Apple Health, the Washington State Health Care Authority (HCA) brand for Medicaid, covers adults at or below 138% of the Federal Poverty Level in 2026 and children up to 312% FPL through Apple Health for Kids, Washington's CHIP-funded children's coverage. Losing Apple Health can follow an income increase, an unreturned renewal packet, a change in household size, or a data-matching error. Whatever the cause, losing Apple Health is a qualifying life event that opens a Marketplace Special Enrollment Period (SEP) on Washington Healthplanfinder at wahealthplanfinder.org. The standard 60-day window applies: you can apply up to 60 days before your coverage ends and up to 60 days after. Washington runs a state-based exchange, so healthcare.gov does not process Washington applications. Two Apple Health safety valves run on separate clocks. HCA restores coverage without a gap if you return a completed renewal within 90 days of the termination date, and you have 90 days from the notice date to request an administrative hearing. The ACA subsidy cliff returned for 2026 after enhanced premium tax credits expired on January 1, 2026, so check your projected 2026 income before choosing a path.
Washington expanded Medicaid in 2014 and is one of the 40 expansion states plus DC in 2026, so any adult age 19 to 64 with household income at or below 138% FPL qualifies for Apple Health with no asset test. For 2026, 138% FPL equals $22,025 for a single person and $45,540 for a family of four, per HHS ASPE 2026 Poverty Guidelines. Children qualify at higher incomes: Apple Health for Kids is free at or below 210% FPL and available for a monthly premium up to 312% FPL in 2026, per HCA. If your income is above the adult line, premium tax credits on Healthplanfinder usually make a Silver or Gold Cascade Care plan the best choice, and the state's Cascade Care Savings program typically adds $55 per member per month in 2026 for projected income at or below 250% FPL. Use the Medicaid income limits and ACA income limits pages to check your household size, then follow the six steps below. Open Enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027, which is a fallback if your SEP window closes.
6 Steps to Get Coverage
Common Mistakes That Cost People Thousands
Washington residents lose coverage in 2026 most often through these avoidable mistakes after an Apple Health termination:
- Letting the 60-day SEP window close. After 60 days past your coverage end date, the next option is Open Enrollment starting November 1, 2026, which means months without a plan. Apply as soon as you receive the notice.
- Skipping the 90-day renewal fix. A procedural termination can be reversed without a gap if you return a completed renewal within 90 days of the termination date. Many people enroll in a new plan without trying this first.
- Reporting 2025 income instead of projected 2026 income. Healthplanfinder calculates premium tax credits on projected 2026 income, so a lower expected income means a larger credit.
- Forgetting the children. Apple Health for Kids is free up to 210% FPL and available with a premium up to 312% FPL in 2026, with year-round enrollment, even when the adults move to a Cascade Care plan.
- Choosing Bronze over Silver. For incomes up to 250% FPL, Cascade Care Silver plans carry cost-sharing reductions that cut deductibles and copays, which can make Silver cheaper overall than Bronze.
How to Reverse an Apple Health Termination in Washington in 2026
Washington Apple Health terminations are often procedural, meaning coverage ended because HCA did not receive a completed renewal rather than because you became ineligible. Under WAC 182-504-0035, you have 90 days from the termination date to give HCA a completed renewal, and if HCA finds you still eligible it restores Apple Health without a gap in coverage. A separate clock governs disputes: you have 90 days from the date at the top of the notice to request an administrative hearing, and only 10 days if you want to keep Apple Health while the hearing is pending. You can request a hearing by calling 1-855-WAFINDER (1-855-923-4633) or 1-800-562-3022, or by sending Form HCA 12-511 by fax to 1-360-586-9080 or by mail to the Health Care Authority, PO Box 45504, Olympia, WA 98504-5504. Pursuing a renewal or a hearing does not cancel your Marketplace SEP, so start both at once: the 60-day Healthplanfinder window keeps running from your original end date.
Washington Apple Health Income Limits and Cascade Care Savings for 2026
Washington Apple Health covers adults age 19 to 64 at or below 138% of the Federal Poverty Level, which is $22,025 for a household of one and $45,540 for a household of four in 2026, per HHS ASPE. Washington children qualify at higher incomes: Apple Health for Kids is free for households at or below 210% FPL ($69,300 for a family of four in 2026) and available for a monthly premium at or below 312% FPL ($102,960 for a family of four in 2026), per HCA. Above the adult Apple Health line, Washington households can claim federal premium tax credits up to 400% FPL, and the state's Cascade Care Savings program typically adds $55 per member per month in 2026 for projected income at or below 250% FPL. Washington's Exchange also offers an off-cycle enrollment option for low-income households into Cascade Care Silver or Gold plans, so confirm your eligibility on Healthplanfinder if your SEP has already closed. The table below shows the 2026 thresholds by household size.
Documents You Need to Enroll After Losing Apple Health in Washington
Washington Healthplanfinder and HCA verify identity, income, and residency before approving coverage, so gathering documents first prevents delays and coverage gaps. Your Apple Health termination notice is the key document because it proves the qualifying life event behind your Marketplace SEP. Recent pay stubs, an employer letter, or a self-employment income estimate establish projected 2026 income, which drives your premium tax credit. Social Security numbers are required for every household member applying, while some immigrant categories can use other identifiers or immigration documents. A utility bill, lease, or government mail confirms your Washington address, which also determines the plans offered in your county. Birth certificates help when you add children, who may qualify for Apple Health for Kids. If you had a Marketplace plan earlier, keep your prior Form 1095-A, because Healthplanfinder and the IRS use it to reconcile your premium tax credit on Form 8962 when you file your 2026 return.
Frequently Asked Questions
How long do I have to get new coverage after losing Apple Health in Washington?
Washington Healthplanfinder gives you a 60-day Marketplace Special Enrollment Period around the date Apple Health ends. You can apply up to 60 days before your coverage ends and up to 60 days after. If Apple Health ends October 31, 2026, your window runs September 1 through December 30, 2026. A plan selected before Apple Health ends starts the next day, so applying early prevents a gap. If the window closes, Open Enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027. Apply at wahealthplanfinder.org or call 1-855-WAFINDER (1-855-923-4633).
What documents do I need to enroll after losing Washington Apple Health?
Start with the Apple Health termination notice from the Health Care Authority, which proves the qualifying life event for your SEP. Add proof of projected 2026 income such as pay stubs or an employer letter, Social Security numbers for everyone applying, and proof of Washington residency such as a utility bill or lease. Bring birth certificates if you are adding children and immigration documents for non-citizen household members. If you had a Marketplace plan before, keep your prior Form 1095-A for premium tax credit reconciliation. Upload everything when you apply at wahealthplanfinder.org to avoid verification delays.
What happens if I miss the SEP window after losing Apple Health?
Missing the 60-day SEP window without another qualifying life event means you wait for Open Enrollment, which runs November 1, 2026 through January 15, 2027 for 2027 coverage, and you may go months uninsured. Two options stay open year-round. You can reapply for Apple Health if income is at or below 138% FPL ($22,025 for one person in 2026), and children can enroll in Apple Health for Kids. Washington's Exchange also offers off-cycle enrollment in Cascade Care Silver or Gold plans for low-income households, so check eligibility on Healthplanfinder.
Can I get retroactive coverage after losing Apple Health?
Marketplace plans bought through Washington Healthplanfinder are not retroactive: coverage starts the day after Apple Health ends if you select a plan before it ends, or the first of the month after you select a plan if you apply later. Apple Health is different when the termination was procedural. If you return a completed renewal within 90 days of the termination date and HCA finds you still eligible, HCA restores Apple Health without a gap, as if coverage never ended (WAC 182-504-0035). That 90-day renewal route is the closest thing to retroactive coverage, so use it quickly.
What is the difference between COBRA and Marketplace coverage after losing Apple Health?
COBRA applies only to employer plans, so losing Apple Health alone gives you no COBRA rights. If your employer coverage also ended, COBRA preserves your old plan at 102% of the full premium, often $400 to $900 per month for one person in 2026, with a 60-day election window. A Cascade Care plan on Healthplanfinder is usually cheaper once premium tax credits apply, and Cascade Care Savings typically adds $55 per member per month in 2026 at or below 250% FPL. Choose COBRA only to keep a specific specialist or a deductible you already met.
What Washington-specific rules apply after an Apple Health termination?
Washington runs its own state-based exchange, Washington Healthplanfinder, so healthcare.gov does not process Washington applications. Apple Health is run by the Health Care Authority, which gives you 90 days from the termination date to return a completed renewal and 90 days from the notice date to request a hearing, or 10 days to keep coverage during the hearing. Apple Health for Kids is free up to 210% FPL and available with a premium up to 312% FPL in 2026. Cascade Care plans and Cascade Care Savings are Washington-only features of the Marketplace.
Do I qualify for Apple Health again after losing it?
You qualify again if your projected 2026 household income is at or below 138% FPL: $22,025 for one person, $29,863 for two, $37,702 for three, and $45,540 for four. Enrollment is year-round, so you can reapply at wahealthplanfinder.org or washingtonconnection.org at any time, even after your SEP closes. If your income is above 138% FPL, premium tax credits make a Cascade Care plan the usual choice through 400% FPL ($63,840 for one person in 2026). Check the household-size table on this page against your own household.
What happens to my children's coverage if I lose Apple Health?
Children keep their own path. Apple Health for Kids covers children under 19 for free in households at or below 210% FPL and for a monthly premium at or below 312% FPL in 2026, with year-round enrollment, so a parent's termination does not remove that option. For a family of four in 2026, those lines are $69,300 and $102,960. Add your children to the same Healthplanfinder application so the system screens them for Apple Health for Kids, even when the adults move to a Cascade Care plan. Washington's CHIP funding sits inside this program.
