Washington’s Medicaid program, called Apple Health, uses income limits based on the Federal Poverty Level (FPL) to determine who qualifies.
In 2026, a single person earning up to about $1,836 per month may qualify for adult coverage.
Understanding these limits helps you know if you or your family can get free or low-cost health coverage.
Quick Summary:
- 100% FPL for one person is $1,330/month in 2026
- Most adults qualify at 138% FPL (~$1,836/month)
- Pregnant individuals and children have higher income limits
- Long-term care Medicaid has different rules
- New work requirements apply to some adults
- Continuous eligibility protects young children
Page Contents
- 1 2026 Apple Health Monthly Income Limits
- 2 Long-Term Care Income and Asset Limits
- 3 What Counts as Income for Apple Health?
- 4 Important 2026 Apple Health Policy Changes
- 5 Medicare Savings Programs (MSP)
- 6 Special Coverage for Pregnant People and Children
- 7 Apple Health Expansion for Undocumented Adults
- 8 How to Apply for Apple Health
- 9 Frequently Asked Questions (FAQs)
- 9.1 What is the income limit for Apple Health in Washington in 2026?
- 9.2 Does Washington Medicaid count all income?
- 9.3 Can undocumented immigrants get Apple Health in 2026?
- 9.4 What is the asset limit for Washington Medicaid in 2026?
- 9.5 How often do I need to renew Apple Health coverage?
- 9.6 What happens if my income goes over the limit?
- 10 Conclusion
2026 Apple Health Monthly Income Limits
Apple Health covers different groups of people. Each group has its own income limit. Most limits are based on a percentage of the Federal Poverty Level.
The table below shows who qualifies and at what income level. These numbers are effective as of January 1, 2026.
Income Limits by Program Category
| Program Category | Income Limit (% of FPL) | Monthly Limit (1 Person) | Monthly Limit (4 Person) |
|---|---|---|---|
| Adults (Ages 19–64) | 138% FPL | ~$1,836 | ~$3,795 |
| Pregnant Individuals | 210% FPL | $2,803 | $5,760 |
| Children (Free Coverage) | 215% FPL | $2,804 | $5,760 |
| Children (CHIP with Premium) | 317% FPL | $4,134 | $8,492 |
| Aged, Blind, or Disabled (SSI-Related) | ~75% FPL | $994 | $1,483 (for 10 persons) |
Adults get a 5% income disregard. This effectively raises the limit to 138% FPL. Children and pregnant individuals have higher limits to ensure coverage.
Long-Term Care Income and Asset Limits
Long-term care Medicaid helps seniors and people with disabilities pay for nursing homes or home care. The rules are different from regular Apple Health.
These limits apply to those needing institutional or waiver-based care. They went into effect on January 1, 2026.
Nursing Home and Waiver Programs
Institutional/Nursing Home Medicaid:
- Monthly income limit: $2,982 for one person
- Asset limit: $2,000
Home and Community-Based Services (HCBS) Waivers:
- Monthly income limit: $2,982
- Helps people stay at home instead of nursing homes
Medically Needy Program (Spenddown)
If your income is too high, you may still qualify. You must “spend down” your excess income on medical bills each month.
- Medically Needy Income Level (MNIL): $994/month
- You subtract your medical expenses from your income
- Once you meet the spenddown, Medicaid covers the rest
Community Spouse Protections
If only one spouse needs long-term care, the other spouse is protected financially.
- The healthy spouse can keep up to $162,660 in assets
- This is the Federal Spousal Resource Maximum for 2026
- Income rules also protect the at-home spouse
For more details on how these limits compare to other states, visit Medicaid income limits by state in 2026.
What Counts as Income for Apple Health?
Washington counts most types of earned and unearned income. Knowing what counts helps you estimate your eligibility accurately.
Countable Income Includes:
- Salaries and wages
- Tips and commissions
- Self-employment income (minus business expenses)
- Social Security benefits
- Unemployment benefits
- Pensions and retirement income
Income That Does NOT Count:
- Child support payments
- Supplemental Security Income (SSI)
- Veterans disability payments
- Certain disaster relief payments
Washington Healthplanfinder reviews your income monthly. If your income changes, report it right away to avoid coverage gaps.
Important 2026 Apple Health Policy Changes
Washington made several changes to Apple Health in 2025 and 2026. These updates affect how people enroll, renew, and use benefits.
Work Requirements for Adults
Some adults on Apple Health must now complete work-related activities.
- Must work, train, or volunteer 80 hours per month
- Applies mainly to Apple Health for Adults (childless adults)
- Exemptions exist for those unable to work
Renewal Frequency Changes
People in the “Adults” category now renew coverage more often.
- Was: Once per year
- Now: Every six months
This change aims to keep enrollment records more accurate.
Retroactive Coverage Reduced
Retroactive coverage is the time Medicaid covers before you applied.
- Apple Health for Adults: 1 month retroactive coverage
- Other programs: 2 months retroactive coverage
- Previously, coverage could go back 3 months
New Cost-Sharing Requirements
Some adults may now pay small fees for certain services.
- Cost-sharing up to $35 per service
- Does NOT apply to primary care, emergency services, or behavioral health
- Designed to reduce state costs
These changes are part of budget adjustments and federal waiver approvals.
Medicare Savings Programs (MSP)
If you have Medicare, Apple Health can help pay your premiums and copays. These programs are called Medicare Savings Programs.
Qualified Medicare Beneficiary (QMB)
- Income limit: 110% FPL ($1,454/month for one person)
- Covers Medicare Part A and Part B premiums
- Pays deductibles and copays
Special Low-Income Medicare Beneficiary (SLMB)
- Income limit: 120% FPL ($1,585/month for one person)
- Covers Medicare Part B premium only
No Resource Limit in 2026
Good news: Washington eliminated asset limits for Medicare Savings Programs in 2026. You only need to meet the income limit.
Special Coverage for Pregnant People and Children
Washington offers expanded coverage for families. Income limits are higher to protect maternal and child health.
Pregnancy Medical Coverage
- Income limit: 210% FPL ($2,803/month for one person)
- Covers prenatal care, delivery, and postpartum care
- After-Pregnancy Coverage (APC) lasts 12 months after delivery
Children’s Coverage
Children have some of the highest income limits.
- Free coverage up to 215% FPL
- CHIP with small premiums up to 317% FPL
- Continuous eligibility for kids under age 6 (no income checks until they turn 6)
These protections ensure children don’t lose coverage due to small income changes.
Apple Health Expansion for Undocumented Adults
Starting in 2024 and continuing in 2026, Washington expanded Apple Health to undocumented adults.
- Income limit: 138% FPL (same as other adults)
- Enrollment is capped due to limited state funding
- Waitlists may apply during high-demand periods
This makes Washington one of the few states offering Medicaid to all income-eligible adults, regardless of immigration status.
How to Apply for Apple Health
Applying is free and can be done online, by phone, or in person.
Application Methods:
- Online: Visit Washington Healthplanfinder at wahealthplanfinder.org
- Phone: Call 1-855-923-4633
- In-person: Visit a local community health center or DSHS office
Documents You May Need:
- Proof of income (pay stubs, tax returns, SSI letter)
- Proof of identity (driver’s license, birth certificate)
- Proof of residence (utility bill, lease)
- Social Security numbers for household members (if available)
Most people get a decision within 45 days. Emergency Medicaid can be approved faster.
For provider payment information, check the Medicaid Fee Schedule 2026.
Frequently Asked Questions (FAQs)
What is the income limit for Apple Health in Washington in 2026?
For adults ages 19–64, the income limit is about $1,836 per month for one person (138% FPL). Pregnant individuals and children have higher limits. Long-term care Medicaid has a $2,982 monthly income cap for nursing home services.
Does Washington Medicaid count all income?
No. Washington counts wages, tips, self-employment income, and Social Security. It does not count child support, SSI, or certain disaster relief. Always report all income when applying to avoid errors.
Can undocumented immigrants get Apple Health in 2026?
Yes. Washington expanded Apple Health to undocumented adults with incomes below 138% FPL. Enrollment may be capped due to funding limits. Check with Washington Healthplanfinder for current availability and waitlist status.
What is the asset limit for Washington Medicaid in 2026?
Most Apple Health programs have no asset limit. Long-term care Medicaid has a $2,000 asset limit for individuals. Medicare Savings Programs eliminated asset limits in 2026, making it easier to qualify.
How often do I need to renew Apple Health coverage?
It depends on your category. Adults must renew every six months. Other groups renew annually. Children under 6 have continuous eligibility and don’t lose coverage due to income changes until age 6.
What happens if my income goes over the limit?
If your income increases, you may lose Apple Health. However, you may qualify for subsidized Qualified Health Plans through Washington Healthplanfinder. Report income changes within 30 days to avoid coverage gaps or repayment issues.
Conclusion
Understanding Washington Medicaid income limits helps you access the health coverage you need. In 2026, most adults qualify at 138% FPL, while children and pregnant individuals have higher limits. Long-term care and Medicare Savings Programs have separate rules.
If you think you qualify, apply today through Washington Healthplanfinder. Coverage is free or low-cost, and most people can enroll year-round.
Sources:
- Washington State Health Care Authority: hca.wa.gov
- Washington Healthplanfinder: wahealthplanfinder.org
- Federal Poverty Guidelines: aspe.hhs.gov
Last Updated: February 2026
