WAC 182-505-0240 Family medical eligibility.

1. A person is eligible for categorically needy (CN) medical assistance when they are:

   1. Receiving temporary assistance for needy families (TANF) cash benefits;

   2. Receiving Tribal TANF; 

   3. Receiving cash diversion assistance, except SFA relatable families described in WAC 388-400-0010 (2);

   4. Eligible for TANF cash benefits but choose not to receive; or

   5. Over the TANF cash payment standard but under the family medical payment standard as described in WAC 388-478-0065; or

   6. Not eligible for or receiving TANF cash assistance, but meet the eligibility criteria for aid to families with dependent children (AFDC) in effect on July 16, 1996 except that:

      1. Earned income is treated as described in WAC 388-450-0210; and

      2. Resources are treated as described in WAC 388-470-0005  for applicants and WAC 388-470-0026  for recipients.

2. An adult cannot receive a family medicaid program unless the household includes a child who is eligible for:

   1. Family Medicaid;

   2. SSI; or

   3. Children’s Medicaid.

3. A person is eligible for CN family medical coverage when the person is not eligible for or receiving cash benefits solely because the person:

   1. Received sixty months of TANF cash benefits or is a member of an assistance unit which has received sixty months of TANF cash benefits;

   2. Failed to meet the school attendance requirement in chapter 388-400 WAC;

   3. Is an unmarried minor parent who is not in a department-approved living situation;

   4. Is a parent or caretaker relative who fails to notify the department within five days of the date the child leaves the home and the child's absence will exceed one hundred eighty days;

   5. Is a fleeing felon or fleeing to avoid prosecution for a felony charge, or is a probation and parole violator;

   6. Was convicted of a drug related felony;

   7. Was convicted of receiving benefits unlawfully;

   8. Was convicted of misrepresenting residence to obtain assistance in two or more states;

   9. Has gross earnings exceeding the TANF gross income level; or

   10. Is not cooperating with WorkFirst requirements.

4. An adult must cooperate with the division of child support in the identification, use, and collection of medical support from responsible third parties, unless the person meets the medical exemption criteria described in WAC 388-503-0540 or the medical good cause criteria described in Chapter 388-422 WAC.

5. Except for a client described in WAC 388-505-0210, a person who is an inmate of a public institution, as defined in WAC 388-500-0005, is not eligible for CN or MN medical coverage.