Apple Health Expansion enrollment cap

Apple Health Expansion enrollment update

The enrollment limit for Apple Health Expansion has been met for all age groups. Continue encouraging people to complete an application to be considered if space opens in the program. Learn how to apply for Apple Health Expansion coverage.

Only one application needs to be submitted. If someone applied for Apple Health Expansion on or after June 20, 2024, and was denied because the cap was met, there are no additional steps they need to take. There is still a possibility they may be randomly selected to enroll if space opens in the program. Those selected for enrollment will receive an eligibility notice through their preferred communication method (email or mail).

If you're helping someone who isn't sure if their application is complete, encourage them to log in to their account or contact one of the following customer service teams to check their application status.

  • If you are age 19 - 64, log in to Washington Healthplanfinder or call at 1-855-923-4633.
  • If you are age 65 or older, log in to Washington Connection or call 1-877-501-2233.

Who is enrolled in Apple Health Expansion?

On June 20, 2024, HCA began enrolling eligible individuals into Apple Health Expansion, with coverage beginning July 2024. Individuals may be eligible for Apple Health Expansion if they are aged 19 and older with certain immigration statuses. 

The Health Care Authority (HCA) is enrolling up to 13,000 people into Apple Health Expansion. Eligible groups (detailed below) were transitioned into the program first, prior to applications opening on June 20 at 8 a.m. The remaining spaces will be filled with new applicants.

Groups with current coverage who were or will be automatically transitioned to Apple Health Expansion

Qualified Health Plan (QHP) enrollees who are eligible for Apple Health Expansion

QHP customers who paid their health coverage premiums, who are eligible for Apple Health Expansion, were transitioned if they were:

1) Enrolled in QHP coverage in May; and

2) Did not have their QHP coverage cancelled before coverage transitions in June.

  • State premium subsidies for QHP coverage can no longer be applied if a QHP customer has a free coverage option through Apple Health Expansion.

HCA is following current eligibility practices to transition eligible individuals to this new program effective July 1, 2024, in partnership with the Washington Health Benefit Exchange.

  • Individuals age 19 through 64: Impacted customers started receiving notifications from Washington Healthplanfinder about the transition in May.
  • Individuals age 65 and older: Impacted customers started receiving notifications from Washington Connection about the transition in early June.

QHP customers who did not sign up by the end of April, will not be automatically transitioned and will need to apply when Apple Health Expansion.

Clients transitioning from AEM coverage

Clients enrolled in Emergency Medical (AEM) will transition to Apple Health Expansion starting July 1, 2024. AEM only covers qualifying medical emergencies.

  • HCA made the decision to provide these clients enrolled in AEM with comprehensive health coverage.
  • Transition notices were mailed out to affected clients starting June 18, 2024.

Clients enrolled through Apple Health application systems

Note: New clients applying for Apple Health Expansion are being enrolled until the enrollment cap is met. The enrollment began after the above groups were transitioned.

Applications for enrollment into Apple Health Expansion were processed through one of two application portals.

  • Washington Connection (administered by the Department of Social and Health Services (DSHS) for individuals who are age 65 or older).
    • Applications submitted to DSHS require additional processing and do not provide real time enrollment results.
  • Washington Healthplanfinder (administered by HBE for individuals who are age 19 through 64).
    • Applications through Washington Healthplanfinder are processed in real time.

Paper applications for individuals 65 and older continue to be processed in the order they are received until the cap is met. HCA accounted for differences in the application systems' processing times and paper applications when determining when the cap will be met to prevent over enrollment.

What happens now that the enrollment limit has been met?

Due to a limited budget, HCA needed to manage the number of people who can enroll into the program to ensure clients receive the highest value care possible.

HCA will enroll up to 13,000 people into Apple Health Expansion. This number may change as HCA ensures we stay under the budget for the program. HCA will provide additional information on the budget cap by mid-July.

Eligible groups were transitioned into the program first, followed by clients applying for Apple Health Expansion until the enrollment cap was met. HCA will work with advocates and stakeholders to develop a long-term technology-based solution to manage enrollment into the program. Until this solution is in place, we will follow a temporary enrollment management plan that was determined in partnership with the Temporary Community Engagement Advisory Committee (TCEAC).

Short-term enrollment management policy

In the event that the agency determines additional individuals can be enrolled in Modified Adjusted Gross Income (MAGI) (individuals age 19 - 64) or Classic Apple Health Expansion (individuals age 65 and older), the agency will implement its short-term enrollment management policy. The enrollment management policy requires HCA to randomly select individuals who are ineligible for Apple Health Expansion due to the enrollment cap being met. This includes clients from one of the following three groups. Clients who:

  • Submitted a completed application on or after 6/20/2024 and receive a denial due to the enrollment cap being met,
  • Were enrolled in Apple Health for Kids, Emergency Medical (AEM), or After-Pregnancy Coverage who meet eligibility requirements for Apple Health Expansion and their coverage ended after the cap was met, or
  • Are enrolled in a qualified health plan (QHP) through Health Benefit Exchange’s 1332 waiver coverage who applied after 4/30/2024.

Do I have other options for health care coverage?

View other health care options currently available to see if you or your family qualify for:

Apple Health programs

Qualified Health Plans and Cascade Care Savings options for immigrant communities

All Washingtonians, regardless of immigration status, may shop for and purchase QHPs.

Where can I get more information?

Learn more about Apple Health Expansion eligibility, benefits, and services and stay up to date on changes.