Apple Health Income Limits (Washington Medicaid, 2026)

Apple Health is Washington state's name for its Medicaid program, operated by the Washington State Health Care Authority (HCA) and covering more than 2 million residents. Washington was among the earliest states to expand Medicaid under the Affordable Care Act, restoring and extending full adult coverage on January 1, 2014. The result is one of the more generous Medicaid programs in the Pacific Northwest: any adult ages 19 to 64 with income at or below 138% of the Federal Poverty Level qualifies for Apple Health with no asset test for MAGI-based categories. The 2026 Federal Poverty Level, anchored at $15,960 for a single person in the 48 contiguous states and $33,000 for a family of four, sets every income threshold on this page. Per the HHS ASPE 2026 Poverty Guidelines published at aspe.hhs.gov, these figures took effect February 1, 2026.

Apple Health eligibility divides into several main population groups. Adults ages 19 to 64 qualify up to 138% FPL under the standard expansion (no dependent-child requirement). Pregnant individuals qualify up to 215% FPL, with coverage continuing through the end of the month 12 months after the pregnancy ends. Children under age 19 qualify for Apple Health at no cost up to 215% FPL, and Apple Health for Kids with premiums extends coverage to 317% FPL for a modest monthly premium. Seniors age 65 and older, and individuals who qualify for Medicare, are served through Apple Health coverage paired with Medicare Savings Programs (QMB, SLMB, QI-1) and the Aged, Blind, and Disabled (ABD) category with its own income and asset rules. Washington also runs Apple Health for Long-Term Services and Supports (LTSS) for individuals who need nursing-facility-level care, subject to an asset test and a 60-month lookback for transfers.

Apple Health applications in Washington go through Washington Healthplanfinder at wahealthplanfinder.org, the state's combined health coverage portal run by the Washington Health Benefit Exchange. The same portal handles Apple Health (Medicaid), CHIP (Apple Health for Kids), and ACA marketplace plan enrollment. Applicants can also apply by phone at 1-855-923-4633, by paper through local Community Service Offices operated by the Washington Department of Social and Health Services (DSHS), or through certified application assisters statewide. Washington requires no waiting periods for Apple Health: if you are eligible, coverage generally begins on the date you apply or the first day of the month of application. The household-size table below shows the 2026 Apple Health income limits across adults, children, and pregnant individuals.

Apple Health (Washington Medicaid) income limits by household size (2026)

The 2026 Apple Health (Washington Medicaid) income guidelines below are based on the 2026 Federal Poverty Level for the 48 contiguous states. Adult column = Apple Health for Adults (138% FPL, covers adults ages 19 to 64 with or without dependent children). Children column = Apple Health for Kids free tier (215% FPL, no premiums); premium-based Apple Health for Kids extends to 317% FPL. Pregnancy column = Apple Health for Pregnant Individuals (215% FPL, with 12-month postpartum coverage). Add $5,680 of annual income per additional household member beyond 8.

Apple Health (Washington Medicaid) eligibility requirements (non-income)

Apple Health eligibility is based on income, household size, residency, citizenship or immigration status, and program category. Washington uses MAGI-based income rules for most Apple Health categories (adults, children, pregnant individuals, and parents or caretakers), meaning no asset test applies for these groups. Only SSI-linked categories (aged, blind, and disabled adults and long-term services and supports) carry an asset test.

• Washington residency: you must live in Washington state. Washington does not impose a durational residency requirement, so you can apply on the day you move to the state. Homeless individuals may declare a Washington county as their place of residence.
• Citizenship and immigration status: U.S. citizens qualify immediately. Lawful permanent residents and certain qualified immigrants must wait 5 years before accessing MAGI Medicaid under the federal bar (PRWORA 1996). Washington state uses state-only funds to cover children and pregnant individuals regardless of immigration status. Apple Health Expansion (undocumented adults ages 19 to 64) was available starting July 1, 2024, but new enrollment was capped in December 2025 due to federal funding constraints; existing enrollees retain coverage.
• Age requirements by category: Apple Health for Adults covers ages 19 to 64. Apple Health for Kids covers children under age 19. Pregnant individuals of any age may qualify for Apple Health for Pregnancy. Adults age 65 and older or those enrolled in Medicare are served through the Aged, Blind, and Disabled (ABD) category or Medicare Savings Programs.
• Income limit by population: adults ages 19 to 64 qualify up to 138% of the 2026 Federal Poverty Level ($22,025 per year for a single person). Children under 19 qualify at no cost up to 215% FPL ($34,314 per year for a single-person household), with premium-based coverage to 317% FPL. Pregnant individuals qualify up to 215% FPL ($34,314 per year for a household of one, $70,950 for a household of four). Income is calculated using MAGI rules, which include most taxable income but exclude SSI, child support received, veterans' benefits, and workers' compensation.
• No asset test for MAGI categories: Washington does not impose a savings or asset limit for Apple Health for Adults, Apple Health for Kids, or Apple Health for Pregnancy. You can have a car, home, savings account, or other assets and still qualify, as long as your income falls within the applicable limit.
• Other coverage: Apple Health is the payer of last resort. If you have access to employer-sponsored insurance that meets minimum value and affordability standards, Washington may ask you to enroll in that coverage first. However, you cannot be denied Apple Health solely because you have access to other insurance unless it meets specific cost-effectiveness criteria.
• SSI and long-term care asset rules: adults who qualify for Supplemental Security Income (SSI) automatically qualify for Apple Health. For Apple Health for Long-Term Services and Supports (LTSS), including nursing facility care and home and community-based services, an asset limit of $2,000 for an individual applies, along with a 60-month lookback period for asset transfers. Washington uses estate recovery for long-term care Medicaid recipients, generally pursuing assets in the probate estate of deceased recipients who were 55 or older when they received Apple Health LTSS.

What income counts for Apple Health (Washington Medicaid)

Apple Health uses MAGI (Modified Adjusted Gross Income) rules to count income for most categories: adults, children, pregnant individuals, and parents and caretakers. MAGI starts with the adjusted gross income on your federal tax return and adds back certain deductions. Washington applies the standard 5% federal disregard for MAGI-based Apple Health categories, which effectively raises the posted 138% FPL threshold to approximately 143% FPL in practice. Only for SSI-linked categories (aged, blind, disabled, and long-term care) does Washington use a different income-counting methodology with an asset test. Sources: Washington Administrative Code (WAC 182-505-0100, WAC 182-509-0001) and Washington HCA Income and Resource Standards (HCA 19-0096, April 2026).

Income sources included

• Wages, salaries, and tips (W-2 income): all wages from employment, including tips and bonuses, count in full toward your Apple Health MAGI income.
• Self-employment net earnings: net profit from self-employment, gig work, or freelance income after deducting allowable business expenses counts toward MAGI. Use Schedule C (or Schedule F for farming) to determine net self-employment income.
• Social Security Disability Insurance (SSDI) benefits: the taxable portion of SSDI counts as MAGI income. Note: Supplemental Security Income (SSI) is excluded (see below).
• Social Security retirement and survivor benefits: the taxable portion of Social Security retirement and survivor benefits counts toward MAGI. Many lower-income households pay little or no tax on Social Security, so in practice the counted amount may be less than the gross benefit.
• Unemployment insurance benefits: Washington State unemployment compensation counts as MAGI income in the year received, whether paid by the Washington Employment Security Department or another state.
• Pension and retirement distributions: distributions from 401(k), 403(b), IRA, or pension plans count as MAGI income in the year distributed, including the taxable portion of Roth conversions.
• Interest, dividends, and capital gains: taxable interest from savings accounts, dividends from investments, and net capital gains all count toward MAGI income under Medicaid MAGI rules.
• Rental and royalty income (net): net rental income after allowable deductions (depreciation, mortgage interest, property taxes, maintenance) and net royalty income count toward MAGI.
• Alimony received under pre-2019 divorce agreements: alimony payments received under divorce decrees finalized before January 1, 2019, count as MAGI income. Alimony under post-2018 agreements is not counted (TCJA change).

Income sources excluded

• Supplemental Security Income (SSI): SSI payments from the Social Security Administration are not counted as income for Apple Health MAGI categories. Receiving SSI actually makes you categorically eligible for Apple Health automatically.
• Child support payments received: child support you receive for your children is excluded from MAGI income for Apple Health purposes under federal Medicaid rules.
• Veterans' benefits: VA disability compensation, pension, dependency and indemnity compensation (DIC), and GI Bill education benefits are all excluded from MAGI income for Apple Health.
• Workers' compensation: payments received from Washington Labor and Industries (L&I) or any workers' compensation program for a work-related injury or illness are excluded from MAGI income.
• TANF and WASHCAP cash assistance: Temporary Assistance for Needy Families (TANF) grants and Washington's WorkFirst cash grants are excluded from MAGI income for Apple Health purposes.
• Gifts, inheritances, and one-time lump-sum payments: one-time gifts and inheritances are generally not counted as MAGI income. However, ongoing distributions from an inherited IRA count as income in the year distributed.
• Foster care and kinship care payments: payments received for providing foster care or kinship care to children placed by the state are excluded from MAGI income.

How to apply for Apple Health (Washington Medicaid) in Washington

Apple Health applications in Washington go through Washington Healthplanfinder, operated by the Washington Health Benefit Exchange (WAHBE) at wahealthplanfinder.org. The same application captures Apple Health (Medicaid), Apple Health for Kids (CHIP), and ACA marketplace plan enrollment. Applying online takes roughly 15 to 30 minutes. Applicants can also apply by phone at 1-855-923-4633 (available in multiple languages), by paper using Form HCA 18-001, or in person at any DSHS Community Service Office or certified application assister location. Apple Health has no enrollment windows, so applications are accepted year-round.

1. 1. Gather your documents before you start: photo ID, Social Security Numbers for all household members applying for coverage, proof of Washington residency, proof of income for the most recent 30 days (pay stubs, self-employment records, or award letters for benefits), and proof of citizenship or immigration status.
2. 2. Create an account at wahealthplanfinder.org or call 1-855-923-4633 to start an application by phone. Washington Healthplanfinder accepts applications in English, Spanish, and multiple other languages through interpreter services.
3. 3. Complete the application by listing every household member, reporting all income sources, and answering eligibility questions for your household. The system will automatically screen for Apple Health, CHIP, and marketplace subsidies based on your answers.
4. 4. Submit your application and record your confirmation number. Washington Healthplanfinder will send a confirmation by email or mail. Many Apple Health applicants receive real-time eligibility decisions at the time of application if the system can verify income electronically through federal data sources.
5. 5. Respond promptly to any requests for additional information. If the HCA or DSHS cannot verify your income or identity through electronic data sources, you will receive a notice requesting paper documentation. You typically have 10 to 30 days to respond. Failing to respond on time is the most common reason applications are denied.
6. 6. Wait for your eligibility determination notice. Apple Health applications are generally decided within 45 days; pregnancy applications are decided within 15 days under federal expedited rules. If approved, your Apple Health card or managed care enrollment notice will arrive within a few weeks.

Official portal: wahealthplanfinder.org

Documents needed

• Photo ID for the head of household (Washington driver's license, state ID, passport, or tribal ID card)
• Social Security Numbers for every household member applying for Apple Health coverage (or documentation explaining why an SSN is not available)
• Proof of Washington state residency: utility bill, lease or mortgage statement, bank statement, or other official document showing your current address in Washington
• Proof of U.S. citizenship or qualifying immigration status: birth certificate, U.S. passport, Certificate of Naturalization, Permanent Resident Card (green card), or other immigration documents
• Last 30 days of pay stubs, or self-employment records covering the most recent 12 months (for self-employed and gig workers). If you receive Social Security, unemployment, or other benefits, bring your most recent award letter.
• For pregnancy applications: a statement from a healthcare provider confirming pregnancy and the expected due date, which enables expedited 15-day processing

Processing timeline: Standard Apple Health applications are decided within 45 days. Pregnancy applications receive expedited 15-day processing under federal rules. Applications where income and citizenship are verified electronically through federal data sources may receive a real-time determination on the same day. Aged, blind, and disabled (ABD) applications that require a medical disability determination can take 60 to 90 days. Apple Health for Long-Term Services and Supports (LTSS) applications involving nursing-home placement can take up to 90 days.

Common reasons applications get denied

• Income above the applicable Apple Health threshold: this is the most common reason for denial. Adults are denied if household income exceeds 138% FPL ($22,025 for a single person in 2026). Children with family income above 317% FPL are also ineligible for Apple Health for Kids with premiums.
• Failure to provide requested documentation within the response deadline: the Washington HCA or DSHS may request additional documents to verify identity, income, or residency. Failing to respond within 10 to 30 days of the request results in denial for insufficient information.
• Not a Washington resident: applicants must reside in Washington. Applications are denied when the address provided is in another state or cannot be verified as a Washington address.
• Federal 5-year immigration bar: certain lawful permanent residents and other qualified immigrants who entered the U.S. after August 22, 1996, are subject to a 5-year federal bar on MAGI Medicaid eligibility. This does not apply to children, pregnant individuals, or emergency Medicaid.
• Age or category mismatch: adults age 65 or older who apply for Apple Health for Adults (the MAGI category) are redirected to the Aged, Blind, and Disabled program or Medicare Savings Programs. Applications filed in the wrong category are denied and must be resubmitted under the correct category.

If your child's family income is over the free Apple Health for Kids limit

Apple Health for Kids covers children under age 19 for free when family income is at or below 215% of the Federal Poverty Level, which equals $70,950 per year for a family of four in 2026. If family income is between 215% and 317% FPL, children qualify for Apple Health for Kids with premiums: families between 215% and 265% FPL pay $20 per child per month (up to $40 per month total for multiple children), and families between 265% and 317% FPL pay $30 per child per month (up to $60 per month total). The 317% FPL limit equals about $104,610 per year for a family of four in 2026. Apple Health for Kids covers the same full Medicaid benefit package as standard Apple Health, including dental, vision, preventive care, and behavioral health services. Washington's Apple Health for Kids program draws on both federal Medicaid and CHIP funding to deliver this seamless coverage continuum. Compare income limits for children's programs across all 50 states using the national Medicaid income limits guide.

Compare Medicaid and CHIP income limits across all 50 states

If you are 65 or older with limited income: Washington Medicare Savings Programs

Washington administers four Medicare Savings Programs (MSPs) through Apple Health for low-income Medicare beneficiaries. As of April 1, 2026, the monthly income limits are: Qualified Medicare Beneficiary (QMB, covers Part A and B premiums, deductibles, and copays) at 110% FPL ($1,483 per month for one person); Specified Low-Income Medicare Beneficiary (SLMB, covers Part B premium only) at 120% FPL ($1,616 per month for one person); Qualifying Individual-1 (QI-1, covers Part B premium only) at 138% FPL ($1,855 per month for one person); and Qualified Disabled and Working Individuals (QDWI, for working individuals with disabilities who lost Medicare) at 200% FPL ($2,680 per month for one person). Washington eliminated the asset test for MSP-only eligibility in 2026, so savings and bank balances no longer affect MSP qualification. Dual-eligible individuals who qualify for both Apple Health and Medicare can access Dual Eligible Special Needs Plans (D-SNPs) through Washington's managed care contractors. To apply for any MSP, use the same Washington Healthplanfinder portal at wahealthplanfinder.org or call the Apple Health Customer Service line at 1-800-562-3022.

Read the Medicare eligibility and Medicare Savings Programs guide

Frequently Asked Questions