Government Programs

Health Care Programs and Services


Apple Health for Kids

What it is:

Medical coverage for children living in Washington State. Each program has its own eligibility guidelines.

Who is eligible:

Children under age 19.

Income and resource Requirements:

There are no resource limitations for the for the Apple Health for Kids program.

Family Size Children’s Medical
(200% of FPL)
SCHIP Medical
(250% of FPL)
$20 premium
SCHIP Medical
(300% of FPL)
$30 premium
1 $1,805 $2,257 $2,708
2 $2,429 $3,036 $3,643
3 $3,052 $3,815 $4,578
4 $3,675 $4,594 $5,513
5 $4,299 $5,373 $6,448
6 $4,922 $6,153 $7,383
7 $5,545 $6,932 $8,318
8 $6,169 $7,711 $9,253
9 $6,792 $8,490 $10,188
10 $7,415 $9,269 $11,123
Remember- Each unborn child counts as one family member

Program Highlights

Apple Health for Kids

When determining income we deduct:

  • Actual work-related child care costs
  • Child support paid by your family
  • An earned income deduction

Premium-based Coverage

To be eligible for premium-based coverage, a child:

  1. Cannot be covered by Medicaid
  2. Cannot be covered by other insurance; and
  3. Must pay monthly premiums to the department

Additional information about the State Children’s Health Insurance Programs is available at the Health and Recovery Services Administration SCHIP website.

Applying for Apple Health for Kids:

You can apply at your local community services office or online using our Online Application for Services.

In addition, you can apply by mail for all children’s medical programs. Applications for children’s medical are available at your local Community Services Office, or you can call the number below to have an application sent to you:

  • Phone: 1-800-204-6429
  • TTY: 1-800-204-6430

Basic Health

Health Care coverage at a reduced rate for individuals and families who are Washington residents, and income qualify.  View our page on this here.

Healthcare for Workers with Disabilities (HWD) Program

What it is:

Healthcare for Workers with Disabilities (HWD) allows people with disabilities who are working to purchase medical coverage by paying a monthly premium that is based on their income.

Who is eligible:

  • Are age 16 through 64
  • Meet federal disability requirements
  • Are employed (including self-employment) full or part time
  • Has monthly income that does not exceed 220% of the federal poverty level or the “net” amounts show below
HWD Monthly Net Income Limits
Single person Married Person
$1,986.00 $2,672.00

The resource test is waived for HWD.

HWD benefits include:

  • Medicaid benefit package, including Medicaid personal care services
  • Greater personal and financial independence
  • Members can earn and save more without the risk of losing their healthcare coverage

What does it cost?

Your monthly premium is based on a sliding scale. It cannot be more than 7.5% of your total monthly income – but it can be less!

How to apply:

If you are applying for the HWD program only, please mail your application to:

DSHS-HWD
PO Box 34350
Seattle, WA 98124-9511

For more information call 1-800-337-1835 or locally 206-272-2169.

If you are applying for other programs in addition to HWD, such as Food Assistance or Cash, please apply at your local office or apply online.


If you have been afraid to pursue your career goals because doing so might disqualify you from needed healthcare, this program may perfect for you.

Family Medical

What it is:

A medical program for families.

Who is Eligible:

Families with dependent children under the age of 19, whose income and resources are below Temporary Assistance to Needy Families (TANF) limits.

Income and Resource Limits

In determining net income, a family can deduct 50% of their earnings, their actual child care costs and child support paid out by the family.

FAMILY MEDICAL INCOME LIMITS
Number of Persons Monthly Income Limit
1 $359
2 $453
3 $562
4 $661
5 $762
6 $866

For family medical, a family may have $1,000 in resources at the time of application. Certain resources, such as the home you live in and $5,000 equity in a vehicle, are not counted.

Additional information about the Family Medical Program is available at Health and Recovery Services Administration web site.

How to Apply:

You can apply for the Family Medical Program at your local Community Services Office or apply online using our Online Application for Services.

As with all our programs, the only way to know for sure if you’re eligible is to apply.

Medicare Savings Programs

What it is:

Medicare Savings Programs help Medicare recipients pay for all or part of their Medicare premiums.

Who is eligible:

Medicare recipients who meet income and resource requirements.

Programs available:

  • Qualified Medicare Beneficiary Program (QMB)
  • Specified Low-Income Medicare Beneficiary Program (SLMB)
  • Qualified Individual(QI-1) Program

Resource requirements for cost-sharing programs:

For any of the cost-sharing programs your resources (assets) must be under $6,600 for an individual and $9,910 for a couple.

Examples of resources:

  • Cash
  • Bank accounts
  • Certificates of deposits
  • Savings bonds
  • Stocks
  • Real property (except the home you live in)
  • Recreational vehicles

Income limits are different in each program and listed under the program information.

Qualified Medicare Beneficiary (QMB) Program

QMB pays your Part B Medicare premium, and the cost, if any, of your Part A premium. QMB also pays your Medicare co-payments and deductibles. To be eligible your income must be no more than:

  • $903 per month for one person, or
  • $1,215 per month for a couple

Specified Low-Income Medicare Beneficiary (SLMB)& Qualified Individual(QI-1) Program:

The Part B premium is …

Specified Low-Income Medicare Beneficiary (SLMB):

  • $1,083 per month for one person, or
  • $1,457 per month for a couple

Qualified Individual(QI-1) Program:

  • $1,219 per month for one person, or
  • $1,640 per month for a couple

Additional information on Medicare Savings Programs is available at Health and Recovery Services Administration’s website.

How to apply for cost-sharing programs:

You can apply for QMB, SLMB, or QI-1 at your local Community Services Office or you can apply online using our Online Application for Services.

Alien Emergency Medical Program

What it is:

An emergency medical program for persons who do not meet the citizenship requirements of other DSHS medical programs.

Who is eligible:

Person or persons with an emergency medical condition who are:

  • Children, or
  • Parents or relatives caring for a child, or
  • Age 65 or older, disabled or blind.

For this program, “emergency medical condition” means the sudden onset of a medical condition so severe that without immediate medical attention, it would be expected that there would be:

  • Serious jeopardy to your health;
  • Serious impairment of your bodily functions; or
  • Serious dysfunction of any bodily organ or part.

If you are not sure if you qualify, check with DSHS. Many conditions may qualify, such as those requiring nursing home care or mental health services for depression.

Income and Resources:

The income and resource requirement will depend on the medical program that you qualify for. Because there are many different programs, your DSHS worker is your best source of information.

Additional information about Alien Emergency Services is available at Health and Recovery Services Administration.

How to Apply:

You can apply for Alien Emergency Medical Services at your local Community Services Office or apply online using our Online Application for Services.

As with all our programs, the only way to know for sure if you’re eligible is to apply.

Pregnancy Medical Program

What it is:

A medical program for pregnant women.

Who is eligible:

You are eligible for the pregnancy medical program if:

  • You are pregnant, and
  • You live in Washington State, and
  • You meet income requirements.

Income and Resource Requirements:

The pregnancy medical program has no resource limits. Your income eligibility is determined by your family’s income and the number of people in your family. Your unborn child counts as a family member .

Number of Persons Monthly Income Limit
1 n/a
2 $2,247.75
3 $2,823.10
4 $3,400.30
5 $3,977.50
6 $4,552.85
Add $577 for each additional household member

Once you are found eligible for pregnancy medical benefits, you will remain eligible throughout your pregnancy regardless of changes of income or who lives in your home. Women who are covered by Pregnancy Medical are also eligible for First Steps services.

Additional information about Pregnancy Medical is available at Health and Recovery Services Administration’s website.

Aged, Blind and Disabled Medical Program

What it is:

Medical coverage for aged, blind or disabled persons.

Who is eligible:

Persons who are age 65 and over, blind or disabled who meet income and resource requirements.

Income and Resource Requirements:

There are three types of medical coverage offered through the Aged, Blind and Disabled Medical Programs. They are:

  1. Categorically Needy Program (CN); and
  2. Medically Needy Program with no spenddown (MN); and
  3. Medically Needy with spenddown (MN with spenddown).

If you have income below the level of Supplemental Security Income (SSI) standard for your area, you may be eligible for CN medical coverage.

If your income falls between the SSI benefit level and the MN income limit level, you may be eligible for MN medical coverage.

If you’re over the MN income limit level, you may be eligible for MN with spenddown.

The programs resource limits are $2,000 for an individual and $3,000 for couples.

Before we compare your income to these standards below we may allow income deductions.

Additional information about aged, blind and disabled programs is available at Health and Recovery Services Administration website.

How to Apply:

You can apply for aged, blind and disabled medical programs at your local Community Services Office or apply online using our Online Application for Services.