Washington Medicaid Office

Washington Apple Health office (HCA)

Washington brands its Medicaid program as Apple Health. The Health Care Authority (HCA) administers Apple Health, separate from the Department of Social and Health Services (DSHS), which still handles many Classic Medicaid intake functions. HCA splits applications across two portals depending on the eligibility category — Washington Healthplanfinder for MAGI Apple Health and Washington Connection for Classic Apple Health.

How to reach HCA

• Apple Health Customer Service — 1-800-562-3022 (askmedicaid@hca.wa.gov); client-line business hours Monday–Friday 7 a.m. to 5 p.m. Pacific.
• DSHS Customer Service Contact Center (Classic Medicaid appeals and intake) — 1-877-501-2233.
• DSHS Home and Community Based Service — 360-725-2300 for long-term services and supports questions.
• Washington Healthplanfinder — wahealthplanfinder.org for MAGI-based Apple Health applications, renewals, and Cascade Care marketplace plans.
• Washington Connection — washingtonconnection.org for Classic Apple Health (ABD), HWD, long-term care, SNAP, and TANF.
• HCA agency website — hca.wa.gov for policy bulletins, provider directories, and HCA news.

HCA's office is at Cherry Street Plaza, 626 8th Avenue SE, Olympia, WA 98501; lobby hours are Monday through Friday, 8 a.m. to 4 p.m. The agency's mailing address is PO Box 45531, Olympia WA 98504.

Who qualifies for Apple Health?

Apple Health spans more than a dozen coverage programs, each tailored to a specific population. The MAGI programs apply through Washington Healthplanfinder; the Classic Medicaid programs apply through Washington Connection. HCA also runs Apple Health Expansion — a state-funded coverage program for people regardless of immigration status.

Apple Health coverage programs HCA lists

• Apple Health for Adults — Medicaid for adults age 19 through 64 under the ACA expansion category.
• Apple Health for Kids — children under 19 covered through Medicaid or CHIP (HCA also calls Apple Health for Kids "CHIP" for higher-income tiers).
• Apple Health for Pregnant Individuals — covered during pregnancy and the postpartum period.
• Apple Health Expansion — state-funded coverage for adults regardless of immigration status. Enrollment is capped — verify status at hca.wa.gov.
• Apple Health for Workers with Disabilities (HWD) — buy-in for working adults with disabilities; higher resource limit than standard ABD.
• Apple Health Medicare Connect — integrated coverage for adults dually enrolled in Medicare and Medicaid in participating counties.
• Medically Intensive Children's Program (MICP) — for medically fragile children who need an institutional level of care at home.
• COFA Islander programs — state-funded coverage for people from Marshall Islands, Micronesia, and Palau under the Compact of Free Association.
• Family Planning Only (FPO) — family planning services for residents above Apple Health income limits.
• Tailored Supports for Older Adults (TSOA) — adult HCBS support without an underlying Medicaid award, administered through DSHS HCS.
• Foundational Community Supports — supportive housing and supported employment for eligible Medicaid members.

Resource rules

MAGI categories carry no asset test. Classic Medicaid (ABD) categories apply the federal $2,000 individual / $3,000 couple resource limit; the home, one vehicle, and burial assets do not count. HWD uses a higher resource limit and excludes retirement accounts — confirm the current HWD asset ceiling at hca.wa.gov.

Renewals

HCA attempts ex parte renewals first using federal and state data. When data confirms eligibility, coverage continues without paperwork. When it doesn't, a renewal packet appears in Healthplanfinder or Washington Connection and by mail. Sign in to either portal to check your renewal due date and upload supporting documents.

Apple Health income limits

HCA publishes Apple Health income limits by program in an annual chart on hca.wa.gov. The percentages and dollar amounts update with the federal poverty level each year — verify a current figure on hca.wa.gov or by calling Apple Health Customer Service at 1-800-562-3022 before relying on it.

Where to find the current numbers

• HCA income chart — hca.wa.gov publishes the current Apple Health income chart by program (Apple Health for Adults, Apple Health for Kids, Apple Health for Pregnant Individuals, Family Planning Only, Apple Health Expansion).
• Apple Health Expansion — state-funded coverage for adults regardless of immigration status; enrollment is capped, so applicants may face a waitlist.
• Apple Health for Workers with Disabilities (HWD) — uses a higher resource limit than standard ABD and excludes retirement accounts. Confirm the current HWD asset ceiling and earned-income limit at hca.wa.gov.
• Classic Medicaid (ABD) — uses the federal $2,000 individual / $3,000 couple resource limit; nursing-facility and HCBS applicants follow the state's special-income standard with community-spouse protections.
• Medicare Savings Programs (MSP) — QMB (up to 100% FPL), SLMB (100–120% FPL), and QI-1 (120–135% FPL) follow federal MSP standards updated annually by CMS.

Residents whose income is above Apple Health limits can shop subsidized plans on Washington Healthplanfinder, the state-based marketplace.

How to apply for Apple Health

Washington runs two application portals depending on what kind of Apple Health you need. The MAGI portal handles most working-age adults, children, and pregnant individuals. The Classic Medicaid portal handles older adults, people with disabilities, and long-term care applicants.

Washington Healthplanfinder (MAGI Apple Health)

Apply at wahealthplanfinder.org for Apple Health for Adults, Apple Health for Kids, Apple Health for Pregnant Individuals, and the Family Planning Only program. The same site sells subsidized Cascade Care marketplace plans for residents above Apple Health income limits. The Healthplanfinder Customer Support Center is at 1-888-849-3681, Monday–Friday 6:30 a.m. to 8 p.m. and Saturday 7 a.m. to 6 p.m. Pacific.

Washington Connection (Classic Apple Health)

Apply at washingtonconnection.org for Classic Apple Health (older adults and people with disabilities), HWD, long-term care, and other Classic Medicaid programs. Washington Connection also handles SNAP (Basic Food), TANF, and child-care assistance.

By phone

Call Apple Health Customer Service at 1-800-562-3022 for general Medicaid questions (Monday–Friday 7 a.m. to 5 p.m. Pacific). For Classic Medicaid, call the DSHS Customer Service Contact Center at 1-877-501-2233. For long-term services and supports, call DSHS Home and Community Based Service at 360-725-2300.

In person

HCA accepts in-person visits at 626 8th Avenue SE in Olympia (lobby hours Monday–Friday 8 a.m. to 4 p.m.). DSHS Home and Community Services (HCS) and Community Services Offices (CSOs) handle Classic Medicaid intake and assessments throughout Washington — the DSHS site lists locations.

Decision timelines

Federal rules give HCA up to 45 days to decide a non-disability application and up to 90 days for disability-based determinations. Retroactive coverage runs up to three months before the application month for households with qualifying medical bills.

What Apple Health covers

Most Apple Health enrollees pick an Apple Health Managed Care plan from the menu HCA publishes for their Regional Service Area. Members in some specialty categories — dual-eligibles in Apple Health Medicare Connect, certain LTSS recipients, and others — remain in fee-for-service Apple Health Coverage Without Managed Care. HCA's "I need medical, dental, or vision care" menu organizes the full Apple Health program lineup.

Apple Health Managed Care plans

HCA publishes its current list of Apple Health managed care plans on hca.wa.gov. Members pick a plan at enrollment or are auto-assigned, and can change during the annual open-change window or after a qualifying event. Check hca.wa.gov for current plan availability in your Regional Service Area.

Core medical benefits

• Primary and specialty care, urgent care, emergency services
• Hospital inpatient and outpatient care
• Prescription drugs
• Lab and imaging
• Maternity care and postpartum coverage
• Behavioral health and substance use disorder treatment, integrated with physical health through Apple Health Managed Care
• Non-emergency medical transportation through HCA's regional brokers

Specialty Apple Health programs HCA lists

• Apple Health Medicare Connect — integrated Medicare-Medicaid coverage for dually enrolled adults in participating counties.
• Apple Health Expansion — state-funded coverage for adults regardless of immigration status (capped enrollment).
• Apple Health for Workers with Disabilities (HWD) — buy-in that lets workers with disabilities keep Apple Health as their earnings rise.
• Medically Intensive Children's Program (MICP) — for medically fragile children needing institutional-level care at home.
• COFA Islander programs — for people from Marshall Islands, Micronesia, and Palau under the Compact of Free Association.
• Foundational Community Supports — supportive housing and supported employment for eligible Medicaid members.
• Tailored Supports for Older Adults (TSOA) — adult HCBS without an underlying Medicaid award.

Long-term services and supports

Apple Health covers nursing facility care for ABD-eligible members. HCA and DSHS Home and Community Services (HCS) jointly run several HCBS waivers and supports for adults who need nursing-facility-level care at home, plus waivers operated by the Developmental Disabilities Administration (DDA) for people with intellectual or developmental disabilities. The Medically Intensive Children's Program (MICP) serves medically fragile children. Confirm the current waiver list and waitlist status at hca.wa.gov and dshs.wa.gov.

Other state Medicaid pages