Apple Health in Washington: choose the right coverage route
Apple Health is Washington’s Medicaid coverage. Start with the person who needs care: age, Medicare, pregnancy, disability and long-term-care needs can affect the route. People in one home do not necessarily have the same coverage result.
Your first step
Choose an application route below. If several descriptions fit, use HCA’s application guide or ask an enrollment helper. This page does not determine eligibility, enroll you or estimate medical bills.
Check the coverage category for each person
- Children and pregnancy: separate coverage rules apply. Do not use the adult income reference to rule out either route.
- Adults ages 19–64: the usual adult route considers income, Medicare status and other conditions. Parents and caretakers may also have a family-coverage route.
- Age 65 or over, disability or long-term care: ask about Classic Medicaid, help with Medicare costs, and any other applicable route. Some categories use resources as well as income.
Washington adult coverage rule · Washington Connection: programs and health-coverage routes
Healthplanfinder or Washington Connection?
| Situation | Where to start | What still needs checking |
|---|---|---|
| Child, pregnancy, parent/caretaker, or adult under 65 without Medicare | Washington Healthplanfinder | The person’s category, household, income and other conditions. |
| Age 65+, Medicare-cost help, disability-related coverage or long-term services | Washington Connection / DSHS | The appropriate Classic or other route, including any resource rules. |
| More than one description fits | Ask an enrollment helper to review the person and the application route. | A disability does not by itself exclude the adult Healthplanfinder route for someone under 65 without Medicare. |
Washington application rule, sections (2)–(4). These categories can overlap; they are not exclusive checkboxes.
Three examples of where to begin
- A parent and an eight-year-old: start with Healthplanfinder; ask for a separate coverage result for each person.
- A 45-year-old with a disability and no Medicare: the adult Healthplanfinder route may apply. Ask about additional disability-related routes if needed.
- A 70-year-old needing help with Medicare costs: start with Washington Connection’s Medicare-assistance route. It is different from buying a Marketplace plan.
These examples choose a next step; none establishes eligibility.
An Apple Health household is not a Basic Food household
For coverage based on MAGI (a method using tax-related income rules), Washington creates a medical assistance unit for each person. People on the same application may have different units and results. Living together is only part of the question; family and tax relationships matter.
For example, a parent and child can apply together while being assessed under different coverage categories. Do not transfer a Basic Food food-sharing group into a medical form without checking its instructions.
Washington: individual medical assistance units
2026 adult income reference
This table is arithmetic using 2026 HHS poverty guidelines at 138%. It is not Washington’s official eligibility table, not a take-home-pay test, and not the rule for every Apple Health category. The agency decides whose income counts, which exclusions apply, and the relevant period.
| Household size for the applicable category | Approximate monthly reference | Approximate annual reference |
|---|---|---|
| 1 | $1,835 | $22,025 |
| 2 | $2,489 | $29,863 |
| 3 | $3,142 | $37,702 |
| 4 | $3,795 | $45,540 |
Calculation: annual HHS guideline × 1.38; monthly reference = the unrounded annual figure ÷ 12, then round to the nearest dollar. Do not stop an application just because your figure is near a boundary.
HHS 2026 guidelines · HealthCare.gov: adult expansion and other categories
Two different uses of “expansion”
The adult expansion income reference above is different from the Washington program named Apple Health Expansion, which serves certain people who cannot get other Apple Health coverage because of immigration requirements. That program has an enrollment limit. Check HCA’s current enrollment notice; do not assume that a new place is available.
Prepare, submit and keep the right notice
- Choose the route. Use the table above. Apple Health applications can be made during the year; category rules and any specific enrollment limits still apply.
- Prepare information for that person. Have current income information, family and tax relationships, existing coverage and relevant notices ready. Follow the official form’s questions. If information is missing, ask for help; do not invent an answer or send private documents to GetBenefits.
- Save the submission record. Note the portal, case reference and date. A draft is not a completed submission, and submission alone does not show that coverage has begun.
- Follow the agency’s next step. Reply to evidence requests and read the decision for the people covered, coverage dates and renewal instructions. Report changes through the service handling your coverage.
For Healthplanfinder application support, call 1-855-923-4633. Its contact page also explains free language assistance and where to direct Apple Health eligibility, billing or coverage questions.
Apply or renew through Healthplanfinder · Washington Connection options
Common questions
Can I apply for Apple Health at any time of year?
Apple Health applications can be made during the year. That does not mean every person or program can enroll: the agency must check the category and current requirements. The separately named Apple Health Expansion program has an enrollment limit; check its current HCA notice.
Does a disability mean I must use Washington Connection?
Not always. An adult under 65 without Medicare can use the Healthplanfinder adult route even if blind or disabled. Washington Connection also handles disability-related and long-term-care routes. If more than one route fits, ask for help choosing the right application.
Can I use my Basic Food household size for Apple Health?
Do not assume it is the same. Basic Food groups people under food-sharing and family rules. Apple Health’s MAGI rules create a medical assistance unit for each person; people on one application can have different income calculations or results.
Is 138% of poverty the limit for every Apple Health program?
No. The table is an arithmetic reference for the common adult expansion income level. Children, pregnancy, disability-related coverage, Medicare assistance and long-term care have their own rules. A reference number is not a decision about your case.
Does using Medicaid affect immigration status?
Other help in Washington · Choose another state · Esta guía en español
Reviewed September 8, 2026. Income references use the 2026 HHS guidelines; official program and case rules control. The immigration section separates the current framework from the change scheduled for September 18, 2026 and needs rechecking before that date.
Return to this next step when you need it
You can save a link to this guide on this device. Your income, answers and results are not saved. This is not an application or an official case record.
Prepare for your Apple Health renewal
Keep your contact details current, read requests promptly and keep copies of what you send. Follow the renewal notice; do not assume that coverage renewed automatically. Free enrollment assistance can help you understand documents and the right portal. Washington Developmental Disabilities Council: practical renewal steps, August 25, 2026.
An upcoming change for Apple Health for Adults
HCA announces six-month coverage periods for some members of Apple Health for Adults from January 1, 2027, beginning with the person’s first renewal in 2027. HCA identifies an exception for American Indian and Alaska Native (AI/AN) members in its frequently asked questions. Follow your renewal notice and ask HCA which requirements apply to you. This is not a January 1 renewal deadline for every member and does not describe all Apple Health categories. Check HCA’s work-requirements and renewals fact sheet and current HCA updates.
- Identify the request: program name, person covered and action requested.
- Use the existing route: follow the notice and the portal guide above; do not start a duplicate application simply because you received a renewal notice.
- Prepare one question: “Does this notice require a response from me, which document is needed, and what date applies?” Ask about other requirements or exceptions if your notice raises them.
- Keep the response: retain the submission receipt and the agency’s decision separately.
GetBenefits does not decide whether a new rule, exception or immigration consequence applies to you. Prepare a follow-up call. Reviewed September 9, 2026; verify the current HCA instructions when your notice arrives.