WAC 388-475-1050 Healthcare for workers with disabilities (HWD) - Program requirements.

This section describes requirements a person must meet to be eligible for the healthcare for workers with disabilities (HWD) program.

1. To qualify for the HWD program, a person must: 

   1. Meet the general requirements for a medical program described in WAC 388-503-0505(3)(a) through (f);

   2. Be age sixteen through sixty-four;

   3. Meet the federal disability requirements described in WAC 388-475-1150;

   4. Have net income at or below two hundred twenty percent of the federal poverty level (FPL) (see WAC 388-478-0075 for FPL amounts for medical programs); and

   5. Be employed full or part time (including self-employment) as described in WAC 388-475-1200.

2. To determine net income, the department applies the following rules to total gross household income in this order:

   1. Deduct income exclusions described in WAC 388-475-0800, 388-475-0820, 388-475-0840, and 388-475-0860; and

   2. Follow the CN income rules described in:

      1. WAC 388-475-0600, SSI-related medical -- Definition of income;

      2. WAC 388-475-0650, SSI-related medical -- Available income;

      3. WAC 388-475-0700 (1) through (5), SSI-related medical -- Income eligibility;

      4. WAC 388-475-0750, SSI-related medical -- Countable unearned income; and

      5. WAC 388-506-0620, SSI-related medical clients; and

3. The HWD program does not require an asset test.

4. Once approved for HWD coverage, a person must pay his/her monthly premium in the following manner to continue to qualify for the program:

   1. The department calculates the premium for HWD coverage according to WAC 388-475-1250;

   2. If a person does not pay four consecutive monthly premiums, the person is not eligible for HWD coverage for the next four months and must pay all premium amounts owed before HWD coverage can be approved again; and

   3. Once approved for HWD coverage, a person who experiences a job loss can choose to continue HWD coverage through the original twelve months of eligibility, if the following requirements are met:

      1. The job loss results from an involuntary dismissal or health crisis; and

      2. The person continues to pay the monthly premium.