COFA Islander programs

Compact of Free Association (COFA) Islander programs provides health and dental coverage for eligible COFA islanders. COFA Islanders include people from the Republic of the Marshall Islands, the Federated State of Micronesia, and the Republic of Palau.

COFA Islander program questions? 

Apple Health (Medicaid) and COFA Islanders

Washington Apple Health (Medicaid) was restored in December 2020 for individuals from the Federated States of Micronesia, the Republic of Palau, and the Republic of the Marshall Islands through the Consolidated Appropriations Act, 2021. The Health Care Authority (HCA) transitioned eligible COFA Islanders living in Washington to Apple Health coverage in July 2021. Learn how COFA islanders can apply for coverage.

More information

About the program

HCA pays the monthly premiums and out-of-pocket expenses for silver level qualified health plans and qualified dental plans for eligible COFA islanders.

Program requirements

COFA Islander Health Care

COFA Islander Health Care

If you applied and were denied Apple Health (Medicaid), you may be eligible for COFA Islander Health Care, if you:

  • Are a COFA islander
  • Have income less than 133 percent of the federal poverty level (FPL)*
  • Live in Washington
  • Enroll into a silver level qualified health plan
  • Agree to file federal taxes (even if you do not meet tax filing requirements)
  • Not receiving other federal or state medical coverage

COFA Islander Health Care fact sheet | Chuukese | Kosraean | Marshallese | Palauan | Pohnpeian | Yapese

COFA Islander Dental Care

COFA Islander dental care

If you applied and were denied Apple Health (Medicaid), you may be eligible for COFA Islander Dental Care if you enroll in a qualified dental plan and:

  • Have COFA Islander Health Care or if you have Medicare and:
    • Are a COFA islander
    • Have income less than 133 percent of the federal poverty level (FPL)*
    • Live in Washington

COFA Islander Dental Care fact sheet | Chuukese | Kosraean | Marshallese | Palauan | Pohnpeian | Yapese

Income standards
Household Size

Single person

2-person household

3-person household

4-person household

5-person household

Monthly Income $1,616 $2,186 $2,755 $3,325 $3,895
Household Size 6-person household

7-person household

8-person household

9-person household

10-person household

Monthly Income $4,464 $5,034 $5,604 $6,173 $6,743

*The income standards listed in these examples are subject to change every November.

How to apply

Submit applications for coverage during open enrollment or apply for a special enrollment period throughout the year. If you have Medicare, you can enroll in dental without a special enrollment period.

Things you'll need to apply

When you're ready to apply, you'll need this information:

  • Your household monthly income
  • The Social Security numbers and dates of birth for each member of your household
  • Your immigration information

How to use your benefits

Learn how to use your COFA Islander Health Care benefits:

Learn more about how your Navia Benefits Card covers your out-of-pocket costs: