Who Is Eligible?

Apple Health for Adults: Adults aged 19-64 may qualify for Apple Health. To qualify, you cannot be on Medicare and you must have monthly household income under 138% of the FPL (in 2024: $1,732 for one person, $2,351 for two people). You must also meet other requirements to qualify, such as US citizenship or qualifying immigrant status, and state residency. Enrollment in Apple Health for Adults is year-round—you can apply any time. For more information, see the Apple Health section in Health Care Coverage Options in Washington State. If you have a disability, visual impairment, or are age 65 or older, see Coverage for Those Who Are Over 65, or Have Long-Term Care Needs below.

Apple Health for Families: Medicaid benefits are available to parents and other relatives caring for children through Washington Apple Health for Families. To qualify, you must have monthly household income under $511/month for an individual or $658/month for a 2-person household (in 2024) or experienced a recent increase above that level due to earnings. Since a person whose income increases above that level would also qualify for Apple Health for Adults, this mainly benefits those whose income increases to a level above 138% of the FPL because as custodial parents and relatives, they can get an extension of Medicaid. You must also meet other requirements to be eligible, such as US citizenship or qualifying immigration status, and state residency. Adults and children who are not eligible may still qualify for the Apple Health programs below.

Apple Health for Pregnant Women: People who are pregnant or postpartum can get Medicaid through Apple Health for Pregnant Individuals and After Pregnancy Coverage. To qualify, you must have monthly household income under 198% of the FPL (in 2024: $3,373 for two people, $4,260 for three people). In November 2024, the FPL amount will increase to 210%. Note that a pregnant person's household size is increased by the number of unborn children. You do not need to be a citizen or have a qualifying immigration status to be eligible, but you must be a Washington state resident. You can get After Pregnancy Coverage for up to a year after your pregnancy ends, even if you did not previously have coverage during your pregnancy. Pregnancy and After Pregnancy coverage are available even if your pregnancy ends in miscarriage or abortion.

Coverage for Immigrants: Alien Emergency Medical (AEM) offers limited coverage for other immigrants who have an emergency medical condition. These programs are available for emergency hospital care, cancer treatment, kidney dialysis, COVID care, and nursing facility care. For more information including new programs for immigrants starting in 2024, see Immigrant Access to Health Care In WA.

What Is Covered?

Enrollees in Apple Health for Adults receive full-scope coverage with a broad range of services; for a list, see those under the "ABP" category.

Enrollees are not required to pay cost sharing, co-payments or deductibles for any service.

Enrollees are usually required to be in a managed care plan called Apple Health Managed Care. This means you must have a primary provider who is the gatekeeper to other medical providers, and the plan determines which providers will be covered under their plan. There are exemptions from Apple Health Managed Care for certain reasons, such as the need to continue with a treating provider, status as an American Indian/Alaska Native, living in a county where managed care participation is voluntary, or being a Medicare enrollee.

Coverage may be retroactive, up to 3 months before the month you apply. You can use this form to request retroactive coverage.

Other Things to Know

Pregnant teens under age 19 can apply on their own without their parents. They must use a paper application to apply, available from the Health Care Authority.

There are no time limits, work requirements or limits on resources you can own.

You can apply for Apple Health coverage year-round or renew your coverage through Washington Healthplanfinder. You can also apply or renew with in-person assistance with applying or renewing. Find a navigator in your community.

If your family income changes over the year, you may apply based on an average of that income.

Family Planning Coverage:

The Washington State Health Care Authority offers Family Planning Only for individuals not eligible for full Apple Health coverage, individuals age 18 or younger, and others who need confidential services. The income limit is 265% of the FPL ($3,326 month for an individual in 2024) and there is no resource limit. This program is available regardless of immigration status. Individuals can apply through family planning providers or on their own. If you're a teen, you may be eligible for Apple Health coverage on your own. More information is available by calling Washington Healthplanfinder at 1-855-923-4633.