NoHLA and health care advocates across the state have deep concerns about how the ending of the Public Health Emergency (PHE) may affect many of the 2.3 million Washingtonians who are covered by Apple Health.  An estimated 300,000 people may lose their coverage when the Health Care Authority (HCA) resumes the pre-pandemic annual eligibility renewal process.  The process began on April 1^st and will continue for a year. But advocates expect the majority of termination notices to be sent during May through July, with terminations effective at the end of the month of the notice.   

NoHLA has been advocating for strong protections for Apple Health enrollees during this process. We’ll share more as the coverage terminations begin, but here are some top things to know now:

What’s the most important thing to know?

The top takeaway is that Apple Health clients must update their contact and enrollment information. A big concern is that enrollees who have moved since the last time they had to renew may not receive the letter that tells them the deadline to respond. The letters are mailed the month before their renewal deadline. Another major concern is scammers, people pretending to be calling from HCA or Apple Health and asking for payment information. Clients will never be asked to share their banking or credit card information for enrolling. If they receive a phone call or text they think is a scam, they should report it to Apple Health customer service at 1-800-562-3022.

How are people finding out?

In addition to letters, postcards started going out in April. Last week, HCA started sending text messages to certain enrollees with information about the need to update their information. Starting this week, HCA and other agencies will begin calling clients with a pre-recorded message informing them that they will lose coverage at the end of the month if they do not provide current information.

What are the options to update information?

People with Medicaid who do not also have Medicare eligibility can update their information by using the Washington Healthplanfinder website or downloading the WAPlanfinder app.  They also can:

• call the Washington Healthplanfinder Customer Support Center at 1-855-923-4633 (TTY: 1-855-627-9604) or getting help from WA Healthplanfinder Navigator;
• call their Managed Care Organization;
• email askmagi@hca.wa.gov; and
• download a paper application (Form 18-001P) and mail to HCA-MEDS, PO Box 45531, Olympia WA 98504.

But people with Apple Health Classic Medicaid Coverage (Classic) or who are 65 or older, have blindness or a disability can update their information: 

• online at Washington Connection by following the directions under “Report a change”;
• with a call to the DSHS Customer Service Center at 1-877-501-2233; and
• by mailing the change to DSHS-CSD, PO Box 11699, Tacoma, WA 98411-6699.

Learn about coverage options, appeals, and how you can help.

What happens if mail is returned? 

If mail is returned with a forwarding address, it will be mailed to the new address. If there is no forwarding address, HCA and DSHS will attempt to reach the enrollee at least twice. 

What are the options when an enrollee’s Medicaid coverage is terminated?

Losing Apple Health coverage is considered a Qualifying Life Event, which allows people to enroll in a Marketplace plan outside of the annual Open Enrollment Period. WA Healthplanfinder can provide coverage options, such as Qualified Health Plans that may include subsidies to help with the costs of coverage. An estimated 4 out of 5 enrollees can find plans that cost less than $10 a month and cover prescription drugs, doctor visits, urgent care, and more, but it’s important that they enroll within 60 days of losing coverage. 

There are also options for people who turned 65 or experienced a disability during the pandemic and now need to transition to Medicare. People should enroll in Medicare and look into whether they might be eligible for help with costs through dual Medicaid or Medicare Savings Programs. It’s important that people act soon after losing Medicaid so they can qualify for a Medicare Special Enrollment Period. SHIBA volunteers can help people with questions about transitioning to Medicare. 

How can a termination or denial be appealed?

Enrollees who want to appeal a termination or denial of Apple Health coverage and want their coverage to continue during the appeal have a very short time to do so. Although a request for an administrative hearing may be made within 90 days, “continued benefits” can only be requested when the appeal is filed within 10 days from receiving the notice or before coverage ends (whichever is later). To ensure timeliness, the appeal should be requested right away by phone at 1-800-562-3022 and followed-up with an appeal request in writing.

A written appeal can be made by completing the form that comes with the termination letter or by downloading and completing an Appeal Request Form. Enrollees should include a copy of the denial letter if possible, and should keep a copy of the appeal form and notes about the date of their phone request for their own records. More information on how to file Apple Health Appeals (mail, online, phone) is available at the Office of Administrative Hearings webpage. 

How can you help?

HCA has issued a call for volunteer Apple Health Ambassadors, to help spread the word and ensure that Apple Health clients hear how they can maintain their coverage. Ambassadors can be from anywhere: HCA is hoping to include representatives from clinics, community groups, schools, county and state agencies, faith-based organizations, insurance plans, medical providers, and others to provide accessible information wherever clients are located. There are materials to help you spread the word, like social media messages, a flyer in 15 languages, and monthly educational and training webinars–the next webinar will be held on June 1st at 10am. 

If you know someone who is experiencing trouble with the eligibility review process, let us know!

Have other questions?

• You can receive updates directly from HCA by signing up on this mailing list.
• All of HCA’s webinars and presentations on the PHE Unwind are available on the HCA website.
• Washington LawHelp has helpful information on the changes to Apple Health and food stamps after the ending of the PHE.