Medically Intensive Children's Program (MICP)

With MICP, children ages 17 and younger with complex medical needs can receive skilled nursing services from a registered nurse. These services may be provided at home, foster homes, and contracted children’s groups.

What is the eligibility criteria for MICP?

 


To be eligible, children must:
 

Be 17 or younger.
 

Have complex medical needs (example: ventilator dependent, require tracheostomy care).
 

Be enrolled in Washington Apple Health (Medicaid).
 

Require at least four hours of continuous skilled nursing care per day.

 


To learn more, contact our Case Management department:
 

Email us at cmrefwash@wellpoint.com
 

Call toll free at 855-323-4688, ext. 33118
 

 

If you need extra help getting private duty nurses, call the Health Care Authority Medical Assistance Customer Service Center at 800-562-3022 (TTY 711).

 

Wellpoint and the Health Care Authority (HCA)

This program is run by Wellpoint in partnership with the Washington State HCA.

How Wellpoint and the HCA work together

 


Wellpoint:

 

Determines eligibility 
 

Assesses the child and arranges for timely access of medically needed services
 

Sends the written authorization letter

 

Health Care Authority (HCA):

 

Oversees how Wellpoint delivers MICP services
 

Helps families get private duty nursing services
 

Ensures children enrolled in Apple Health receive services

 

Developmental Disabilities Association (DDA):

 

Determines eligibility for Developmental Disabilities (DD) waiver services

Provides DD waiver services



This program is also supported by:

 

DSHS Children’s Administration; DSHS Home and Community Services Divisions
 

Health Care Authority
 

Service providers

Families of clients

Community organizations

Hospitals