Apple Health eligibility based on your status
Note: Continuous Apple Health (Medicaid) coverage for children 6 and under is still in place. Children Apple Health coverage continues through the end of the month they turn 6. Please see the eligibility section for children 0-6 for more information.
Apple Health (Medicaid) eligibility depends on your income and life situation. Read through the requirements below to find out if you’re eligible.
Apple Health coverage is excluded from reporting under public charge and does not affect immigration status.
*The income standards listed in these examples are subject to change annually every April.
Apple Health for individual adults (age 19-64)
You may be eligible if you:
- Are age 19 through 64.
- Have annual household income at or below the Medicaid standard (see income chart below).*
- Are a U.S. citizen or meet Medicaid immigration requirements.
- Are not entitled to Medicare.
Apple Health for Adults (age 19 through 64 years of age) Income Eligibility Requirements |
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Size of Household | Single person | 2-person | 3-person | 4-person | 5-person | 6-person | 7-person |
Monthly income | $1,732 | $2,351 | $2,969 | $3,588 | $4,207 | $4,825 | $5,444 |
Apple Health Expansion for individual adults (age 19 and older)
You may be eligible if you:
- Are a Washington resident age 19 or older.
- Have countable income under 138% of the federal poverty level. (see income chart below*)
- Do not qualify for other Apple Health programs based on immigration status**.
- Are not pregnant or did not have a pregnancy end in the last 12 months.
- Are not eligible for qualified health plans (QHP) with advance premium tax credits (APTC) or federally funded medical assistance programs.
Apple Health Expansion for Adults (age 19 and over) Income Eligibility Requirements |
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Size of Household | Single person | 2-person | 3-person | 4-person | 5-person | 6-person | 7-person |
Monthly income | $1,732 | $2,351 | $2,969 | $3,588 | $4,207 | $4,825 | $5,444 |
**Immigrants who have not met the five-year waiting period to become eligible for Apple Health are not eligible for Apple Health Expansion.
Apple Health for parents/caretakers
You may be eligible for Apple Health for Parent/Caretaker coverage if you:
- Have annual household income at or below the Medicaid standard (see income chart below)*
- Have dependent children under the age of 18 living in your home.
Apple Health for Parents/Caretakers (adults with dependent children under age 18) Income Eligibility Requirements |
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Size of Household | Single person | 2-person | 3-person | 4-person | 5-person | 6-person | 7-person |
Monthly income | $511 | $658 | $820 | $972 | $1,127 | $1,284 | $1,471 |
Apple Health for kids (ages 0 - 6)
Your newborn up to age 6 child may be eligible for Apple Health for Kids, a free or low-cost coverage plan, if your income is at or below the Medicaid standard (see income charts below).*
If your child qualifies for and is enrolled under Apple Health for Kids, and your income or life situation changes, your child will still be covered through the end of the month they turn 6.
The month following when they turn 6 is when you will need to participate in the renewal process. Your income at that time will be taken into consideration for your child to continue to be covered by Apple Health for Kids.
Under this plan, your child’s health care may be free.
Apple Health for Kids (Free Coverage) Income Eligibility Requirements |
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Size of Household | Single person | 2-person | 3-person | 4-person | 5-person | 6-person | 7-person |
Monthly income | $2,698 | $3,662 | $4,626 | $5,590 | $6,554 | $7,518 | $8,482 |
Apple Health for kids (ages 7 - 19)
Your child may be eligible for Apple Health for Kids, a free or low-cost coverage plan, if your income is at or below the Medicaid standard (see income charts below).*
Under this plan, your child’s health care may be free.
Apple Health for Kids (Free Coverage) Income Eligibility Requirements |
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---|---|---|---|---|---|---|---|
Size of Household | Single person | 2-person | 3-person | 4-person | 5-person | 6-person | 7-person |
Monthly income | $2,698 | $3,662 | $4,626 | $5,590 | $6,554 | $7,518 | $8,482 |
Apple Health for kids (with premiums)
If you do not meet the Medicaid income standard for the free Apple Health for Kids coverage plan, you may qualify for a low-cost premium plan. Please see both premium tiers in the chart below*.
Under this plan, your child’s health care may have a low premium.
Apple Health for Kids (Low-Cost Coverage) Income Eligibility Requirements |
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Size of Household | Single person | 2-person | 3-person | 4-person | 5-person | 6-person | 7-person |
Monthly income for Tier 1: $20 monthly premium per child, $40 family maximum |
$3,326 | $4,514 | $5,702 | $6,890 | $8,078 | $9,266 | $10,454 |
Monthly income for Tier 2: $30 monthly premium per child, $60 family maximum |
$3,978 | $5,400 | $6,821 | $8,242 | $9,663 | $11,084 | $12,506 |
Apple Health for pregnant individuals
You may be eligible for Apple Health for Pregnant individuals coverage if you:
- Are pregnant.
- Live in Washington State
- Have income at or below 193% of the Federal Poverty Level (FPL) (see income chart below).*
Apple Health for Pregnant Individuals Income Eligibility Requirements |
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Size of Household | Single person | 2-person | 3-person | 4-person | 5-person | 6-person | 7-person |
Monthly income | N/A** | $3,373 | $4,260 | $5,148 | $6,036 | $6,923 | $7,811 |
**Household includes your unborn child. For example, a single individual expecting one child is a 2-person household.
Apple Health for noncitizens
Individuals who do not meet the program requirements for Apple Health solely due to immigration status may be eligible for the Alien Emergency Medical (AEM) Program if they have a qualifying medical condition (must have or need at least one of the following):
- A qualifying emergent medical condition such as emergency room care, inpatient hospital admission, or outpatient hospital surgery
- A cancer treatment plan
- Dialysis treatment
- Anti-rejection medication for an organ transplant
- Long-term Care (LTC) services (prior approval required)
- COVID-19 assessment and testing
Not sure whether your medical condition qualifies? Call the Health Care Authority (HCA) Customer Service Center at 1-800-562-3022 (TRS: 711).
Apple Health for the aged, blind, or disabled
If you are age 65 and older, blind, or disabled and meet income and resource requirements,* Apple Health (Medicaid) may provide health care coverage and help pay for Medicare premiums and medical expenses.
Apple Health for the Aged, Blind, or Disabled Income Eligibility Requirements |
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Size of Household | Single person | 2-person |
Monthly income | $963 | $1,435 |
Apple Health for adults age 65+
Some Medicare recipients are also eligible for Apple Health (Medicaid) coverage.
This coverage could include free or low-cost coverage, help paying for Medicare premiums, or long-term services and supports.
Eligibility for Apple Health coverage is determined by your household’s income and resources (except for Apple Health for Workers with Disabilities). Call the Department of Social and Health Services at 1-877-501-2233.
Not sure which of these categories applies to you? Call us at 1-866-907-1904 (TTY Dial: 711), Monday through Friday from 8:00 a.m. to 5:00 p.m., and we’ll be happy to help you.
Depending on your life situation, you may qualify for a different kind of health plan. CHPW also offers these health plans:
If your income level is above Apple Health standards you may qualify for Cascade Care. Cascade Care plans are affordable health plans offered on wahealthplanfinder.org. Cascade Care includes plans like CHPW Cascade Select.
People who are 65 or older, or who have certain types of disabilities, may qualify for a CHPW Medicare Advantage plan. Some people may qualify for both Medicare and Apple Health (Medicaid).