Most adults in Washington qualify for Apple Health, the state’s Medicaid program, if their household income is at or below 138% of the federal poverty level. For a single person in 2026, that works out to roughly $22,025 per year, based on an FPL of $15,960.1HealthCare.gov. Federal Poverty Level (FPL) Medicaid eligibility in Washington State is not a single cutoff, though. Children, pregnant people, parents, and those who are 65 or older, blind, or disabled follow different rules, and some of those rules let you qualify at substantially higher incomes. Here is how to tell where you fit.
Income Limits by Who You Are
Washington’s Health Care Authority publishes a chart each year with the exact monthly dollar cutoffs by program and household size, and those cutoffs shift every January when the federal poverty level updates.2Washington State Health Care Authority. Program Standard for Income and Resources The percentages below are the effective thresholds.
Adults Age 19 to 64
Non-disabled adults who are not entitled to Medicare qualify at household income up to 138% of the FPL. You do not need to have children. This is the Affordable Care Act expansion group, and it is the single largest category of Apple Health enrollment.3Washington State Health Care Authority. Eligibility Overview – Washington Apple Health (Medicaid) Programs
Children Under 19
Washington covers kids at much higher income levels than adults, in three tiers:4Washington State Health Care Authority. Washington Apple Health Income and Resource Standards
- Apple Health for Kids (free): household income up to 215% of the FPL, with no premiums or cost-sharing.
- CHIP Tier 1: income above 215% but at or below 265% of the FPL, with a $20 monthly premium.
- CHIP Tier 2: income above 265% but at or below 317% of the FPL, with a $30 monthly premium.5Washington Healthplanfinder. Washington Apple Health for Kids with Premiums
A family of four earning around $104,000 can still get children’s coverage under CHIP Tier 2. Many families who assume they earn too much do not actually.
Pregnant Individuals
The income limit for Apple Health pregnancy programs rose to 210% of the FPL on November 1, 2024.6Washington State Health Care Authority. Income Limit Increasing for Apple Health Pregnancy Programs The unborn child counts as a household member, which raises the dollar cutoff for the same family. After pregnancy ends, Washington provides After-Pregnancy Coverage for 12 months regardless of income changes during that period, with benefits that include dental, contraception, preventive care, and behavioral health.7Washington State Health Care Authority. After-Pregnancy Coverage (APC)
Parents and Caretaker Relatives
There is a separate, lower income standard for parents and caretaker relatives who live with dependent children: $511 per month for a single-parent household and $820 for a three-person household.2Washington State Health Care Authority. Program Standard for Income and Resources In practice, parents whose income exceeds these amounts almost always qualify under the adult expansion group at 138% FPL, so this lower limit rarely leaves anyone uncovered.
Age 65 or Older, Blind, or Disabled
These programs do not use the MAGI formula. They are administered through the Department of Social and Health Services, and they count both income and assets. Income limits for SSI-related programs track the federal SSI payment standards, which change each January. The asset limit is $2,000 for a single person and $3,000 for a married couple.8Washington State Health Care Authority. SSI-Related Medicaid Overview
How Washington Measures Your Income
Most Apple Health programs use Modified Adjusted Gross Income (MAGI). MAGI begins with the adjusted gross income from your tax return and adds back items like tax-exempt interest and foreign earned income.9Internal Revenue Service. Modified Adjusted Gross Income One practical consequence: MAGI programs do not count assets. If you are a non-disabled adult, a parent, a child, or pregnant, your savings balance and your car do not affect eligibility.
Federal rules also include a 5% FPL income disregard. If your income is slightly above a program’s stated cutoff, the state subtracts an amount equal to 5 percentage points of the FPL before deciding you are ineligible.10eCFR. 42 CFR 435.603 That is why a program with a nominal threshold of 133% effectively covers people up to 138% FPL. The disregard applies only when it would change the outcome from ineligible to eligible.11Medicaid.gov. With Respect to MAGI Conversion, How Will the 5% Disregard Be Applied
Residency and Immigration Status
You must live in Washington and intend to stay. That includes people without a fixed address and people who moved here for work or to look for work. Someone who entered the state only to get health care generally does not qualify, with one exception for people moving directly from another state into a Washington nursing facility.12Washington State Legislature. Washington Administrative Code 182-503-0520 – Washington Apple Health Residency Requirements Persons Who Are Not Residing in an Institution
U.S. citizens and nationals qualify automatically. Lawful permanent residents, refugees, asylees, and other qualified immigrants also qualify, though most qualified immigrants face a five-year waiting period before they can access federally funded Medicaid. Refugees, asylees, and several other groups named in state rules are exempt from that waiting period.13Washington State Legislature. Washington Administrative Code 182-503-0535 – Washington Apple Health Citizenship and Immigration Status
Immigration status does not disqualify everyone. Nonqualified immigrants and undocumented individuals can access Apple Health for Kids, Apple Health for pregnant people, emergency medical coverage, and state-funded medical care services.13Washington State Legislature. Washington Administrative Code 182-503-0535 – Washington Apple Health Citizenship and Immigration Status Washington covers children and pregnant individuals regardless of status.
Assets and Long-Term Care
For most adults qualifying under the ACA expansion, assets are irrelevant. The picture changes if you need nursing home care, home and community-based waiver services, or other long-term supports. Those programs apply the $2,000 single / $3,000 married resource limit on top of their income tests.8Washington State Health Care Authority. SSI-Related Medicaid Overview Certain assets are exempt from the count, including personal belongings, household furnishings, one vehicle, irrevocable burial trusts, and your primary home as long as your equity does not exceed $1,130,000 in 2026.
The Tailored Supports for Older Adults (TSOA) waiver program is a notable exception. Its resource limit is set at six times the state’s average monthly private nursing facility rate, which is far more generous than the $2,000 cap, and the exact figure updates each January.14Washington State Health Care Authority. TSOA Income and Resources
If Your Income Is Too High: The Medically Needy Spenddown
People who are 65 or older, blind, or disabled and have significant medical bills can still get coverage through the Medically Needy program, even above the standard income limits. It works like a large deductible. You accumulate qualifying medical bills until the total equals the amount your income exceeds the program limit, and once you hit that threshold, Apple Health covers the rest of the certification period.15Washington State Department of Social and Health Services. Spenddown
You will not have coverage until you submit bills to DSHS showing you have met the spenddown. DSHS does not pay those bills; they just reduce your spenddown amount. The resource limits are the same $2,000 single / $3,000 couple. There is no upper income cap on the program itself, but the higher your income, the more you have to spend before coverage starts.2Washington State Health Care Authority. Program Standard for Income and Resources
How to Apply
Washington uses two online portals, and the right one depends on your category. Adults 19 to 64, parents applying with children, and pregnant people apply through Washington Healthplanfinder at wahealthplanfinder.org. People 65 or older, blind, disabled, or applying for long-term care services apply through Washington Connection at washingtonconnection.org instead.16Washington State Health Care Authority. Apply for or Renew Coverage
Both portals are open around the clock. You can also apply by phone (1-855-923-4633 for Healthplanfinder, 1-877-501-2233 for Classic Medicaid), submit a paper application, or go to a local enrollment office. An online application usually takes 15 to 30 minutes. For each person applying, have ready: legal name, date of birth, Social Security number (you can still apply without one), income information, any current health coverage details, and citizenship or immigration documents.17Washington Healthplanfinder. Steps to Apply
If you are denied, you have the right to request a fair hearing, and the denial notice will include instructions.18Washington State Health Care Authority. File an Appeal – Apple Health (Medicaid)