Effective Nov. 1, 2024, the Health Care Authority (HCA) will increase income standards for pregnant and postpartum Apple Health clients from 193% of the Federal Poverty Level (FPL) to 210% FPL.
Other than countable income, factors that determine eligibility for the state After-Pregnancy Coverage (APC) program include: Washington state residency, a pregnancy within the last 12 months and ineligibility for another Apple Health program.
According to the NIH, more than half of pregnancy-related deaths occur during the postpartum period. To work to decrease preventable maternal mortality in the state, on June 30, 2022 CMS approved Washington’s state plan amendment which sought to expand postpartum coverage from 60 days after pregnancy to 12 months postpartum. To ensure there is no gap in access to care, Medicaid enrollees will receive full Medicaid benefits during this 12 month postpartum period.
For more information on the increased income limits and coverage, please review HCA’s rulemaking notice and press release. (Mary Storace)
