As of Wednesday, March 18, HCA’s lobby is closed. In-person customer services for Apple Health and the PEBB and SEBB Programs will not be available. Learn more.

Apple Health eligibility manual

Welcome to the Apple Health (AH) Manual for program eligibility. The manual is split into four topics that filter by methodology — not what each agency or department administers.

Apple Health Eligibility Manual redesign demonstration

Manual topics

General eligibility requirements that apply to all Apple Health programs

These requirements apply to all Apple Health programs. Information includes (for example) residency, Social Security number requirements, and appeals. View General eligibility requirements that apply to all Apple Health programs

Classic (Non-MAGI-based) programs manual

Information for 65+, blind or disabled, and other Apple Health programs that do not use MAGI methodology. View the Classic (Non-MAGI) based programs manual

Modified Adjusted Gross Income (MAGI-based) programs manual

Information for MAGI-based programs. View the Modified Adjusted Gross Income (MAGI) based programs manual

Long-term services and supports (LTSS) manual

Information on programs such as Community First Choice, HCB waivers, nursing facility care, and programs supporting the Developmental Disabilities Administration (DDA). View the Long-term services and supports (LTSS) manual

Additional tools

Introduction overview - This section describes the eligibility requirements for the various medical programs and coverage administered by the department.

Program standards for income and resources - Information regarding current and past income standards for both MAGI and non-MAGI programs, including resource standards.

Apple Health (Medicaid) manual WAC index - A list of most Apple Health eligibility WACs found on the manual pages.

Forms & publications - A comprehensive list of all HCA and DSHS forms and publications relating to all Apple Health programs.

Apple Health (Medicaid) manual revision log - History of the significant revisions made to the manual pages.