WAC 182-518-0025

Effective October 1, 2013

WAC 182-518-0025 Washington apple health -- Notice requirements -- Changes in and terminations of coverage.



(1) We send you written notice before your Washington apple health (WAH) coverage changes or ends. The notice includes:

(a) The change in coverage;

(b) The date your coverage will change or end;

(c) Specific facts and reason(s) for the decision;

(d) Specific rules the decision is based on; and

(e) Information found in WAC 182-518-0005(4).

(2) Before we send any notice to end your WAH coverage because your income is more than the modified adjusted gross income (MAGI) standard, we determine if you are eligible for other health care coverage as described in WAC 182-504-0125.

(3) We notify you at least ten days before we change or end your health care coverage. The ten days start on the day we send you the notice and end on the tenth day. We are not required to give ten days’ notice if:

(a) You asked us to change or end your coverage;

(b) We are changing or ending your coverage due to a change in law;

(c) We are ending your coverage because everyone in your household either died or has been accepted to receive medicaid coverage somewhere else (another local jurisdiction, state, territory, or commonwealth);

(d) We are ending your coverage because mail we sent you was returned to us with no forwarding address; or

(e) You are incarcerated and it is expected to last more than thirty days.

(4) If we do not have to give ten days' advance notice, we send the notice right away after getting the information that caused the change, but no later than the date we took the action the notice is about.

(5) You may request an appeal if you disagree with our decision to change or end your health care coverage and you may request continued coverage as described in WAC 182-504-0130.

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.