Washington’s Medicaid program is called Apple Health — and it’s one of the most expansive in the country by both coverage breadth and income thresholds.
Two features set Washington apart from virtually every other state in this series:
Immigrant coverage — As of July 2024, Washington extended Apple Health to undocumented adults with incomes up to 138% FPL through state-funded Apple Health Expansion. An enrollment cap of 13,000 was reached within days of launch. Washington is one of very few states offering Medicaid to all income-eligible residents regardless of immigration status.
Home equity limit of $1,103,000 — Washington’s threshold for the primary home exemption in long-term care Medicaid is among the highest in the country, reflecting the state’s elevated housing market — particularly in the Seattle metro. Most states cap this at $730,000. Washington’s higher limit protects more homeowners from being forced to sell their homes to qualify for nursing home care.
Washington also has the highest children’s Medicaid threshold in this series — 319% FPL ($4,147/month for one person) — ensuring near-universal coverage for children regardless of family income.
The program is administered by the Washington State Health Care Authority (HCA) and delivered through Washington Healthplanfinder (for most enrollees) and Washington Connection (for seniors, blind, and disabled individuals). These are two distinct portals — an important practical detail for applicants.
This guide covers every Apple Health program, 2026 income limits, the COPES waiver, immigrant coverage pathways, the $1.1M home equity exemption, and how to apply. For comparison to other states, see Medicaid income limits across all 50 states.
Apple Health Programs
Apple Health (ACA Expansion Adults, 19–64) covers adults with incomes up to 138% FPL with no asset test.
Washington expanded Medicaid in 2014 and is one of the original expansion states. About 597,699 Washingtonians are enrolled under expansion as of June 2025. Care is delivered through five managed care plans — members choose a plan or are assigned one.
Apple Health for Kids (CHIP) covers children up to age 19 with household incomes up to 319% FPL ($4,147/month for one person) — the highest children’s threshold in this series.
No-premium coverage is available at lower income levels. Monthly premiums of $20/child (maximum $40/family, up to $60 for higher-income families) apply above certain thresholds.
Children under age 6 have continuous eligibility — they cannot lose Apple Health coverage due to income changes until they turn 6. This eliminates churning for families with young children.
Apple Health for Pregnancy covers pregnant women up to 194% FPL ($2,596/month for one person).
Coverage extends 12 months postpartum regardless of income changes after delivery. Presumptive eligibility is available — prenatal care can begin on the day of application.
Apple Health Expansion for Immigrants is Washington’s state-funded program extending Apple Health to adults 19+ with certain immigration statuses who don’t qualify for federal Medicaid, with incomes at or below 138% FPL.
As of July 2024, this includes undocumented immigrant adults. The program has an enrollment cap (13,000 slots, reached within days of opening). Apply regardless — you’ll be considered if space opens. No 5-year bar applies to state-funded Apple Health programs. Contact 1-855-923-4633 or visit wahealthplanfinder.org.
Alien Emergency Medical (AEM) covers immigrants who meet Apple Health income requirements but aren’t eligible for full coverage due to immigration status.
AEM covers: emergency room visits, inpatient hospital admissions, outpatient hospital surgery, and — without requiring a hospital setting — cancer treatment, dialysis, and antirejection medications. Coverage is limited to dates of qualifying services.
Regular Medicaid (Aged, Blind, and Disabled — ABD) covers low-income elderly, blind, or disabled Washingtonians who don’t need nursing home care.
Income limit: $967/month (single). Asset limit: $2,000 (single).
Medicare Savings Programs — Apple Health helps eligible Washington seniors pay Medicare Part A and B premiums, copays, and deductibles.
In 2026, Washington eliminated asset limits for Medicare Savings Programs — making it significantly easier for seniors with modest savings to get help paying Medicare costs.
Nursing Home / Institutional Medicaid covers long-term care in Medicaid-certified nursing facilities and ICF/IID facilities.
This is an entitlement. Income limit: $2,901/month (single). Asset limit: $2,000 (single).
COPES (Community Options Program Entry System) is Washington’s primary HCBS waiver for seniors and adults with disabilities who need nursing home-level care but want to remain at home.
COPES provides: personal care assistance, adult day programs, home modifications, respite care, meal delivery, and emergency response systems. It is non-entitlement — waiting lists may apply. Contact ALTSA (Aging and Long-Term Support Administration) at 1-800-422-3263 to initiate the functional assessment.
Medical Care Services (MCS) — State-funded coverage for State Family Assistance (SFA) recipients, including survivors of certain crimes.
Income Limits — 2026
All figures are monthly gross income. The Federal Benefit Rate (FBR) is $967/month for 2026.
| Program | Single | Married (Both Applying) |
|---|---|---|
| Nursing Home / COPES Waiver | $2,901/mo (300% FBR) | $5,802/mo |
| Regular Medicaid (ABD) | $967/mo (100% FBR) | $1,450/mo |
| ACA Expansion Adults (19–64) | $1,799/mo (138% FPL) | $2,432/mo |
| Apple Health Expansion (Immigrants) | Up to $1,799/mo (138% FPL) | — |
| Children / Apple Health for Kids | Up to $4,147/mo (319% FPL) | — |
| Pregnant Women | Up to $2,596/mo (194% FPL) | — |
Key Notes on Washington’s Income Rules
$75.23/month Personal Needs Allowance — Washington’s nursing home PNA is one of the higher ones in this series.
When nursing home income exceeds $2,901/month, residents retain $75.23/month for personal spending after directing the remainder toward care costs. For context: Vermont $79.93, Texas $75, Washington $75.23, South Carolina $65, Tennessee/Rhode Island $50.
No QIT required in Washington. Like Vermont and Virginia, Washington uses the Medically Needy spend-down pathway rather than a Qualified Income Trust.
Qualifying medical expenses are deducted from countable income to bring it below the eligibility threshold. No separate trust account or attorney is required.
Community Spouse Allowance: The community spouse may keep income up to $3,948/month as a MMMNA if housing and utility costs exceed $793.13/month (effective July 1, 2025 – June 30, 2026).
Children under 6: Washington provides continuous eligibility for children under age 6 — they cannot lose Apple Health coverage due to income changes until their 6th birthday.
Postpartum coverage: 12 months after the end of pregnancy, regardless of income changes.
Federal Poverty Level Reference — 2026
| Household Size | 100% FPL | 138% FPL (Adults) | 194% FPL (Pregnant) | 319% FPL (Kids) |
|---|---|---|---|---|
| 1 | $1,304/mo | $1,799/mo | $2,596/mo | $4,147/mo |
| 2 | $1,762/mo | $2,432/mo | $3,508/mo | $5,622/mo |
| 3 | $2,221/mo | $3,064/mo | $4,420/mo | $7,084/mo |
| 4 | $2,679/mo | $3,697/mo | $5,332/mo | $8,547/mo |
Use the federal poverty level calculator to find the exact threshold for your household size.
Washington’s $1,103,000 Home Equity Exemption
Washington’s home equity limit for long-term care Medicaid is $1,103,000 — one of the highest in the country.
Most states cap the primary home equity exemption at $730,000. Washington’s higher threshold reflects the state’s elevated housing values, particularly in King County and the Puget Sound region, where median home prices regularly exceed $700,000.
In practical terms: a Washington senior with a home worth $900,000 and a $150,000 remaining mortgage ($750,000 equity) can still qualify for Medicaid nursing home coverage — their home is exempt from the asset calculation.
Compare to other states in this series: Oregon $730,000, Pennsylvania $730,000, Texas $730,000, Vermont $730,000, Virginia $730,000. Washington’s $1,103,000 cap is nearly 50% higher.
The home remains exempt while the applicant or spouse resides there or has intent to return.
Asset Rules for Washington Medicaid
No asset test applies to ACA expansion adults, immigrant expansion, Apple Health for Kids, or pregnant women. Asset limits apply to nursing home, COPES, and ABD programs.
| Situation | Countable Asset Limit |
|---|---|
| Single applicant (LTC / Nursing Home / COPES) | $2,000 |
| Married, both applying (LTC) | $3,000 |
| Married, one applying — applicant | $2,000 |
| Married, one applying — community spouse | Up to $157,920 (CSRA) |
| ABD Regular Medicaid (single) | $2,000 |
| ABD Regular Medicaid (couple) | $3,000 |
| Medicare Savings Programs | No asset limit (eliminated 2026) |
Home equity limit: $1,103,000 — see above for context.
CSRA: The community spouse may keep up to 50% of the couple’s total countable assets, with a maximum of $162,660. If the non-applicant’s share falls below $32,532, they may keep up to 100% of assets up to that floor.
Exempt (Non-Countable) Assets
- Primary home (within the $1,103,000 equity cap)
- One vehicle
- Household goods and personal effects
- Pre-paid funeral contracts (irrevocable)
- Medicaid Compliant Annuities
- Life insurance with face value $1,500 or less
Washington’s Medically Needy Spend-Down — No QIT Needed
Washington does not require a Qualified Income Trust for seniors whose income exceeds the LTC limit.
Instead, Washington uses the Medically Needy pathway: qualifying medical expenses reduce countable income to the eligibility threshold each month. No trust account is required. This is the same model used by Vermont and Virginia — simpler than the QIT structure in Texas, Pennsylvania, Tennessee, and most other states.
Contact a Washington Certified Medicaid Planner or elder law attorney for help calculating your spend-down amount under the specific rules that apply to your situation.
Washington’s 60-Month Look-Back Period
Washington enforces a 60-month (5-year) look-back for Nursing Home Medicaid and COPES Waivers.
All asset transfers within 5 years before the application date are reviewed. Transfers below fair market value trigger a penalty period of ineligibility.
Exempt transfers:
- Transfers to a spouse
- Transfers to a blind or disabled child
- Home transfer to a caregiver child who lived there at least 2 years before institutionalization and whose care delayed nursing home placement
- Transfer to a sibling with an equity interest who lived there at least 1 year before institutionalization
No look-back applies to ABD Regular Medicaid, ACA expansion adults, immigrant expansion, children, or pregnant women.
Medical and Functional Requirements
To qualify for Nursing Home Medicaid or COPES, applicants must demonstrate Nursing Facility Level of Care (NFLOC) through documented limitations in:
ADLs: Mobility, bathing, dressing, eating, and toileting.
IADLs: Cooking, shopping, managing finances, medication management.
Cognitive or behavioral issues: Alzheimer’s or dementia — diagnosis alone is not sufficient; functional limitations must be formally assessed by ALTSA.
For ABD Regular Medicaid, proof of disability or blindness per SSA standards is required — NFLOC is not necessary.
Medicaid Estate Recovery
Washington’s Medicaid Estate Recovery Program may seek reimbursement for long-term care costs from a beneficiary’s estate after death.
Recovery most commonly targets the primary home when not protected through a surviving spouse, a child under 21, or a blind or disabled child of any age.
Federal Policy Changes Coming to Washington Apple Health
Work Requirements (January 2027): Will apply to ACA expansion adults who are not seniors, disabled, pregnant, or otherwise exempt.
Washington has not historically implemented Medicaid work requirements and may seek legal or policy avenues to resist. For context on how these requirements function, see how SNAP work requirements apply. Full policy detail: how the One Big Beautiful Bill affects Medicaid and SNAP.
Reduced Retroactive Coverage (January 2027): Apple Health for Adults will cover only 2 months prior to application. Apply promptly.
More Frequent Renewals (December 2026): Adults renew every 6 months (some groups already renewing at this frequency under state changes). Use Washington Healthplanfinder to renew online.
New Cost-Sharing (October 2028): Non-exempt enrollees may face up to $35 per specialist visit. Primary care and preventive services remain free. Seniors, children, pregnant women, and nursing facility residents are exempt.
Two Portals: Washington Healthplanfinder vs. Washington Connection
Washington Apple Health uses two separate online portals depending on who you are:
Washington Healthplanfinder (wahealthplanfinder.org) — For most Apple Health enrollees: expansion adults, children, pregnant women, and immigrants. This is also Washington’s ACA Marketplace where subsidized private plans are available.
Washington Connection (washingtonconnection.org) — For people who are 65+, blind, or living with a disability. Also used for SNAP (Basic Food) applications for all groups through DSHS.
This split is important: a 67-year-old applying for Apple Health and Basic Food (SNAP) would use Washington Connection for both; a 35-year-old applying for Apple Health and Basic Food would use Washington Healthplanfinder for Apple Health and Washington Connection for SNAP.
Useful links for Washington residents:
- Washington Basic Food (SNAP) benefits and eligibility
- How to apply for Basic Food SNAP in Washington
- Washington WIC income guidelines
- Whether seniors on Social Security can also qualify for food stamps
How to Apply for Apple Health
Online — Most applicants: Apply through Washington Healthplanfinder at wahealthplanfinder.org.
Create an account, enter your information, and view your eligibility results. The same application screens for Apple Health, Marketplace private plans, and subsidies simultaneously.
Online — Seniors, blind, and disabled: Apply through Washington Connection at washingtonconnection.org.
By Phone: Call the Apple Health Customer Service Center at 1-855-923-4633.
For Apple Health for Kids specifically, call WithinReach’s Apple Health hotline at 206-204-3503 (weekdays) or visit ParentHelp123.org.
In Person or By Mail: Visit your nearest DSHS Community Services Office across Washington’s 39 counties, or download an application from hca.wa.gov.
Long-Term Care / COPES Waiver: Contact ALTSA at 1-800-422-3263 to initiate the functional assessment before applying. You do not need to be in a nursing home to apply for COPES — apply from home or the hospital.
For the complete step-by-step application guide: applying for Apple Health in Washington.
Documents You’ll Need
- Washington residency proof (utility bill, lease, or official mail; a letter from a shelter works for homeless applicants)
- U.S. citizenship or qualifying immigration status documentation (or immigration documents for state-funded programs)
- Income proof: pay stubs, SSA award letters, pension statements
- SSNs for all household members (or document numbers for immigrants)
- For LTC / ABD: bank statements, property records, 60 months of financial history
Processing Times
- Standard applications: Up to 45 days
- Disability-based applications: Up to 90 days
- Pregnant women and children: Expedited; presumptive eligibility available for pregnancy
Frequently Asked Questions
Does Washington cover undocumented immigrants through Apple Health?
Yes — as of July 2024, Washington offers Apple Health Expansion to undocumented adults with incomes up to 138% FPL through state-funded (not federal) dollars.
The program had an enrollment cap of 13,000 — reached within days of launch. Apply through wahealthplanfinder.org regardless; you’ll be placed on a waitlist and considered if space opens. Washington also covers undocumented children and pregnant women with no enrollment cap. No 5-year waiting period applies to state-funded Apple Health programs.
What is Washington’s home equity limit for Medicaid and why is it so high?
Washington’s primary home equity exemption for long-term care Medicaid is $1,103,000 — nearly 50% higher than the $730,000 used by most other states in this series.
Washington set this higher limit to reflect its elevated housing market, particularly in King County (Seattle metro) and the broader Puget Sound region. A senior with $800,000 in home equity can still qualify for nursing home Medicaid — their home is protected from the asset calculation. Most states would count anything above $730,000 as a countable asset.
Does Washington require a QIT/Miller Trust for excess income?
No — Washington uses the Medically Needy spend-down pathway.
When income exceeds the nursing home limit ($2,901/month), qualifying medical expenses are deducted from countable income to bring it below the threshold. No separate trust account is required — unlike Texas, Pennsylvania, or Tennessee, where applicants must establish and maintain a Qualified Income Trust. Vermont and Virginia use the same spend-down approach as Washington.
What is the COPES Waiver in Washington?
COPES (Community Options Program Entry System) is Washington’s primary HCBS program for seniors and adults with disabilities who qualify for nursing home-level care but want to remain in the community.
COPES provides personal care assistance, adult day programs, home modifications, respite care, meal delivery, and emergency response systems. It is non-entitlement — slots are limited and waiting lists may apply. Contact ALTSA at 1-800-422-3263 early. You can apply from home, a hospital, or before entering a facility.
What is the difference between Washington Healthplanfinder and Washington Connection?
These are two separate portals for two different Apple Health populations.
Washington Healthplanfinder (wahealthplanfinder.org) — Used by expansion adults, children, pregnant women, and immigrants. Also the ACA Marketplace.
Washington Connection (washingtonconnection.org) — Used by people who are 65+, blind, or disabled. Also used by all groups to apply for Basic Food (SNAP).
If you’re unsure which to use, start at wahealthplanfinder.org — the site will guide you to the right portal.
Why is Washington’s children’s Medicaid threshold so high?
Washington covers children up to 319% FPL ($4,147/month for a single-parent household) — the highest children’s threshold in this article series.
This ensures that nearly all Washington children have access to Apple Health, including those in working- and middle-income families who might struggle to afford private insurance. Vermont covers children to 312% FPL; Oregon to 213%; most states cover children to 200–300% FPL. Washington’s commitment to near-universal children’s coverage reflects its broader progressive health policy approach.
Can I get both Apple Health and SNAP in Washington?
Yes — many Washington households qualify for both simultaneously.
However, note that these programs use different portals: Apple Health through Washington Healthplanfinder (for most groups) or Washington Connection (for seniors/disabled), and Basic Food (SNAP) through Washington Connection for all groups. See Washington Basic Food SNAP benefits and eligibility for income limits and application details.
Last updated: 2026 | Sources: Washington State Health Care Authority (HCA), Washington Healthplanfinder, DSHS, healthinsurance.org/medicaid/washington, CMS.gov, USDA FPL guidelines. Verify current thresholds at hca.wa.gov or by calling Apple Health at 1-855-923-4633. This guide is for informational purposes only — eligibility is determined by HCA and DSHS.