CHPW Apple Health Eligibility - Washington State Local Health Insurance - CHPW

CHPW Apple Health Eligibility

Apple Health eligibility based on your status

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 effect 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
Size of Household Single person 2-person 3-person 4-person 5-person 6-person 7-person
Monthly income $1,482 $2,004 $2,526 $3,048 $3,570 $4,092 $4,614
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
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 pregnant individuals

You may be eligible for Apple Health for Pregnant individuals coverage if you:

  • Are pregnant.
  • Have income at or below the Medicaid standard (see income chart below).*
Apple Health for Pregnant Individuals
Income Eligibility Requirements
Size of Household Single person 2-person 3-person 4-person 5-person 6-person 7-person
Monthly income N/A $2,875 $3,624 $4,373 $5,122 $5,871 $6,620
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
Size of Household Single person 2-person
Monthly income $794 $1,191
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.

Apple Health for kids (up to age 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 or low-cost, with a low premium.

Apple Health for Kids (Free or Low-Cost Coverage)
Income Eligibility Requirements
Size of Household Single person 2-person 3-person 4-person 5-person 6-person 7-person
Monthly income $2,308 $3,122 $3,935 $4,748 $5,562 $6,375 $7,189

 
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:

 

CHNW Cascade Select
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 CHNW Cascade Select.

See eligibility details ➜

CHPW Medicare Advantage

 

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) regardless of income.

See eligibility details ➜

Become a CHPW member:

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