Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-524 - COFA ISLANDER HEALTH CARE
Section 182-524-0600 - Payments
Current through Register Vol. 24-18, September 15, 2024
(1) We pay your silver level qualified health plan (QHP) premium costs directly to the QHP carrier unless we determine good cause exists to reimburse you for the premium costs.
(2) We pay your mandatory out-of-pocket costs separate from your premium costs through cost-sharing funds.
(3) Cost-sharing funds are only for your out-of-pocket costs.
(4) We will not pay for, or reimburse you for, costs not considered as out-of-pocket costs or expenses incurred by people not covered under COFA islander health care.
(5) You are responsible for ensuring the services you receive are covered under your QHP and rendered as in-net-work.
(6) We may stop payments of your silver level QHP premium costs and your cost-sharing funds when you:
(7) You must follow the requirements of any agency-contracted vendor that provides services enabling you to access your cost-sharing funds.
(8) We monitor payments and cost-sharing transactions under COFA islander health care.
