Apple Health customer service phone lines down Thursday, October 10.
This Thursday, Apple Health customer service lines will be down from 1:30 to 3:15 pm. We apologize for the inconvenience. View other ways to contact Apple Health.
Apple Health Expansion enrollment update
The enrollment limit for Apple Health Expansion has been met. If you have not applied, you can still complete your application for Apple Health Expansion to be considered if space opens in the program.
If you applied for coverage and were denied because the cap was met, there are no additional steps you need to take. There is still a possibility you may be randomly selected to enroll if space opens in the program. You will receive an eligibility notice if you are selected for enrollment.
View the enrollment announcement for regular updates or visit the Apple Health Expansion webpage for more information. Send questions about what this means for you and your family, and what to expect over the coming months to the Apple Health Expansion inbox.
Noncitizens
Find information about the limited coverage available to noncitizens under Apple Health (Medicaid).
Notices
Children and pregnant individuals may qualify for Washington Apple Health coverage regardless of their immigration status. View eligibility requirements for children, pregnant individuals and After-Pregnancy Coverage to see if you qualify. If you don't qualify for Apple Health coverage, you may qualify for Family Planning Only coverage.
Federal law requires many qualified immigrants to wait five years before becoming eligible for Medicaid. This 5-year waiting period is commonly referred to as the 5-year bar. This 5-year waiting period usually begins when the person receives their qualifying immigration status, not when they entered the U.S.
Programs
Apple Health Expansion
Apple Health Expansion is a new program designed to provide full-scope health care coverage to people age 19 or older with certain immigration statuses. Eligible clients include those who do not qualify for other Apple Health programs based on their immigration status. Apple Health Expansion is designed to mirror to the extent possible the services provided to individuals enrolled in Apple Health (Medicaid) managed care. View the eligibility requirements to see if you qualify for Apple Health Expansion.
Due to program funding, the number of people who can enroll in Apple Health Expansion is limited. This will ensure clients receive the highest value care possible. View the enrollment cap announcement to learn how this impacts you.
Medical Care Services (MCS)
MCS is state-funded health care coverage for individuals who are enrolled in one of the following programs:
- State Family Assistance (SFA) – Survivors of Certain Crimes
- Housing and Essential Needs (HEN) referral
- Aged, blind, or disabled (ABD) cash program and do not meet citizenship or immigration status requirements
These programs are administered by the Department of Social and Health Services (DSHS), Community Services Division.
To be eligible, individuals must:
- Apply for cash assistance with DSHS via:
- Online: Washington Connection
- Fax: 1-888-338-7410
- In-person: local community services office
- Phone: 1-877-501-2233
- Meet eligibility requirements for and enroll in, ABD cash program, HEN referral, or SFA for Survivors of Certain Crimes.
Alien Emergency Medical (AEM)
AEM is coverage for individuals who do not meet citizenship or immigration status requirements, or for qualified individuals who have not met the 5-year immigration bar and have a qualifying medical condition.
To be eligible, individuals must:
- Meet eligibility requirements of an Apple Health program, but not be eligible for full coverage due to Citizenship and immigration requirements (which program an individual is eligible for determines whether they follow the MAGI or Classic Medicaid eligibility rules and application processing); and
- Have a qualifying emergency medical condition, including one of the following:
- A qualifying emergent medical condition such as emergency room care, inpatient hospital admission, or outpatient hospital surgery
- A cancer treatment plan
- Dialysis treatment
- Antirejection medication for an organ transplant
State-funded long-term care
The applicant must meet all other eligibility factors for nursing home placement and receive prior authorization by the Aging & Long-Term Support Administration (ALTSA). This program is subject to caseload limits.
AEM qualifying medical conditions
More information on qualifying medical conditions and AEM coverage:
- Inpatient, outpatient surgery and emergency room visit – Qualifying services must be provided in a hospital setting that includes evaluation and management visits by a physician and be needed to treat the emergency medical condition. Certification is limited to the dates on which the qualifying services were provided.
- Dialysis, cancer treatment, and antirejection medication do not need to be provided in a hospital setting – The qualifying services must be needed to treat the qualifying condition of cancer, acute renal failure, or end stage renal disease, or be antirejection medication.
Applying for Apple Health coverage
The income and resource limits are designated by the program an individual is eligible for. See Apply for or renew coverage for more details.
About coverage options
Qualified Health Plans and Cascade Care Savings options for immigrants: All Washingtonians, regardless of immigration status, now have the opportunity to shop for and purchase qualified health and dental plans for 2024. Learn more about immigrant health care and other cost saving options and how to apply during a special enrollment period.