Apple Health Expansion

What is 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.

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.

Am I eligible?

You may be eligible for Apple Health coverage if you:

• Are a Washington resident age 19 or older,
• Have countable income up to 138 percent of the federal poverty level,
• Do not qualify for other Apple Health programs based on immigration status,
  • Immigrants who have not met the five-year waiting period to become eligible for Apple Health are not eligible for Apple Health Expansion.
• Are not pregnant or did not have a pregnancy end in the last 12 months, and
• Are not eligible for qualified health plans (QHP) with advance premium tax credits (APTC) or federally funded medical assistance programs

What is the most I can make per month to qualify?

*The income standards listed in these examples are subject to change annually every April.

Members of a multi-person household, including pregnant people and children up to age 19, may be eligible for other Apple Health programs. View eligibility and income charts for other Apple Health programs.

Client resources

View client scenarios to see examples of different Apple Health Expansion application pathways. These scenarios are intended to help individuals determine if they might be eligible for Apple Health Expansion or any other Apple Health program and how they would apply depending on their age.

Applying for coverage

The enrollment limit for Apple Health Expansion has been met. If you applied on or after June 20, 2024, and were denied because the cap was met, there is still a possibility you will be randomly selected to enroll if space opens in the program. There are no additional steps you need to take at this time. You will receive an eligibility notice through your preferred communication method (email or mail) if you are selected for enrollment.

Only submit one application and keep your income and contact information up to date. Submitting more than one application will not increase your chances of enrollment into Apple Health Expansion.

What happens if I apply for coverage now that the enrollment limit is 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. Sign up for email notifications and stay up to date. You will receive an eligibility notice if you are selected for enrollment through your preferred communication method (email or mail).

Options to apply for or renew coverage

If you are age 19 to 64 years old:

• Online: Go to Washington Healthplanfinder. Select the "Apply Now" button.
• Mobile app: Download the WAPlanfinder app​. Select “sign in” or “create an account”.
• Phone: Call the Washington Healthplanfinder Customer Support Center at 1-855-923-4633.
• Paper: Submit an Application for health care coverage (18-001P).
• In-person: Local resources who, at no additional cost, can help you apply for health coverage.
  • Local enrollment assistance

If you are age 65 or older:

• Online: Go to Washington Connection. Select "Apply Now."
• Paper: Submit an Application for aged, blind, disabled/long-term care coverage (HCA 18-005).
• Phone: Request an application by calling 1-877-501-2233.
• In-person: Visit your local Department of Social and Health Services (DSHS) office.

Have your documents ready to help you complete your application

• Proof of identity in the form of a driver’s license, passport, or other official documentation.
• Immigration documentation that shows your status (visa, passport, etc.). No immigration documentation is needed if you are undocumented.
• The income you make before taxes. If you work, this could be wage stubs, pay receipts, or other ways that show how much money you make.

Get help in person

• Schedule an appointment with a navigator to get help near you.
  • Navigators can help walk you through the application process, upload documents, and answer questions along the way.

If you’re accepted, you'll receive a ProviderOne services card in about two weeks. Coverage will begin on the first day of the month in which the application was submitted. You'll have the option to select a managed care plan online or you'll be auto-enrolled into a plan.

Apple Health Expansion clients are enrolled in managed care, which includes preventive, primary, specialty, and other health services. This means you must see providers who are in your plan's provider network, unless prior authorized or to treat urgent or emergent care.

What services are covered?

Apple Health Expansion will cover the following services:

• Physical and behavioral health services
• Dental services
• Vision hardware (for clients under 21 years of age)
• Transportation to Apple Health covered appointments
• Pharmacy (Over the counter and prescription drugs on the Apple Health preferred drug list)
• Interpreter Services
  • Contact your health plan for help accessing interpreter services.

View a full list of services covered by Apple Health.

What Apple Health Expansion managed care plans are available?

You can choose any one of the four available plans that serve your area when you enroll in Apple Health Expansion. Not all plans are available in all areas.

View the health plans available in your area:

• Apple Health Expansion (managed care) service area map

How do I contact my health plan?

Contact your plan to:

• Find a new doctor or see if the doctor you want to see is in your Apple Health plan.
• File a complaint because you're not happy with the service you were provided by your doctor or the health plan.
• Replace your Apple Health plan benefits card.
• Find out more information about your Apple Health Expansion plan.

What other health care coverage is available for immigrants?

Other Apple Health coverage

If you need to go to the doctor now, you can check to see if you qualify for:

• Apple Health for Kids
• Apple Health for pregnant individuals
• Alien Emergency Medical (AEM)
• Medical Care Services (MCS)
• Family Planning Only

Qualified Health Plans (QHP) and Cascade Care Savings options for immigrants

All Washingtonians, regardless of immigration status, may shop for and purchase qualified health and dental plans. Learn more about immigrant health care and other cost saving options.

People with income over 250% of the Federal Poverty Level (FPL) may apply for a QHP and qualified dental plans during a special enrollment period outside of open enrollment. Life events can include job loss, birth, adoption, marriage and more. To apply during special enrollment, visit Washington Healthplanfinder or call Washington Healthplanfinder Customer Support Center at 1-855-923-4633.

Privacy

The Health Care Authority (HCA) Apple Health Expansion will use existing Apple Health program data privacy and protection standards to ensure clients’ identity and information remain confidential. View HCA's notice of privacy practices for more information.

HCA does not share client information with any immigration agency, including Immigration and Customs Enforcement (ICE) or other federal agencies. Eligibility for Apple Health Expansion is exempt from the public charge test. View the announcement to learn more (Español). If you have questions or concerns about how an application for Apple Health Expansion may impact your immigration status or chances of becoming a permanent resident or citizen, contact an immigration attorney.

Getting help in your language

Language assistance services are available to Apple Health clients free of charge and include direct services by bilingual employees, interpreter services, and translation of printed materials. To learn more, download our flyer on how to access language assistance. Also available in the following languages: