CHPW Apple Health Eligibility

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.

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.

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.

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.

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).*

**Household includes your unborn child. For example, a single individual expecting one child is a 2-person household.

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).

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.

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.