What Is the Income Limit for Medicaid in Washington State?

A single adult in Washington qualifies for Apple Health, the state’s Medicaid program, with monthly income up to $1,835 as of April 2026. That figure sits at 138 percent of the Federal Poverty Level and is the income limit for Medicaid in Washington State for most working-age adults. The exact cutoff depends on your household size, your age, and whether you fall into a specific eligibility group such as children, pregnant individuals, or people who are aged, blind, or disabled. Because the limits are tied to federal poverty guidelines, they update each April.

2026 Income Limits by Group

The Washington Health Care Authority publishes a monthly dollar figure for each Apple Health category. The limits below already include a 5-percentage-point FPL disregard that raises the cutoff above the nominal percentage, and they took effect April 1, 2026.¹

Adults Ages 19 Through 64

Adults without Medicare qualify at or below 138 percent of the FPL. This covers both parents or caretaker relatives and adults without dependents. Monthly limits:

1 person: $1,835
2 people: $2,490
3 people: $3,142
4 people: $3,795

In annual terms, that’s roughly $22,020 for a single person or $45,540 for a family of four.¹

Children Under 19

Children qualify for free Apple Health at 215 percent of the FPL, with no premiums, copays, or deductibles. Monthly limits:

2-person household: $3,879
3-person household: $4,896
4-person household: $5,913

Children in families earning above 215 percent FPL but below 317 percent FPL can still get coverage through Washington’s Children’s Health Insurance Program with a small premium: $20 per month between 215 and 265 percent FPL, and $30 per month between 265 and 317 percent FPL.¹

Pregnant Individuals

Pregnant individuals qualify at the same 215 percent FPL threshold as children. The unborn child counts as a household member when calculating size, so a pregnant person with no other dependents is treated as a two-person household with a $3,879 monthly limit. Coverage continues through the end of the month that falls 12 months after the pregnancy ends.¹

Aged, Blind, and Disabled

People who are 65 or older, blind, or who have a qualifying disability follow different rules and do not use the MAGI calculation that applies to other adults. For Supplemental Security Income recipients, the Apple Health income threshold matches the federal SSI payment: $994 per month for an individual or $1,491 for a couple in 2026.²

Long-Term Care and Nursing Facility Coverage

The income limit for Medicaid-funded nursing home care is 300 percent of the SSI federal benefit rate, which works out to $2,982 per month for a single person in 2026. The personal needs allowance for a resident in a nursing facility is $108.74 per month; countable income above that goes toward the cost of care. Long-term care Medicaid also imposes asset limits, discussed below.¹

What Counts as Income

Most Apple Health programs measure eligibility using Modified Adjusted Gross Income. MAGI starts with the adjusted gross income on your federal tax return and adds back items such as tax-exempt interest and foreign income. In practice, wages, self-employment earnings, Social Security benefits, unemployment compensation, and most retirement distributions all count.

Some income is excluded. Scholarships and fellowship grants used for tuition and fees do not count, and most income American Indian and Alaska Native tribal members receive from treaty rights or trust land is excluded. Lump-sum payments count only in the month they arrive.³

Household size follows tax-filing relationships: who files jointly, who claims whom as a dependent. The income of a child or tax dependent under 19 is excluded if it falls below the federal tax-filing threshold. A 5-percentage-point FPL disregard is then subtracted from countable income for most groups, which is why the published dollar limits sit slightly above a direct FPL calculation.⁴

Asset Limits

If you’re applying as an adult, a child, or a pregnant individual under the standard MAGI-based programs, there are no asset limits. You can hold savings, own a second car, or carry investments and still qualify as long as your income is under the threshold.³

Asset limits apply only to the Aged, Blind, and Disabled programs and to long-term care coverage. A single applicant may have no more than $2,000 in countable assets; a married couple applying together faces a $3,000 limit. Countable assets include bank accounts, stocks, bonds, and real estate you do not live in. Your primary home is exempt as long as you intend to return to it. One vehicle, household belongings, and irrevocable prepaid burial plans are also exempt.¹

When one spouse enters a nursing facility and the other stays home, the at-home spouse keeps up to $162,660 in countable assets under the 2026 Community Spouse Resource Allowance, with a minimum floor of $32,532.¹

If Your Income Is Too High

Medically Needy Spend-Down

If your income exceeds the standard limits but you have significant medical expenses, the Medically Needy program lets you spend down the excess. You pick a three-month or six-month base period, and the state compares your monthly income to the Medically Needy Income Level for your household size. Income above that level across the base period adds up to your spend-down amount.⁵

You then submit qualifying medical expenses to offset that amount. Once verified expenses meet or exceed the spend-down liability, you’re eligible for coverage for the rest of the base period. The state does not pay the expenses you used to meet the spend-down itself, so those bills remain your responsibility. Qualifying expenses include Medicare premiums and cost-sharing, unpaid medical bills from earlier periods with no age limit, and current medical costs not covered by other insurance.⁵

Apple Health for Workers with Disabilities

If you have a disability and earn too much for standard Apple Health, the Health Care for Workers with Disabilities program offers a buy-in option with no asset test. Your monthly premium is calculated on a sliding scale and cannot exceed 7.5 percent of your total monthly income.⁶

How to Apply

The fastest route is online at Washington Healthplanfinder (wahealthplanfinder.org). You can also apply by phone at 1-855-923-4633, by mailing a paper application from the Health Care Authority website, or in person at a local DSHS Community Service Office. Community partners across the state offer free application help.⁷

Have proof of income ready (pay stubs, tax returns, or a letter from your employer), Social Security numbers for everyone in your household, and a form of identification. For long-term care applications, expect to provide detailed financial records going back five years for the asset transfer review.

1
Washington State Health Care Authority. Washington Apple Health Income and Resource Standards
2
Social Security Administration. SSI Federal Payment Amounts for 2026
3
Health Care Authority. Washington Apple Health Eligibility Overview
4
Medicaid.gov. Medicaid, CHIP, and Basic Health Program Eligibility Levels
5
Cornell Law School. WAC 182-519-0110 Spenddown of Excess Income for the Medically Needy Program
6
Washington State Department of Social and Health Services. Apple Health for Workers with Disabilities (HWD) Program
7
Washington State Health Care Authority. Apply for or Renew Coverage