Program Summary - Medical Care Services
DSHS Home Page
 
Search     for:


DSHS Home    Acronyms    Revisions    WAC Number Index    Site Map    WCCC

Program Summary - Medical Care Services


Revised April 29, 2013


Eligibility for medical care services (MCS)


WAC 182-508-0005Eligibility for medical care services.
WAC 182-508-0230Eligibility standards for medical care services (MCS); aged, blind, or disabled (ABD); and Alcohol and Drug Addiction Treatment and Support ACt (ADATSA).

WAC 182-508-0005

WAC 182-508-0005

Effective January 1, 2014

WAC 182-508-0005 Eligibility for medical care services.

  1. A person is eligible for Washington apple health (WAH) medical care services (MCS) coverage to the extent of available funds if the person is determined by the department of social and health services to be eligible for benefits under either the aged, blind, or disabled program as described in WAC 388-400-0060 or the housing and essential needs referral program as described in WAC 388-400-0070.
  2. If an enrollment cap exists under WAC 182-508-0150, a waiting list of persons may be established.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

clarifying information

  1. Persons who are participating in the Department of Corrections Family Offender Sentencing Alternative (FOSA) or Community Parenting Alternative (CPA) program may be eligible for ABD cash benefits. Refer to the Sentencing Alternatives – Offenders with Minor Children SSB 6639 desk aid for additional information.
  2. Ask about tribal affiliation as Native Americans/Alaskan Natives who self identify a tribal affiliation will not be automatically enrolled in MCS.  See worker responsibilities in the TANF/SFA Time Limits-Indian County Disregard section for instructions on asking about and recording tribal affiliation.
  3. Persons who are currently ineligible for TANF due to the non-compliance sanction in WAC 388-310-1600 are not eligible for MCS per WAC 182-508-0005(2)(b) and (c).  
  4. If a person is eligible for a TANF time limit extension, they are not eligible for MCS.

WAC 182-508-0230

Error processing SSI file

Clarifying Information

  1. An individual has an obligation to pay shelter costs if they:
    1. Have a shelter obligation, regardless of whether the shelter costs are being paid by someone else or another agency.
    2. Owns, purchases, or rents their place of residence, even if costs are limited to property taxes, homeowner's/renter's insurance, or utilities; or
    3. Is homeless. Being homeless includes:
      1. Lacking a fixed, regular, and adequate nighttime residence; or
      2. Residing in a public or privately operated shelter designed to provide temporary living accommodations; or
      3. Living in temporary lodging provided through a public or privately funded emergency shelter program.

 


NOTE:

The eligibility standard for Medical Care Services (MCS) is higher than the payment standard for the Aged, Blind, Disabled (ABD) program; however, categorically needy (CN) medical will be authorized for those individuals eligible for the ABD program when their countable income is under the MCS eligibility standard as long as they meet citizenship requirements under WAC 182-503-0532.


Worker Responsibilities

  1. When an individual claiming a disability or incapacity is ineligible for TANF or family medical for reasons other than those stated in WAC 182-508-0005 2 (b) (c) and meets the income/resource eligibility standards for MCS, make an ABD disability/MCS incapacity referral.
  2. When an individual as described in #1 above has countable income exceeding the payment standard for ABD but under the eligibility standard for MCS, make the ABD/MCS referral. ACES will apply the income standards appropriately; and
    1. If the individual is determined disabled under ABD criteria and meets the citizenship criteria under WAC 182-503-0532, ACES will issue CN medical with no grant; or
    2. If the individual is determined incapacitated for MCS, ACES will issue MCS medical.

NOTE:

Individuals who are ineligible for TANF due to the 60-month time limit or permanent disqualification may receive family-related medical.


NOTE:

Individuals who are eligible for family medical are not eligible for MCS.

Modification Date: April 29, 2013