Family Medicaid Programs
Purpose
There are various Medicaid programs available to children and their caretakers in the State of Washington. Medicaid is the federal name for the state and federal funded medical benefit program.
General Eligibility
The family medical programs are available to families who have an eligible child in their home and who meet income and resource guidelines. For medical programs an "eligible child" is a child under the age of 19. Depending on a family's income, they may or may not have to pay a premium for their medical coverage. In addition, depending on the income, the adult members of the family may or may not be eligible for coverage even though their children are covered. In some cases, families must "spend down" their excess income in order to be eligible for medical benefits. This means the family must incur medical expenses equal to their excess income amount before they can be eligible to receive any Medicaid benefits. This spend down process is similar to an insurance deductible.
The chart below provides descriptions of the the various family Medicaid programs available in the State of Washington or review the programs online. Families will always be assigned to the program that has the broadest scope of care for their income level.
| Program Definition | Description |
|---|---|
| TANF Cash | Families who are on TANF receive this type of medical. Includes medical and dental |
| TANF Transitional Medical | Families who received TANF/SFA in 3 of the last 6 months are eligible to receive TANF Transitional Medical for 12 months. Includes medical and dental |
| Medical Extension | TANF terminated due to increased child support. This is a 4-month medical extension from the time TANF terminates. Includes medical and dental |
| TANF related CN Medical | Eligible for TANF but chooses not to receive. Includes medical and dental |
| Newborn Medical | Coverage for child born to a woman receiving Medicaid on the date of the child's birth. Covers to age 12 months. |
| Children's CN Medicaid | For Children under age 19. Has no premium or co-pay. Must review every 12 months. Includes medical and dental. |
| Children's Health Insurance Program (CHIP) | This is a Federal/State funded program that covers children less than age 19 in families whose income is too high for Medicaid, but is below 250% of the Federal Poverty level. Has premiums and co-pays. Includes medical and dental. |
| Children's Health Program | State funded program for alien children. Scope of care is the same as Children's CN Medicaid. Program may be capped if expenditures exceed appropriated budget. |
| Alien Emergency Medical | This is for an alien child under the age of 19 or an alien adult who is the caretaker of a dependent child who has an emergent medical condition. |
| Pregnancy Medical | Medical program providing medical care for pregnant women with family income below 185% of the federal poverty level. |
| Pregnancy Medical-Family Planning Extension | This is a medical program that provides up to 12 months of family planning services for women who were on pregnancy medical when their pregnancy ended. |
How to Apply:
You can apply for the Family Medical Program at your local Community Services Office or apply online.