
Refugee
Temporary Protected
Status
Cuban/Haitian Entrants
Parolee
Battered Spouse, child
or parent (VAWA)
Granted withholding of
deportation/removal
Non-immigrants with
work Visa (H1, H-2A,
H-2B), Student Visa, U-
Visa, T-Visa
Individuals with the following immigration statuses
are eligible for Apple Health and Advanced Premium
Tax Credits:
Apple Health eligible statuses
Deferred Enforced
Departure
Deferred Action status
(excluding DACA)
Lawfully temporary
resident
Administrative order
staying removal
Member of a federally-
recognized Indian tribe or
American Indian born in
Canada
Applicants for Temporary
Protected Status with
employment
authorization
Applicants for Special
Immigrant Juvenile Status
Applicants for Victim of
Trafficking Visa
Applicants for adjustment
for Lawfully Permanent
Resident (LPR) status
Continuation of individuals eligible for Apple Health
and Advanced Premium Tax Credits :
SSN/ITIN
While some of the immigration statuses in both
groups are similar, having the status of “employment
authorized” provides an individual with a valid Social
Security Number (SSN).
Those issued a valid SSN or an Individual Taxpayer
Identification Number (ITIN) allows the individual to file
taxes and eligible to get federal tax credits, making
them ineligible for Apple Health Expansion.
Application Pathways
When can people apply?
Save the date!
Individuals can apply for Apple Health Expansion
coverage at 8 a.m. on June 20!
Coverage will begin on July 1.
This is a limited enrollment program.
The program is expected to fill quickly!
Many ways to apply:
Online
Phone
In-person
Managing Apple Health Expansion
Managing enrollment
Apple Health Expansion will have limited
enrollment.
If limit has been met, an applicant who is otherwise
eligible will receive a denial notice.
All clients may purchase a qualified health plan
(QHP).
Clients under 250% FPL are eligible for Cascade Care
Savings if they enroll in a Cascade Care plan.
Staff will accept client attestation of:
Income
Citizenship/immigration status
Washington residency and all other eligibility
factors.
At capacity
If the individual indicates on the application a
need for Emergency Medical (AEM) services and
Apple Health Expansion enrollment is:
Not limited: Approved for Apple Health Expansion.
Limited: Case reviewed for AEM eligibility.
Individuals denied in Washington
Healthplanfinder due to the enrollment cap being
met, will receive an eligibility notice with health
care coverage options.
Clients under 250% FPL are eligible for Cascade
Care Savings if they enroll in a Cascade Care plan.
Other coverage options
Regardless of MAGI or Classic
Apple Health Expansion
eligibility, individuals who are
denied due to the enrollment
cap will have the option to
apply for AEM or purchase a
Cascade Care QHP plan.
Enrollment cap
There are 13,000 total spots for this new program.
10% (1,300) will be dedicated to Classic population.
90% (11,700) will be dedicated to MAGI population.
Approximately 3,000 individuals will auto-transition
to Apple Health Expansion as of 7/1, including:
Transitioning from other programs into Apple Health Expansion
• Apple Health for Kids – turning 19 in June or July
• After-Pregnancy Coverage
• Emergency Medical Services (AEM)
• Extended Foster Care Kids
• Qualified Health Plans at 138% FPL
Transitioning from other programs into Classic Apple Health Expansion
• Qualified Health Plans at 138% FPL and aged 65+
• Emergency Medical Services (AEM)
Sample letter of transition – AEM
Qualified health plan transition
Requirements to be automatically transitioned to
Apple Health Expansion:
Enrolled in QHP for May 2024 and eligible for Apple
Health Expansion
Those who signed up in April are required to pay for
their May coverage to be deemed, enrolled.
Those who are disenrolled by their carrier for any
reason prior to transition in mid-June will not be
transitioned, regardless of available grace periods.
QHP transition letter
Letter (EE013) notifies transition from a Qualified
Health Plan to Apple Health Expansion.
Onscreen text
Eligibility result of someone approved Apple Health
Expansion in Washington Healthplanfinder.
Eligibility letter
Follow-up letter for Apple Health Expansion
eligibility.
Transition timeline
The following clients must complete a renewal to see if
they qualify for Apple Health Expansion:
Active on Apple Health for Kids and turning 19 in June or
July.
After-Pregnancy Coverage ending in June or July.
Coverage for those enrolled in the program will begin July 1.
Managed Care Plans
Managed Care Organizations available:
Molina Healthcare of Washington
UnitedHealthcare Community Plan
Community Health Plan of Washington
Coordinated Care
Coverage begins for new Apple Health enrollees
on July 1, 2024
Changes made to managed care plans are
effective the first day of the following month.
Same process today to change plan* if needed.
*Source: hca.wa.gov/change-my-plan
Application Time
Applications accepted June 20
th
Individuals can apply for Apple Health Expansion
through Washington Healthplanfinder or Washington
Connection no sooner than June 20 at 8 a.m.
Applications submitted through Washington
Healthplanfinder will receive instant eligibility
determination for Apple Health Expansion.
Applications submitted through Washington
Connection will be processed in the order received.
DSHS will prioritize manual applications to ensure timely
processing.
Enrollment is limited. Program is expected to fill
quickly!
Applications accepted June 20
th
Applications submitted prior to June 20 will be
reviewed for other programs, not Apple Health
Expansion.
If the individual is not eligible for any other programs,
they will be denied for Apple Health Expansion.
Once capacity for Apple Health Expansion has been
met, people will receive a denial letter indicating the
enrollment limit has been met.
EE015 correspondence will be sent.
“Washington Apple Health Expansion enrollment
limit has been met. New customers are not currently
being accepted.”
Getting Ready to Apply
Acceptable forms – DSHS and
Washington Healthplanfinder
It is recommended that all supporting documents are
submitted at the time of application to avoid a delay in
getting coverage.
Proof of identity may include:
Driver license or ID card, even if issued from a foreign
country
Immigration documentation
Third party affidavit or federal or state agency letter
confirming identity
Household members not applying for coverage do not
need to verify identity.
A social security number should be provided if the
individual has one but is not required. Do not provide an
ITIN.
Washington Healthplanfinder requires the primary
applicant pass identity proofing before continuing
with the online application.
Not needed for paper application submission
Have information to verify identify, such as:
Their name and date of birth
Weight, height, eye color
Age, sex, race
In-person ID proofing does not require uploading
of documentation.
Identity proofing
Identity proofing
If working with a Navigator, the navigator may be able to
verify identity of their clients and will not need to upload
documents.
Be sure the name is entered into the system how it is spelled
on the documents provided.
If the individual has two last names, follow the application
data entry standards on how names should be entered.
Examples:
Washington Connection (DSHS)
If an individual comes into Community Service Office
(CSO) a public benefits specialist will be able to verify
identity.
To help in the identification process individuals should
bring their most current documentation.
For individuals applying online through Washington
Connection there is no identity verification needed to
submit their application. It will be manually verified by
DSHS staff when the application is processed.
Note: Applying online through Washington Connection is the
quickest way to get your application in the system.
Income
Must provide gross monthly income for client and
spouse on the application.
If an individual wants help calculating the amount
to provide on their application:
They should have:
Pay stubs (month or 2 months worth)
Receipts that show their earnings
Letter from their employer or phone number to call to
get the information
IRS 1040: View the Chart of acceptable documents.*
*Source: hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-
access-apple-health/chart-acceptable-documents
Income
When reporting income for individuals whose
income varies seasonally, individuals can choose
to use either the point-in-time methodology or
by calculating the monthly average.
Example: Fishermen or farmers who work
seasonally.
Note: Self-attestation is accepted, however the
client may be required to provide proof after
application for a post eligibility verification.
Resources
Live Q&A
