Who Is Eligible?

Newborns are automatically eligible when born to a parent who received Apple Health at the time of the child's birth. The eligibility will last for 12 months.

Children under age 19 may be eligible if their family’s monthly income is less than 317% of the FPL (in 2024: $3,978 for one person, $5,400 for two people). Children under age 6 remain eligible regardless of changes in income. To be eligible above 215% of FPL, children must not be covered by other insurance, and families must pay a monthly premium to HCA (between $20-30 per child). You do not need to provide a citizenship or immigrant status to be eligible, but you must be a Washington State resident.

What Is Covered?

Enrollees receive Categorically Needy (CN) coverage, which is comprehensive. The general categories of CN service are listed in WAC 182-501-0060(6); all medically necessary services are covered.

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 you apply. You can use this form to request retroactive coverage.

Other Things to Know

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

Apply for coverage and renew coverage through Washington Healthplanfinder.

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