Home > Professionals > Frequently Asked Questions

FAQs

WithinReach Staff person

The following questions represent frequently asked questions from social service professionals to WithinReach’s statewide Health and Food Hotlines. Learn more about WithinReach’s Information and Referral Services.

FAQs about Applying for Medical and Food Benefits

FAQs about Medicaid Programs

FAQs about WIC and Basic Food

Applying for Medical and Food Benefits

How do I help a client with verification of income?

For most programs, including the medical coupon, food stamps, and WIC, you only need to provide verification of income for the last 30 days, such as pay stubs or a signed letter from the employer which states the monthly pay.

  • What if my client is self-employed?
    • Self-employed workers have two main options for verifying their income: (a) If their income has been consistent since last year, they can submit their Schedule C (form 1040) from last year’s tax return. (b) If they are newly self-employed, or their income is different from last year, they can have an accountant prepare a profit-loss statement. If they do not use an accountant, they themselves can produce the profit loss statement, but must verify all the numbers (each profit, each expense) with copies of receipts, invoices, checks, etc.

    • You can use the Self-Employment Income Report as an idea for what DSHS expects from a profit-loss statement, though many businesses will have to make their own version to match their own particular kinds of profits and expenses.
  • What if my client’s income varies from month to month or is seasonal?
    • For many people, such as farm workers, construction workers, fisherman, or those who are self-employed, income may vary from week to week or from month to month. In this case the client can give more than one month’s income verification to show an overall average. For example, the client could submit copies for three months worth of pay-stubs, or if she is self-employed, a profit-loss statement for three months.

    • For a self-employed client, if she does not use an accountant for this profit-loss statement, she would still need to verify all the profits and losses with receipts, invoices, checks, etc. It can be a challenge to prepare this documentation for three, six, or even twelve months, but it may be necessary to show that on average, the client is under the income guideline.

When does a client need to prove citizenship and identity?

The Department of Social and Health Services (DSHS) no longer requires U.S. citizens to show proof of citizenship and identity when applying for DSHS programs. But, clients must provide a valid Social Security Number (SSN). If a problem arises with the SSN, DSHS will follow up with the client to verify citizenship and identity.

Non U.S. citizens must continue to verify their alien/residency status to receive benefits. For more information, read the DSHS Letter

How do I address a unique living situation with my clients?

  • Children’s Medical Benefits – Children not living with their biological or legally adoptive parents should only provide proof of their personal income. Their parent’s income will not be counted towards their eligibility. This includes children who live with a family member who is not their legally adoptive parent. The family member’s income will not be taken into consideration for the child’s eligibility.
  • First Steps (Family Planning or Maternity Medical Benefits) – The income of the pregnant woman and the spouse of the pregnant woman determine eligibility. Eligibility for a pregnant teen living with her family will only be determined using her personal income, not her parent’s income.
  • Basic Food (Food Stamps) – The income of everyone living in the household who buys and prepares food together will be counted towards eligibility regardless of their relationships.
  • WIC (Women, Infants and Children) – The income of everyone living in the household who buys and prepares food together will be counted towards eligibility regardless of their relationships. However, if a pregnant woman or a child under age 5 is enrolled in a FREE medical coupon they are automatically income eligible.

Where do I check on the status of an application my client submitted?

  • In King County, you can contact the Region 4 Call Center at (800) 662-6715. Press 5 for immediate help in Spanish. (206) 341-7433 is an alternate local number.
  • For Yakima, Kittitas, Benton, Franklin, Walla Walla and Columbia counties you can contact the Region 2 Call Center at (877) 980-9140. Press 7 for immediate help in Spanish.
  • Applications for the SCHIP (low-cost) program and for children who are non-citizen are processed in Olympia. Please call the Health and Recovery Services Administration (HRSA/MEDS) at (800) 204-6429

Medicaid Programs

What is Healthy Options?

  • Healthy Options is the name for the State’s managed care plans. Managed Care refers to access to health care through a primary care provider (usually a Family Practitioner, Pediatrician or Internist). This provider is a “gatekeeper” and provides all basic and preventive health care and can refer the person to other health services as needed.

What is Fee for Service?

  • Fee for Service is when a client does not enroll into a Healthy Options managed care plan. Fee for Service is also known as an “open coupon”. These clients find a clinic or provider who accepts medical coupons and will bill Medicaid for the health services provided.

Where does my client send the S-CHIP payment?

  • Monthly payments for the State Children’s Health Insurance Program (S-CHIP) should be mailed to:

DSHS, FSA
PO Box 9501
Olympia, WA 98507-9501

What is the Premium Payment Program?

  • The Premium Payment Program helps families keep private insurance while on Medicaid. If eligible, this DSHS program will pay for health insurance premiums for clients that are already enrolled in the Medicaid Program. Please note – not every family/client already enrolled in Medicaid will automatically qualify.
  • If you can answer YES to the following two questions, you might be eligible.
  1. Does at least one person in your family receive Medicaid? (also called the medical coupon)
  2. Do you have access to health insurance such as:
    • Private health insurance you purchase yourself
    • Employer sponsored insurance made available through your job
    • COBRA continuing your job’s health insurance if you become unemployed
    • Medicare Supplement

WIC and Basic Food

What can my client purchase with an EBT card?

Households CAN use EBT benefits to buy foods for the household to eat such as:
  • breads and cereals
  • dairy products
  • fruits and vegetables
  • meats, fish and poultry
  • Seeds and plants which produce food for the household to eat
Households CANNOT use EBT benefits to buy:
  • beer, wine, liquor
  • cigarettes or tobacco
  • pet foods
  • soaps, paper products and household supplies
  • vitamins and medicines
  • hot foods (prepared foods from the deli)
  • fountain drinks and hot coffee

In some areas, restaurants can be authorized to accept food stamp benefits from qualified homeless, elderly, or disabled people in exchange for low-cost meals. Food stamp benefits cannot be exchanged for cash.

What is the connection between Farmer’s Market and WIC – what services are available?

  • In certain areas of the state clients may receive vouchers from their WIC clinic to purchase fresh fruits and vegetables at their local farmer’s markets. This program benefits both families and local farmers! Not all WIC clinics offer this option, so check with your local clinic about the availability of this program. These vouchers don’t replace the regular WIC foods that are offered, but are a one-time benefit.
  • Eligible WIC participants are issued Farmer’s Market Nutrition Program (FMNP) coupons in addition to their regular WIC food instruments. These coupons can be used to buy fresh, unprepared fruits, vegetables and herbs from farmers, farmers’ markets or roadside stands that have been approved by the State agency to accept FMNP coupons. The Federal food benefit level for FMNP recipients may not be less than $10 and no more than $30 per year, per recipient. However, State agencies may supplement the benefit level.

What is the new income limit for Basic Food?

Why did my client qualify for Basic Food, but received a benefit amount of zero?

  • Once someone is income eligible for Basic Food, the next step in the process is to determine the food benefit amount. DSHS determines a family’s benefit amount by looking at household expenses such as housing costs, daycare expenses, medical expenses, and court ordered child support paid out. Families who have three or more in the household, and do not have a lot of expenses, may find they get zero Basic Food benefit. If they are approved for zero benefits, the family will still get access to other programs associated with being approved for Basic Food. Those other programs include: automatic enrollment into the free school lunch program, WIC eligibility, and the telephone assistance program.
  • If a family is approved for zero benefits they can contact DSHS any time they have a change in expenses or income. DSHS can re-determine their food benefit amount without the family needing to reapply for the program.
  • To estimate your client’s Basic Food benefit amount, use the Benefit Estimator or call the Family Food Hotline at 1-888-436-6392 for help with your questions.