Washington State Medical Programs (health coverage) for Children
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Washington State Medical Programs (health coverage) for Children The state of Washington continues to advocate for the health of its children by providing several health coverage options to accommodate differing age, income, and/or citizenship status. The Migrant Education Health Program worked with the Department of Social and Health Services Health Recovery Services Administration to develop a simplified overview of children’s medical programs including a list of regional contacts to provide technical assistance and guidance to individuals assisting families seeking health coverage for their children. *For purposes of income level an unborn child is counted in family size. Apple Health for Kids - No cost Children under the age of 19 and below 200% of the federal poverty level (FPL) (example: family of 4 with an income of $3,675/month). Once a child is enrolled they remain eligible for 12 months regardless of change of income. Citizen and lawfully present alien children are funded by state/federal matching funds; non-citizen children who are not lawfully present receive the same level of coverage using state only funding. 12 month certification. Apple Health for Kids – Low cost Children under the age of 19 and below 300% of the federal poverty level (FPL) (example: family of 4 with an income of $5,513/month. Once a child is enrolled they remain eligible for 12 months regardless of change of income. Citizen and lawfully present alien children are funded by state/federal matching funds; non-citizen children who are not lawfully present receive the same level of coverage using state only funding. Coverage is premium based. Tier 1-(200%-250% FPL) - $20/mon. per child and a family maximum of $40/mon. Tier 2-(250%-300% FPL) - $30/mon. per child and a family maximum of $60/mon. Cannot have other health insurance through employment or other sources. 12 month certification. Medically Needy program – “Spenddown” Children under the age of 19 and above 300% of the federal poverty level (FPL). Children under the age of 19 and above 200% of FPL, but not eligible for premium based Apple Health for Kids coverage because of other health insurance coverage. Must be a U.S. citizen or lawfully present alien. The family shares in the cost of medical expenses (“spenddown”). 3 month certification. Alien Emergency Medical (AEM) An emergency Medicaid program for persons who do not meet the citizenship requirements of other DSHS medical programs and are experiencing an emergent medical need. Must be a non-citizen that meets Medicaid eligibility requirements (a child, parenting a child, blind, aged, or disabled) except for citizenship. Immigration status not an issue. Not eligible for any other medical assistance program. Washington Health Program Managed by the Health Care Authority for children under age 19 who ar not eligible for no-cost/low-cost Apple Health for Kids. Families pay the full premium. Immigration status is not an issue; citizen and non citizen children. Charity Care Available through local hospitals at no charge or at a reduced charge to those who meet financial need requirements. It is generally available for persons considered “indigent”; if their family income is at or below 200% of the federal poverty level; and they do not have other financial resources available such as insurance, government programs, or regular income. Individuals need to contact their local hospital for further information. Immigration status is not an issue. It is critical that parents apply for services when they are income-eligible. Once a child is enrolled in one of these programs (Apple Health for Kids coverage), they remain eligible for 12 months, regardless of change in income. Program enrollment is available through community and migrant health clinics or at a Department of Social and Health Services, Community Service Office (CSO). State and Regional Contacts Regional contacts available to provide families with technical assistance and guidance relating to health insurance programs include: Medicaid Purchasing Administration (MPA) Mary Beth Ingram Region 1& 2 Medicaid Representative Health & Recovery Services Administration Department of Social and Health Services 360-725-1327 ingramb@dshs.wa.gov Kevin Cornell Region 3 Medicaid Representative Health & Recovery Services Administration Department of Social and Health Services 360-725-1423 corneke@dshs.wa.gov Cindy Palko Region 5 Medicaid Representative Health & Recovery Services Administration Department of Social and Health Services 360-725-1324 palkocm@dshs.wa.gov Dody McAlpine Region 4 Medicaid Representative Health & Recovery Services Administration Department of Social and Health Services 360-725-9964 mcalpda@dshs.wa.gov Catherine Fisher Region 6 Medicaid Representative Health & Recovery Services Administration Department of Social and Health Services 360-725-1327 mailto:fishecl@dshs.wa.gov WASHINGTON STATE DEPARTMENT OF SOCIAL AND HEALTH SERVICES CONTACTS Medicaid Purchasing Administration (MPA) Mary Beth Ingram Region 1 & 2 Medicaid Representative Health & Recovery Services Administration Department of Social and Health Services 360-725-1327 ingramb@dshs.wa.gov Kevin Cornell Region 3 Medicaid Representative Health & Recovery Services Administration Department of Social and Health Services 360-725-1423 corneke@dshs.wa.gov Cindy Palko Region 5 Medicaid Representative Health & Recovery Services Administration Department of Social and Health Services 360-725-1324 palkocm@dshs.wa.gov Dody McAlpine Region 4 Medicaid Representative Health & Recovery Services Administration Department of Social and Health Services 360-725-9964 mcalpda@dshs.wa.gov Catherine Fisher Region 6 Medicaid Representative Health & Recovery Services Administration Department of Social and Health Services 360-725-1327 fishecl@dshs.wa.gov Community Services Offices (CSO) Representatives MERO 105 Herminia Esqueda, Program Manager/Trainer Department of Social and Health Services Sunnyside CSO 509-225-7942 esqueh@dshs.wa.gov Sonia Ortega, Financial Service Specialist Department of Social and Health Services Othello CSO 509-932-0701 segurs@dshs.wa.gov Dee Dee Brenner, Financial Supervisor Department of Social and Health Services Othello CSO 509-331-2100 brenndk@dshs.wa.gov Richard Dominguez, FFS Department of Social and Health Services White Salmon CSO 509-493-6140 dominrj@dshs.wa.gov Bea Wilson, Financial Services Specialist 3 Department of Social and Health Services White Salmon CSO 509-493-6140 roberbr@dshs.wa.gov Alma Rojas, Financial Services Supervisor Department of Social and Health Services Region 2 Yakima CSC 206-568-5688 rojasal@dshs.wa.gov Rocio Loera, Community Relations Coordinator Department of Social and Health Services Region 2 DEAP Sunnyside, WA 509-839-7215 loerarc@dshs.wa.gov MERO 171 Nancy Maldonado, FSS 3 Department of Social and Health Services Omak CSO 509-846-2015 gomezno@dshs.wa.gov Adele Snyder, Financial Supervisor Department of Social and Health Services Wenatchee CSO 509-667-6001 snydeam@dshs.w.gov John Paquette, Leadworker 4 Department of Social and Health Services Wenatchee CSO 509-667-6154 johnp@dshs.wa.gov Erin Mooney, Financial Services Leadworker Department of Social and Health Services Wenatchee CSO 509-667-6026 seafoea@dshs.wa.gov MERO 189 Denise Stark, FSS 3 Department of Social and Health Services Chehalis CSO 360-740-3806 Starkdm2@dshs.wa.gov Diane Sinclair, Financial Supervisor Department of Social and Health Services Chehalis CSO 360-740-380 sincldl@dshs.wa.gov Mike Rhoads, Financial Supervisor Department of Social and Health Services Mt. Vernon CSO 360-416-7350 rhoadme@dshs.wa.gov Steve Fogo, Financial Supervisor Department of Social and Health Services Aberdeen CSO 360-537-3700 fogosw@dshs.w.gov Berta Reynolds, Financial Worker Department of Social and Health Services Aberdeen CSO 360-537-2600 ContrRL2dshs.wa.gov Kami Kruzich, Financial Service Supervisor Department of Social and Health Services Bellingham CSO 360-714-4000 kruzikm@dshs.wa.gov June Fritz, Outstation/Outreach Financial Services Supervisor Department of Social and Health Services Bellingham CSO 360-714-4080 FritzPJ@dshs.wa.gov Hector A. Martinez, Financial Supervisor Department of Social and Health Services Bellevue CSO 425-590-3140 martiha@dshs.wa.gov Shelba Marracci, Branch Office Administrator Department of Social and Health Services Long Beach CSO 360-642-6206 marrasi@dshs.wa.gov Audrey Ike, Financial Supervisor Department of Social and Health Services Vancouver (Columbia River) CSO 360-759-2810 richaam@dshs.wa.gov Lisa Pan, Financial Supervisor Department of Social and Health Services Seattle CSO 2006-568-5688 panlh@dshs.wa.gov Marsha Roos, Cover All Kids Medical Outreach Department of Social and Health Services Seattle CSO 253-372-5876 roosmp@dshs.wa.gov Clinic-Based Outreach Workers Martha Rocha, Financial Service Specialist Department of Social and Health Services Outreach Worker, Tri-Cities Pasco Region 2 Yakima CSO 509-545-2654 RochaMT2dshs.wa.gov David D. Ames, Outreach Worker Department of Social and Health Services Columbia Basin Health-Mattawa Clinic Mattawa, WA 99349 509-932-3535 x 6808 amesdd@dshs.wa.gov Mike Geary, FSS3, Financial Service Specialist Department of Social and Health Services Columbia Valley Community Health-Wenatchee Wenatchee, WA 509-661-3651 gearymp@dshs.wa.gov Orlando Gonzalez, Outreach Coordinator Department of Social and Health Services Family Health Centers-Okanogan Okanogan, WA 509-422-5700 x 2920 ogonzalez@myfamilyhealth.org Erika Torres, Outreach Worker Department of Social and Health Services Columbia Basin Health-Othello Clinic Othello, WA 509-488-5256 torreer@dshs.wa.gov Isaac Heist, Outreach Worker Department of Social and Health Services Sea Mar Community Health Centers-Bellingham Clinic Bellingham, WA 360-788-7114 heister@dshs.wa.gov Karen Van Brunt, Outreach Worker Department of Social and Health Services Family Health Centers-Tonasket Tonasket, WA 509-422-7640 vanbrks@dshs.wa.gov Nicole Davidson, Outreach Worker Department of Social and Health Services Whatcom Alliance for Healthcare Access-Bellingham Bellingham, WA 360-788-6542 davidsonn@dshs.wa.gov This document will be electronically disseminated via the Migrant Education Health Program office. It will be updated as change dictates. NOTE: See Migrant Health Program website (www.msdr.org (click “Health” on map), “Migrant Health Internet Links” for hot links to Washington State Medical programs for children.
