Whatcom Alliance for Healthcare Access

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Program	Who is eligible?	What benefits do I get?	Can I lose my benefits?
Kids’ Coverage Medicaid DSHS CHIP S-CHIP CNP Basic Health Plus F06/F07 (listed on coupon)	Children under age 19 who meet the income requirements and are US citizens or qualified immigrants. There is no limit on family resources.	Standard Benefits Package Medical care Dental care Vision services Mental health services Interpreters (to health services) Transportation (to health services)	Child turns 19 Fails to reapply every 12 months Does not supply proof of family’s income when asked When family reapplies, their income is above the allowed limits.

Pregnancy Medicaid or DSHS Pregnancy medical CNP P02/P04 (listed on coupon)	Pregnant women of all ages who meet the income requirements. There is no limit on family resources. And there are no citizenship requirements.	Standard Benefits Package Medical care Dental care Vision services Mental health services Interpreters/Transportation (to health services)	Woman moves and does not report her change of address. 2 months after the baby is born or the pregnancy ends, full benefits end and clients are given 10 months of family planning coverage
Program	Who is eligible?	What benefits do I get?	Can I lose my benefits?
Families with Children under 18 TANF (Temporary Assistance for Needy Families) Medicaid DSHS Family Medical Family Medical Extension CNP F01,2,3,4,9 (listed on coupon)	Families with dependant children living in the home who meet the income requirements and are US citizens or qualified immigrants. There are limits on family resources.	Standard Benefits Package Medical care Dental care and Vision services Mental health services Interpreters/Transportation (to health services) Basic Food Assistance (usually) Cash Benefits Unless you decline the $ and move to the Family Medical program.	All children are now 18 or older Fail to send info DSHS requests every 6 months to be sure the family still qualifies. Doesn’t supply proof of family’s income & resources, when asked Family’s income goes above the allowed limits. The family will then be given 1 year of medical benefits only. Fails to comply with WorkFirst requirements Family reaches the 60 month (5 year) total lifetime limit for receiving cash benefits and is transferred to a medical-only program.

Children’s Health Program DSHS Immigrant Health CHP CNP F08 (listed on coupon)	Children under age 19 who meet the income requirements and are not US citizens or qualified immigrants. There is no limit on family resources.	Standard Benefits Package Medical care Dental care and Vision services Mental health services Interpreters/Transportation (to health services)	Child turns 19 Fails to reapply every 12 months. Does not supply proof of family’s income when asked When family reapplies, their income is above allowed limits.
Program	Who is eligible?	What benefits do I get?	Can I lose my benefits?
Alien Emergency Medical Medicaid DSHS AEM Emergency Only F09/S07 (listed on coupon)	Non-citizens who have an emergent condition AND would have qualified for one of the other DSHS programs if they were a US citizen.	All services directly related to your emergent condition, including the emergency room, hospital and specialist charges, offices visits, prescriptions, etc. Usually this is limited to a three month period either before or after the application is submitted.	No longer meets the requirements for the DSHS program they would have qualified for as a citizen Fails to reapply every 3 months (if condition persists) or does not supply proof of family’s income when asked Condition no longer meets criteria as “emergent”.

General Assistance Unemployable GAU GA-X DSHS G01/G02 (listed on coupon)	Adults who have evidence of a medical or psychiatric problem that will prevent them from working for at least 90 days (12 months for GA-X). They must also meet the income and resource requirements and be US citizens or lawfully admitted immigrants. For more information on the application process.	Limited Benefits Package Medical care Emergent Dental services Vision services NO mental health services Interpreters/Transportation Cash benefits Basic Food Assistance (usually	Fails to reapply every 12 months by supplying adequate proof of income & resources. Fails to provide evidence of inability to work which is required every 3, 6, or 9 months depending on the condition. Income or resources go above the allowed limits Condition no longer meets criteria as preventing employment.
Program	Who is eligible?	What benefits do I get?	Can I lose my benefits?
ADATSA Alcohol & Drug Addiction Treatment Services Act W01,W02,W03 (listed on coupon	Adults who have a substance abuse problem that will prevent them from working for at least 90 days and are willing to receive treatment. They must also meet the income and resource requirements and be US citizens or lawfully admitted immigrants.	Limited Benefits Package Medical & vision services Emergent Dental services NO mental health services Interpreters/Transportation Residential & Out-patient Treatment Detox Cash benefits (county funds) Basic Food Assistance	Withdraw from treatment (which is different than relapsing) Finish treatment plan Gaining employment once you are in outpatient treatment does not make you ineligible for ADATSA

SSI-related CNP Medicaid DSHS S01/S02 (listed on coupon)	Adults who are unable to work for at least 12 months according to Social Security’s definition of disability and/or are over 65 and who meet the income and resource requirements	Standard Benefits Package Medical care Dental care Vision services Mental Health services Interpreters/Transportation (to health services)	“Disability” status changes according to Social Security definition Fails to reapply every 12 months (not required if receiving SSI$) Does not supply adequate proof of income, resources, or disabling condition Income or resources go above the allowed limits See Spend-down below
Program	Who is eligible?	What benefits do I get?	Can I lose my benefits?
Medically Needy Spend-down MN S95/S99 (listed on coupon)	Adults who are unable to work for at least 12 months according to Social Security’s definition of disability and/or are over 65 and do not meet the income requirements. Resources must still be within the limit.	Limited Benefits Package Medical care Limited dental care Vision services Interpreters Transportation *Must meet your spend down amount first!	“Disability” status changes according to Social Security definition Fails to reapply every 3 or 6 months (client chooses the spenddown period) Does not supply adequate proof of income, resources, or disabling condition Resources go above the allowed limits

Healthcare for Workers with Disabilities Medicaid or DSHS CNP HWD S08 (listed on coupon)	Disabled adults (age 18-64) who are working and who meet the income requirements and are US citizens or lawfully admitted immigrants. There are no resource limits for this program. *Must pay a monthly premium!	Standard Benefits Package Medical care Dental care Vision services Mental Health services Interpreters/Transportation (to health services)	Fails to reapply Doesn’t supply adequate proof of income every 12 months Income goes above the allowed limits Fails to complete disability review
Program	Who is eligible?	What benefits do I get?	Can I lose my benefits?
QMB Quimby Medicare Savings Program MSP S03 (listed on coupon)	Person on Medicare who meets income and resource requirements	Pays the Part A & B premiums and deductibles Pays the co-insurance for Medicare covered services Doesn’t pay for services that Medicare won’t cover	Fails to reapply every 12 months. Doesn’t supply adequate proof of income or resources, when asked Income or resources go above the allowed limits

Medicare Savings Program MSP SLMB E-SLMB QI-1	Person on Medicare who meets income and resource requirements	Pays the Part B premium	Fails to reapply every 12 months. Doesn’t supply adequate proof of income Income goes above the allowed limits

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