WA Apple Health Income Limits 2025

By Akash Biswas | Fact-Checked & Updated for 2026

Washington Apple Health is the state’s Medicaid program that provides free or low-cost health coverage to eligible residents, including adults, children, pregnant individuals, and seniors.

As of late 2025 and entering 2026, eligibility is primarily based on monthly income relative to the Federal Poverty Level (FPL).

Currently, limits are set at approximately $1,800/month for single adults and $2,982/month for seniors requiring long-term care.

⚠️ Critical 2026 Update: What You Need to Know Now

Income limits for Apple Health are currently in a transition period. Check the correct rule for your category:

• For Seniors (65+) & People with Disabilities: The new 2026 income limits are effective January 1, 2026, reflecting the confirmed 2.8% federal Cost-of-Living Adjustment (COLA).
• For Adults, Parents & Children: You are still subject to the 2025 MAGI income limits (approx. $1,800/mo). These remain in effect until April 1, 2026, when the state adopts the new 2026 Federal Poverty Guidelines.

Who Qualifies for Apple Health?

You generally qualify if you are a Washington resident, a U.S. citizen or qualified immigrant, and meet the financial requirements for one of the groups below.

(Note: Washington is an expansion state with higher limits than many others. You can compare these numbers in our full Medicaid income limits by state guide.

• Adults (19–64): Income under 138% FPL. No asset test (savings/cars do not count).
• Children (0–18): Higher income limits (up to 210% FPL) with no premiums.
• Pregnant Individuals: Coverage includes 12 months of postpartum care.
• Seniors (65+) & Blind/Disabled: Income limits are tied to SSI rates; an asset limit ($2,000 for individuals) applies.

The tables below provide the confirmed 2025–2026 income charts, asset rules, and a step-by-step guide to applying via Washington Healthplanfinder or Washington Connection.

What Is Washington Medicaid (Apple Health)?

Apple Health is Washington State’s Medicaid program. It provides free or low-cost health care to those who qualify.

Programs under Apple Health include coverage for kids, pregnant women, adults, and long-term care. It helps with everyday needs and serious health issues.

The Health Care Authority oversees it. Enrollment is open year-round for eligible people.

Washington Medicaid Income Limits (2025–2026)

In Washington, Apple Health (Medicaid) looks at how much money you make to decide if you qualify.

This is called your “income limit.”

These limits are based on the Federal Poverty Level (FPL). The government updates these numbers every year.

• For Adults and Families: The numbers usually change in April.
• For Seniors and People with Disabilities: The numbers usually change in January.

The rules are different depending on who you are. We split this into two groups:

1. MAGI Programs: This is for adults, children, and pregnant women. We only look at your income (paychecks). We do not look at your savings.
2. Non-MAGI Programs: This is for seniors (65+) and people with disabilities. We look at both your income and your savings (assets).

Medicaid Income Limits by Household Size (2025–2026 Chart)

This chart shows the monthly income limits for Adults, Children, and Pregnant Women.

• Note: These numbers are currently in effect as of late 2025 and early 2026.

📝 Pro Tip: If you are pregnant, count your unborn baby as a person! A single pregnant woman counts as a Household of 2.

Income Limits by Eligibility Category

Adults (19–64)

• Income Limit: Up to 138% of the poverty level.
• Who is this for? Adults who do not have Medicare.
• Rules: You do not need to have children to qualify.
• Asset Test: None. You can have money in the bank and still qualify.

Children (0–18)

• Income Limit: Up to 210% of the poverty level.
• Who is this for? Babies, kids, and teenagers under age 19.
• Rules: Washington combines Medicaid and CHIP (Children’s Health Insurance Program) to cover more kids. There are no monthly costs (premiums) for families under this limit.

Pregnant Women

• Income Limit: Up to 198% of the poverty level.
• New Rule (Postpartum Coverage): Apple Health now covers you for 12 months after your pregnancy ends. This applies no matter how the pregnancy ends.
• November Update: Washington recently updated rules to make it easier to stay covered during and after pregnancy.

Parents & Caretakers

• Income Limit: Up to 138% of the poverty level (same as other adults).
• Who is this for? A parent or relative taking care of a dependent child.

Seniors (65+)

• Income Limit: Based on SSI rates.
• 2026 Update: Starting January 1, 2026, the income limit rises to approx. $994/month for a single person due to the cost-of-living adjustment.
• Note: If your income is higher, you might still qualify for “Long-Term Care” coverage or a “Spend-Down” program.

Disabled Individuals

• Income Limit: Tied to the federal SSI limit (~$994/month for 2026).
• Rules: You must have a disability that meets Social Security standards.

Washington Medicaid Asset Limits

An “asset” is money you have saved, like cash in the bank, stocks, or a second car.

• Good News for Families: If you are applying as an Adult, Child, or Pregnant Woman (MAGI), there is NO asset limit. You could have $10,000 in the bank and still get Apple Health if your monthly income is low.
• For Seniors & Disabilities: There is an asset limit.

Asset Limits by Program (2025–2026)

This table shows how much you can keep and still qualify.

> Spouse Protection: If one spouse needs a nursing home and the other stays home, the spouse at home can keep over $150,000 in assets. This keeps the healthy spouse from going broke.

🔍 What Does NOT Count as an Asset?

For seniors, the state does not count everything. You can keep:

1. Your Home: If you live in it and the equity is under $1,130,000 (2026 limit).
2. One Car: Used for medical transport.
3. Personal Items: Furniture, clothes, and jewelry.
4. Burial Plans: Certain burial funds are safe.

🔗 Trusted Sources for Verification

We use official government data to keep this guide accurate. You can verify these numbers at:

• Official Application Portal: Washington Healthplanfinder (wahealthplanfinder.org)
• Washington State Health Care Authority: Apple Health Eligibility (hca.wa.gov)
• Federal Guidelines: ASPE Poverty Guidelines (aspe.hhs.gov)

Countable vs. Non-Countable Assets (Washington Medicaid)

When Washington Medicaid (Apple Health) does use an asset test (mainly for seniors, people with disabilities, and long-term care), assets are split into countable and non-countable categories.

This section is critical for eligibility.

Countable Assets

These assets are counted toward Medicaid’s asset limit:

• Cash (on hand)
• Bank accounts (checking, savings, CDs)
• Investments (stocks, bonds, mutual funds)
• Non-retirement accounts
• Extra vehicles (more than one)
• Second homes or rental property

📌 If the total value of countable assets is over the limit, you may not qualify until assets are reduced legally.

Non-Countable (Exempt) Assets

These assets do NOT count toward Medicaid limits:

• Primary home (if you live in it)
• One vehicle (regardless of value, in most cases)
• Personal belongings (clothes, furniture, appliances)
• Burial funds and prepaid funeral plans
• Household goods
• Certain retirement accounts (depending on the program)

📌 Non-countable assets allow many applicants to qualify without selling everything they own.

Important Reminder

• MAGI Medicaid programs (children, adults, pregnant individuals)
  ➜ No asset test at all
• Non-MAGI programs (65+, disabled, long-term care)
  ➜ Asset rules apply

Understanding this difference helps families avoid denials, delays, and unnecessary spend-downs.

Here is the next section of your guide, optimized for high-intent keywords like “Long-Term Care” and “Spend-Down.”

Washington Long-Term Care Medicaid Eligibility

This type of Medicaid pays for nursing homes, assisted living, or in-home caregivers. Because these services are very expensive, the rules are stricter than regular Apple Health.

Income Limits (The “300% Rule”)

Washington uses a special rule for long-term care. You can make 300% of the SSI federal limit and still qualify.

• 2026 Income Cap: $2,982 per month (Single Person)
• Note: If you make less than this, you generally qualify financially. If you make more, you are not automatically disqualified (see “Spend-Down” below).

Asset Limits & Spousal Protections

To qualify, you must have low “countable assets” (like cash, savings, investments).

• Single Applicant Limit: $2,000
• Married Couple Limit: $3,000 (if both apply)

Important for Married Couples (Spousal Impoverishment):

If one spouse needs a nursing home and the other stays home (called the “Community Spouse”), the state does not want the healthy spouse to be poor.

• Community Spouse Asset Limit: The spouse at home can keep up to ~$162,660 (2026 Standard).
• Income Protection: The spouse at home can keep part of the ill spouse’s income to pay bills (up to ~$4,066/month).

Medical Need Requirement (NFLOC)

Money isn’t the only rule. You must prove you need help. Doctors call this “Nursing Facility Level of Care” (NFLOC).

You likely qualify if you need help with Activities of Daily Living (ADLs), such as:

• Bathing or showering
• Getting dressed
• Using the bathroom
• Eating
• Moving from a bed to a chair

Home & Community-Based Services (HCBS)

You do not have to live in a nursing home to get help. Washington has “Waiver” programs (like COPES) that pay for care in your own home or an assisted living facility.

• Benefit: You get the same care as a nursing home but stay comfortable at home.
• Rules: The income limit is the same ($2,982/mo), but spots can be limited.

Medically Needy Medicaid in Washington

“What if my income is too high?”

If you make more than the $2,982 limit, you can still get Apple Health through the Medically Needy (Spend-Down) program. Think of this like an insurance deductible.

How the Spend-Down Works

If your income is over the limit, you must spend the “extra” money on medical bills before Medicaid kicks in.

The Math (Simplified):

1. Your Monthly Income: $4,000
2. Medically Needy Limit: – $994 (approx. 2026 standard)
3. Your “Spend-Down” Amount: = $3,006

What this means: You are responsible for the first $3,006 of your medical bills each month. Once you pay that (or show bills that add up to that), Apple Health pays for everything else for the rest of the month.

Allowable Expenses to Meet Spend-Down

You can use many different costs to lower your income:

• Health insurance premiums (Medicare Part B, private insurance).
• Doctor visits and copays.
• Prescription drugs.
• Past unpaid medical bills (up to 3 months old).

💡 Action Tip: This is very useful for people with high nursing home bills. If a nursing home costs $10,000 a month and your spend-down is $3,000, Medicaid will pay the remaining $7,000!

Here are the Covered Services and Immigration Eligibility sections, optimized for speed and clarity.

Covered Services Under Apple Health

Apple Health provides “whole-person care,” meaning it treats your physical body, teeth, and mind.

Note on Differences: While children (0–20) get full coverage for almost any medically necessary service, adults have some limitations, particularly for dental and vision hardware.

Immigration Status & Apple Health Eligibility

Washington State is one of the most generous states for non-citizens. You do not need to be a U.S. citizen to get coverage, but your specific program depends on your status.

1. Qualified Immigrants (Green Card Holders)

• Status: Lawful Permanent Residents (Green Card), Refugees, Asylees.
• The “5-Year Bar”: In many states, you must wait 5 years after getting your Green Card to get Medicaid.
• Washington Exception: 🟢 You are covered immediately.
  • How? If you are in the 5-year waiting period, Washington uses state funds (Medical Care Services – MCS) to cover you. The benefits are almost identical to regular Medicaid.

2. Undocumented Immigrants & DACA Recipients

If you do not have legal status, you can still get coverage based on your category:

🔍 Important: “Apple Health Expansion” for Adults

• What it is: A new program (launched July 2024) that gives full Apple Health to undocumented adults.
• Current Status: The program has an enrollment cap.
• Action Step: You should still apply now. If the program is full, you will be placed on a list to be notified if spots open up. In the meantime, you may qualify for Alien Emergency Medical (AEM) to cover emergencies like heart attacks, dialysis, or cancer treatment.

Here are the Application, Documents, and Denials sections.

I have added a critical “Expert Distinction” in the application section that most competitors miss: knowing which website to use (Healthplanfinder vs. Washington Connection). This detail prevents users from applying on the wrong site and getting stuck.

How to Apply for Apple Health in Washington

Washington makes it easy to apply, but where you go depends on your age and needs.

⚠️ Critical: Choose the Right Portal

• Most People (Adults, Kids, Pregnant): Use Washington Healthplanfinder.
• Seniors (65+), Blind, Disabled, or Long-Term Care: Use Washington Connection.

Online Application (Fastest Way)

• For Adults & Families: Go to wahealthplanfinder.org.
  • Speed: You often get an answer instantly.
• For Seniors & Long-Term Care: Go to washingtonconnection.org.
  • Speed: These applications take longer because they check assets.

Apply by Phone

If you want someone to help you fill out the forms, call the customer support center. They have interpreters if you need a different language.

• Phone Number: 1-855-923-4633
• Hours: Monday – Friday, 7:30 a.m. to 5:30 p.m.

Apply In-Person

You can walk into a local office to get help face-to-face.

• Where to go: Visit a Department of Social and Health Services (DSHS) Community Services Office (CSO).
• Find an office: Use the locator tool on the DSHS website.

Mail Application

If you prefer paper, you can download the application, fill it out, and mail it.

• Mail to:DSHS Community Services DivisionPO Box 11699Tacoma, WA 98411-6699

⏱️ Processing Time & Retroactive Coverage

• How long does it take?
  • Online (MAGI): Often same-day approval.
  • Paper/Complex Cases: Up to 45 days.
  • Disability Cases: Up to 90 days (because of medical reviews).
• Retroactive Rule: Did you have medical bills in the last 3 months? Apple Health can pay them!
  • Action: On your application, check the box that says “I have unpaid medical bills from the last 3 months.” If you were eligible back then, they will pay those bills.

Documents Needed to Apply for Medicaid

Gather these items before you start. It will make the process much faster.

✅ Identity & Citizenship

• [ ] ID Card: Driver’s license, state ID, or passport.
• [ ] Social Security Number (SSN): For everyone applying (not required for some undocumented immigrants).
• [ ] Immigration Documents: Green Card (I-551), work permit, or visa papers (if applicable).

✅ Income (Proof of Money Coming In)

• [ ] Pay Stubs: The last 30 days of paychecks.
• [ ] Tax Return: Your most recent federal tax return (1040).
• [ ] Benefit Letters: Unemployment, Social Security (SSI/SSDI), or pension letters.

✅ Residency

• [ ] Proof of Address: A utility bill, lease agreement, or driver’s license showing a Washington address.

✅ For Seniors & Disabled (Non-MAGI Only)

• [ ] Bank Statements: Checking and savings account statements for the last 3 months.
• [ ] Asset Proof: Titles for cars, property deeds, or life insurance policies.
• [ ] Medical Records: If applying for disability, bring doctor’s notes proving your condition.

Why Medicaid Applications Get Denied (And How to Fix It)

Getting a “No” letter is scary, but it is often a mistake you can fix. Here are the top reasons and solutions.

Pro Tip: If you are denied, you always have the right to an appeal. The instructions on how to appeal will be on the last page of your denial letter. You usually have 90 days to ask for a hearing.

Get Covered with Apple Health in 2026

Washington Apple Health is a vital safety net. With the 2026 income limit increases and the removal of asset tests for most families, more Washingtonians qualify than ever before.

Your Next Steps:

1. Check the Charts: Look at the tables above to see if your income fits.
2. Gather Documents: Have your ID, pay stubs, and tax info ready.
3. Apply Online: Visit wahealthplanfinder.org for the fastest results.

Don’t wait until you are sick to apply. Coverage is available year-round.

About the Author

Akash Biswas is the Lead Researcher and Founder of Checkmedicaid.com. He specializes in decoding complex government healthcare regulations into clear, simple steps for families.

Recognizing that Medicaid rules are often confusing, Akash dedicates his time to monitoring federal and state policy updates daily—including the latest 2025–2026 income guidelines. His mission is to bridge the gap between hard-to-read government documents and the people who need care the most. Through his in-depth guides and simplified breakdowns, Akash helps readers navigate Apple Health eligibility with confidence and accuracy.