From the rainy evergreens of Seattle to the sunny orchards of Yakima and the rugged coasts of the Olympic Peninsula, Washington’s Evergreen State blends tech innovation with agricultural heartland—but healthcare costs can cloud the view for low-income families. If you’re a parent in Spokane covering kids’ check-ups or a senior in Tacoma managing prescriptions amid rising premiums, the Washington Medicaid application—known as Apple Health—provides clear skies with coverage for doctor visits, hospital stays, and more.
In 2025, Apple Health serves over 2 million Washingtonians, managed by the Health Care Authority (HCA) through Washington Healthplanfinder. With the “One Big Beautiful Bill” (signed July 4, 2025) ushering in $1 trillion in federal cuts through 2034, including work requirements and 6-month eligibility checks, launching your Washington Medicaid application now is a forward-thinking step.
This detailed guide covers eligibility, income limits, required documents, and the full process—tailored for Washington’s rainy winters, rural clinics, and urban access, like the Basic Health Plan for immigrants. Ready to take control? Start by estimating your benefits with the Medicaid Eligibility Calculator.
Eligibility for the Washington Medicaid Application
Before diving into the Washington Medicaid application, let’s clarify who qualifies for Apple Health. It’s not exclusive to the unemployed—it’s for working parents in Vancouver, college students in Pullman, and retirees in Bellingham whose income fits state-federal guidelines. Washington, an expansion state, covers adults up to 138% FPL with no asset test for most.
Core Eligibility Factors
- Household Composition: Your household includes everyone who lives with you, claimed on taxes, or sharing finances—spouses, kids, and dependents.
- Income Thresholds: Up to 138% FPL ($21,597/year for one) for adults; children up to 317% FPL ($49,682 for one); pregnant women up to 200% FPL ($31,300). See Income for Medicaid Eligibility for details.
- Asset Rules: No asset limit for most programs. For long-term care, $2,000 single/$3,000 couple (exempt home under $713,000 equity, one car).
- Citizenship and Residency: U.S. citizens or qualified non-citizens living in Washington.
- Medical Need: For waivers like Community Options Program Entry System (COPES), require nursing home level of care.
Washington’s expansions include immigrant coverage via Basic Health Plan up to 200% FPL. The OBBBA adds work requirements (80 hours/month for adults 19–64 starting 2027) and 6-month checks from December 2026. Overlap with SNAP? Curious about costs? See Is Medicaid Free?.
Washington Medicaid Income Limits for 2025: Know Your Numbers
Washington’s Medicaid income limits vary by program and adjust annually (effective April 1, 2025). Expansion covers adults to 138% FPL with 5% disregard.
Key Income Limits (Monthly, MAGI Basis)
| Program/Group | Household Size 1 | Household Size 4 | Notes |
|---|---|---|---|
| Adults (Expansion) | $1,799 (138% FPL +5%) | $3,728 (138% FPL +5%) | Ages 19–64; no asset test. |
| Children (0–18) | $2,608 (200% FPL) | $5,416 (200% FPL) | Up to age 19; no premium. |
| Pregnant Women | $2,608 (200% FPL) | $5,416 (200% FPL) | Prenatal/postpartum. |
| Parents/Caretakers | $1,799 (138% FPL +5%) | $3,728 (138% FPL +5%) | Expansion covers. |
| Seniors/Disabled (Regular) | $967 (SSI) | $1,450 (SSI couple) | SSI-linked; $2,000 assets. |
| Long-Term Care (COPES) | $2,901 (300% SSI) | $5,802 (300% SSI) | Nursing level care; spend-down. |
Quick Math Tip: MAGI for most; SSI for seniors/disabled. Asset limit $2,000 single/$3,000 couple for LTC (exempt home under $713,000). For SNAP overlap, see SNAP Benefits by State.
Essential Documents for Your Washington Medicaid Application
Streamline your Washington Medicaid application with these must-haves:
- Identification: Driver’s license, state ID, birth certificate, or Social Security card.
- Income Verification: Pay stubs (30 days), W-2s, tax returns, SSI/unemployment letters.
- Residency Proof: Utility bill, lease, or mail with Washington address.
- Household Info: Names, ages, relationships, SSNs for all members.
- Medical Proof: Doctor’s letter for disability/waivers; pregnancy verification.
- Assets: Bank statements, property deeds for long-term care.
Digital uploads preferred; originals for in-person.
How to Apply for Medicaid in Washington: Step by Step
HCA targets 45-day processing (10 days expedited for emergencies). Here’s the roadmap:
Step 1: Pre-Screen Your Odds
Test waters at wahealthplanfinder.org or the Medicaid Eligibility Calculator.
Step 2: Pick Your Path
- Online (Recommended): wahealthplanfinder.org. Sign up, fill digitally, upload—routed to HCA.
- Mail/Fax: Download from hca.wa.gov/forms. Send to HCA (P.O. Box 45504, Olympia, WA 98504-5504).
- In-Person: Visit a DSHS office or community partner for guided help.
- Phone: Call 1-855-923-4633 or 1-800-562-3022 (TTY 711).
Elderly/disabled? Use Form 18-005 for long-term care.
Step 3: Fill and Submit
Detail household, income, assets, medical needs. Sign it—e-sign or print.
Step 4: Interview Time
Phone or in-person within 45 days to chat details. Have docs ready.
Step 5: Decision Awaits
- Approved: ProviderOne card mails 7–30 days; provider setup.
- Denied: Appeal notice—challenge in 90 days (coverage during for some).
- Expedited: 10-day fast lane for emergencies.
Step 6: Activate and Track
Annual renewals; changes in 10 days. Track via wahealthplanfinder.org.
Pro Tips for a Seamless Washington Medicaid Application
- Expansion Perks: Adults up to 138% FPL qualify—no asset test.
- Waiver Focus: COPES covers home care—get functional assessment early.
- Help Hotlines: Washington Law Help (1-888-201-1014) or HCA navigators.
- OBBBA Heads-Up: Work expansions 2027—document hours if applicable.
- Renewals: Use Healthplanfinder reminders—delays happen, appeals fix retroactively.
Frequently Asked Questions About the Washington Medicaid Application
How do I qualify for expedited Medicaid benefits in Washington?
To qualify for expedited Medicaid benefits in Washington, pregnant women and children under 21 get priority processing within 45 days, while emergencies (like labor or acute illness) can fast-track to 10 days. For the Washington Medicaid application, submit via wahealthplanfinder.org with proof like a doctor’s note for pregnancy or hospital records for urgent needs. This is crucial in rural areas like the Olympic Peninsula, where access lags—DSHS offices can assist with same-day intake.
What is the maximum Medicaid income limit in Washington for children?
The maximum Medicaid income limit in Washington for children through Apple Health is 317% of the Federal Poverty Level (FPL)—$49,682 annually ($4,140/month) for a single-parent household or $100,000 ($8,333/month) for a family of four in 2025. This covers kids up to age 19 with no asset test, making the Washington Medicaid application family-friendly. Include immunization records for faster approval, and it’s a lifeline for working parents in Seattle suburbs.
Can pregnant women apply for Medicaid in Washington without income proof?
Pregnant women in Washington can apply for Medicaid with presumptive eligibility, covering prenatal care immediately upon application—even without full income proof—up to 200% FPL ($31,300/year for one). The Washington Medicaid application via wahealthplanfinder.org allows provisional approval based on self-attestation, with verification later. This ensures timely services in high-risk areas like the Cascades, where clinics partner with DSHS for walk-in support.
Does Washington Medicaid cover long-term care for seniors?
Washington Medicaid covers long-term care for seniors through the COPES Waiver, with income up to $2,901/month ($34,812/year) for singles and assets under $2,000. The Washington Medicaid application requires a nursing home level of care assessment—apply through wahealthplanfinder.org for home-based services like in-home aides, avoiding institutionalization. It’s vital for rural elders in the Palouse region, where transportation to facilities is tough.
How often do I need to renew Washington Medicaid coverage?
Washington Medicaid renewal is annual for most programs, but the “One Big Beautiful Bill” mandates 6-month checks for expansion adults starting December 2026, requiring updated income proof via wahealthplanfinder.org. For children and pregnant women, it’s yearly—set reminders to avoid gaps. The Washington Medicaid application process includes auto-renewal notices, but respond within 30 days to keep coverage seamless, especially post-wildfire in eastern counties.
Final Thoughts: Take the First Step Today
The Washington Medicaid application (Apple Health) is your accessible route to healthcare stability—eligibility up to 138% FPL for adults (317% for kids), docs like ID/pay stubs, and apply via wahealthplanfinder.org or DSHS offices. With OBBBA cuts on the horizon, seize the moment.
Plug your numbers into the Medicaid Eligibility Calculator for a quick estimate, dive deeper on Income for Medicaid Eligibility, or learn Is Medicaid Free?. Reach HCA at 1-855-923-4633 or hca.wa.gov. Protect your health, Washington—you deserve it.