Apple Health Renewal Process

Updated October 2016

Agenda

• Auto-Renewal

• Manual Renewal

• How to Process a Renewal in Healthplanfinder

• Other Renewal Info

• Resource Information

Apple Health Renewal Process

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Apple Health (Medicaid) Renewals

For individuals receiving Apple Health MAGI Medicaid*

through Healthplanfinder:

• 60 days prior to an Apple Health recipient’s renewal

due date, the Healthplanfinder system captures the

individual’s original application and determines

whether he or she is eligible for auto-renewal

• Individuals will be notified whether they have been

auto-renewed or that they could not be auto-renewed

and must complete a manual renewal

*MAGI Medicaid: Family, Children, Pregnancy and Adult

medical programs

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Auto-Renewal Vs. Manual

Auto-Renewal

• Data-match finds household under the Medicaid

standard

• No data-match found and income on file under the

Medicaid standard

• No additional information needed by recipient

• Recertified for twelve months

Manual

• Data-match finds household above Medicaid standard

• Individual must manually complete their renewal

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Auto-Renewal

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Auto-Renewal

If the original application is determined to be eligible for

auto-renewal:

• The individual will be sent a pre-populated

notification (Healthplanfinder-EE008) that

summarizes their account, household composition,

tax filing status, and other application-related

information.

• The EE008 notification will inform the individual that

their Washington Apple Health determination and

enrollment has been renewed for 12 months.

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Auto-Renewal

The notification informs the individual they must review

the information carefully.

Incorrect information must be corrected by reporting

required changes:

• Online at www.wahealthplanfinder.org

• Call Healthplanfinder CSC at 1-855-923-4633

• Make changes to the document received, sign and

return via:

 Mail: PO Box 946, Olympia, WA 98507

 Fax: 1-855-889-2266

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Auto-Renewal:

The EE008

notification informs

the individual they

have been auto-

renewed and will

continue receiving

Apple Health

coverage.

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EE008

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Manual Renewal

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Manual Renewal

Example of applications that are not eligible for auto-

renewal:

• Automated data-match shows income over the

Apple Health (Medicaid) standard

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Manual Renewal

If the original application is determined not eligible for

auto-renewal:

• The individual will be sent a notification that they

must manually renew their Apple Health coverage.

The individual can complete their renewal:

• Online at www.wahealthplanfinder.org

• Call Healthplanfinder CSC at 1-855-923-4633

• Update the renewal document received, sign and

return via:

 Mail: PO Box 946, Olympia, WA 98507; or

 Fax: 1-855-889-2266

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Manual Renewal:

The EE009

notification informs

the individual they

must manually

renew their health

care coverage to

continue receiving

Apple Health.

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EE009

How to Process a Renewal

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Let’s process a renewal in Healthplanfinder!

• The following step-by-step process shows how to process

an Apple Health renewal in Healthplanfinder (HPF), when

an individual has an existing account.

 Note: Apple Health users are not required to “create an

account.” Individuals continue to have the option on the

“About You” screen to “Skip Account Creation.”

 Account Creation is strongly encouraged to simplify the

referral process and locate the account in future visits to

Healthplanfinder.

1) Log in to your

existing account

in HPF.

2) Click on

“Update my

Application and

Renew

Coverage”

under Quick

Links

Note: This option

appears 60 days prior

to the end date and

up to 90 days after

coverage has ended

for no renewal.

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About You:

3) Information

should be prefilled.

• Verify that

information is

correct.

• Make changes

as needed.

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Primary

Applicant’s

Information:

4) Information

should be prefilled.

• Verify that

information is

correct.

• Make changes

as needed.

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Primary Applicant’s

Taxes:

5) Information

should be prefilled.

• Verify that

information is

correct.

• Make changes

as needed.

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Other Household

Members or Tax

Dependents:

6) Information

should be prefilled.

• This is where

household

members can be

added/removed.

• Verify that

information is

correct. Make

changes as

needed.

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Set Household

Relationships:

7) Information

should be prefilled.

• Verify that

information is

correct.

• Make changes

as needed.

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Additional

Questions:

8) Information

should be prefilled.

• This is where to

report a

pregnancy or any

changes in

health insurance.

• Verify that

information is

correct. Make

changes as

needed.

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Additional

Screening

Questions:

9) Information

should be prefilled.

• LTC and

retroactive

coverage

requests are

updated here.

• Verify that

information is

correct. Make

changes as

needed.

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Household Income

and Deductions:

10) Information

should be prefilled.

• Report any

income

changes.

• Verify that

information is

correct. Make

changes as

needed.

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Household Income

Details:

11) Information

should be prefilled.

• Update income

information.

• Verify that

information is

correct. Make

changes as

needed.

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Application Review

and Additional

Screening

Questions:

12) Information

should be prefilled.

• Opportunity for

final review.

• Verify that

information is

correct.

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Primary Applicant’s

Signature:

13) Submitting the

application.

• Certify that you

understand your

rights and

responsibilities.

• E-sign the

application.

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Eligibility

Results/

Household

Summary:

14) Review

the final

results.

• Eligibility

Results

• Household

Summary

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Other Renewal Info

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Lost your Healthplanfinder

User Name or Password?

How to recover your HPF user name or password

• The following step-by-step process shows how to obtain

your forgotten user name or password in

Healthplanfinder.

HPF Home

Page:

1) Click either

link at bottom

right.

• Forgot your

username?

• Forgot your

password?

• Our first

example is

“Forgot my

User Name?”

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Forgot User

Name:

2) Provide an

email address

and click next.

• User name is

sent to you

via email.

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Forgot

Password:

3) Provide your

user name and

click next.

• The Forgot

Password

screen will

prompt you to

create a new

password.

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Forgot

Password:

4) Type in new

password,

reenter new

password and

answer Security

Questions.

• If successful,

you’ll see this

response.

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Forgot your Email Address?

Many individuals created an email address specifically

for use with Healthplanfinder. One year later they may

have forgotten their email address.

• An individual may contact the HPF CSC at 1-855-923-

4633 for assistance

• The HPF CSC will verify the individual’s account

information such as name, date of birth and SSN

• HPF CSC can provide the HPF username and email

address and will direct them to the HPF home page to

reset their HPF password

• If not successful, the HPF CSC can reset the HPF

password for the individual

When other members

are active on a QHP

Processing a renewal for Apple Health when others are

active on QHP

• When completing renewal and other household members

are enrolled in a QHP, it is important to not change the

answers to the following questions we will review in the

next slides, unless the other member no longer wishes to

seek coverage through Healthplanfinder.

Note: HIPTC/QHP applicants are required to “create an

account” in Healthplanfinder.

About You:

1) If everyone

who has

coverage still

wants

coverage

(whether

WAH or

QHP), do not

change the

response for

these two

questions.

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Other Household

Members or Tax

Dependents:

2) If everyone

who has coverage

still wants

coverage

(whether WAH or

QHP), do not

change the

response from

“yes” to “no” for

the household

member on QHP.

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Missed Your Renewal?

90 days after coverage ends

• If found eligible for Apple Health within 90 days of

coverage terminating, due to no renewal, coverage goes

back to date of termination.

• No loss of coverage.

Renewals and Age Requirements

Age Reminders

• System sends update reminders 60 days prior to

individual’s birthday

Individuals Turning 19

• No longer eligible for Apple Health for Kids under parents

• If income eligible for Apple Health, individual must apply

for coverage on their own application

Note: If an individual qualifies only for HIPTC/QHP, they

may remain on their parents QHP coverage up to age 26.

Resource & Contact Info

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HCA Community-Based Specialists

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HCA has placed a community-based eligibility worker in

most counties across the state.

These specialists can assist with answering questions

about MAGI Medicaid eligibility.

If a renewal application gets stuck in the system, these

HCA staff are available to assist with error code resolution.

You may find an updated list of these HCA staff at the

following link on the HCA Training & Education web page:

http://www.hca.wa.gov/assets/free-or-low-

cost/community_based_staff_contact.pdf

HCA Area Representatives

Area

Counties

Representative

East

Asotin

Ferry

Garfield

Lincoln

Pend Oreille

Spokane

Stevens

Whitman

Mark Westenhaver

mark.westenhaver@hca.wa.gov

360

-725-1324

North Central

Adams

Chelan

Douglas

Grant

Okanogan

Francesca Matias

francesca.matias@hca.wa.gov

360

-725-0920

South Central

Benton

Columbia

Franklin

Kittitas

Klickitat

Walla Walla

Yakima

Dody McAlpine

dody.mcalpine@hca.wa.gov

360

-725-9964

North West

Island

San Juan

Skagit

Snohomish

Whatcom

Maggie Clay

margaret.clay@hca.wa.gov

360

-725-0934

HCA Area Representatives

Area

Counties

Representative

King

Rebecca Janeczko

rebecca.janeczko@hca.wa.gov

360

-725-0752

Sarah Michael

sarah.michael@hca.wa.gov

360

-725-0919

Central West

Clallam

Jefferson

Kitsap

Mason

Pierce

Melissa Rivera

melissa.rivera@hca.wa.gov

360

-725-1713

South West

Clark

Cowlitz

Grays Harbor

Lewis

Pacific

Thurston

Skamania

Wahkiakum

Dody McAlpine

dody.mcalpine@hca.wa.gov

360

-725-9964

Additional Medicaid Resources

 HCA Training & Education Resources

http://www.hca.wa.gov/free-or-low-cost-health-care/apple-health-medicaid-

coverage/stakeholder-training-and-education

 Cross-agency Desk Aid

http://www.hca.wa.gov/assets/free-or-low-

cost/customer_support_center_referrals.pdf

 HCA Community-Based Specialists

http://www.hca.wa.gov/assets/free-or-low-

cost/community_based_staff_contact.pdf

 Questions? Contact your HCA Area Representative

http://www.hca.wa.gov/assets/free-or-low-cost/area_representatives.pdf

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