Apple Health for Adults

Revised December 17, 2014

WAC 182-505-0250 Washington apple health -- MAGI-based adult medical.

Effective August 29, 2014.

  1. Effective on or after January 1, 2014, a person is eligible for Washington apple health (WAH) modified adjusted gross income (MAGI)-based adult coverage when he or she meets the following requirements:
    1. Is age nineteen or older and under the age of sixty-five;
    2. Is not entitled to, or enrolled in, medicare benefits under Part A or B of Title XVIII of the Social Security Act;
    3. Is not otherwise eligible for and enrolled in mandatory coverage under one of the following programs:
      1. WAH SSI-related categorically needy (CN);
      2. WAH foster care program; or
      3. WAH adoption support program;
    4. Meets citizenship and immigration status requirements described in WAC 182-503-0535;
    5. Meets general eligibility requirements described in WAC 182-503-0505; and
    6. Has net countable income that is at or below one hundred thirty-three percent of the federal poverty level for a household of the applicable size.
  2. Parents or caretaker relatives of an eligible dependent child as described in WAC 182-503-0565 are first considered for WAH for families as described in WAC 182-505-0240. A person whose countable income exceeds the standard to qualify for family coverage is considered for coverage under this section.
  3. Persons who are eligible under this section are eligible for WAH alternative benefit plan as defined in WAC 182-500-0010 coverage. A person described in this section is not eligible for medically needy WAH.
  4. Other coverage options for adults not eligible under this section are described in WAC 182-508-0001.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Clarifying Information

  1. Health care coverage for adults has been "delinked" from cash assistance and no longer requires program relatability.
  2. Adults who are over income for Apple Health for Families (N01) may be eligible for Apple Health for Adults (N05) as described in WAC 182-505-0250.
  3. Adults who are ineligible for Apple Health for Adults (N05) based on citizenship may be eligible for Alien Emergency Medical (N25) as described in WAC 182-507-0110.
  4. Individuals receiving or eligible for Medicare or who are age 65 or older, are not eligible for Apple Health for Adults (N05).

Individuals may apply for MAGI Medicaid using the following options:

  • Online: Healthplanfinder
  • Paper HCA Form 18-001 (Application for Health Care Coverage), can be submitted via:
    • Mail:
      Washington Healthplanfinder
      PO Box 946
      Olympia, WA 98507
    • Fax: 1-855-867-4467
  • Phone: 1-855-923-4633

For assistance in applying for Apple Health through the Washington Healthplanfinder contact an In-person Assister or call Healthplanfinder Customer Support at 1-855-923-4633.

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