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Find information about the limited coverage available to noncitizens under Apple Health (Medicaid).

Note: Children and pregnant individuals may qualify for Washington Apple Health coverage regardless of their immigration status. View eligibility requirements for children and pregnant individuals to see if you qualify.

Note: 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.

Program requirements

The Alien Emergency Medical (AEM) Program 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 status guide  (which program an individual is related to 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
    • Long-term Care (LTC) services (prior approval required)
    • COVID-19 assessment and testing

Qualifying medical conditions

More information on qualifying medical conditions and AEM coverage:

  • Alien Emergency Medical (AEM) – The qualifying services must be provided in a hospital setting (inpatient, outpatient surgery, emergency room) 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.
  • Alien Medical for Dialysis and Cancer Treatment – 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. These services do not need to be provided in a hospital setting.
  • Alien Nursing Facility Program – 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.

Applying for Apple Health coverage

Income and resource limits are the same as the program the individual is categorically relatable. See Apply for or renew coverage for more details.