Washington Medicaid Income Limits 2026: Apple Health

There are two different Washington Medicaid income limits, and which one applies depends on who is applying. An adult under 65 who is not enrolled in Medicare is tested on Modified Adjusted Gross Income (MAGI) at 138% of the federal poverty level, roughly $1,835/month for one person, with no asset test at all.1,2,3,4

Someone 65 or older applying for long-term care is tested against a different number: a $2,982/month special income level paired with a $2,000 asset limit. Washington Apple Health asks for no Miller Trust on that track, so if you're over, you spend down instead, and it runs one of the country's most generous home-equity rules, letting a homeowner keep up to $1,130,000 in equity and still qualify.5

This guide walks through the 2026 income and asset rules for Washington's Medicaid program, which the state calls Apple Health. It covers the MAGI limits by group and what turning 65 does to them, then the long-term-care special income level and how the medically-needy spend-down works, the asset limit, what a nursing-home resident keeps, the home-equity allowance, and what a spouse who stays home is protected from.

Which Washington Medicaid income limit applies to you: MAGI or long-term care?

Washington Apple Health runs two separate income tests, and most of the confusion around "the Washington Medicaid income limit" comes from people being quoted the wrong one.

• The MAGI test applies to adults under 65 who are not enrolled in Medicare, to children, to pregnant individuals, and to parents and caretaker relatives. It measures Modified Adjusted Gross Income against a percentage of the federal poverty level, and it applies no asset test.4,2
• The SSI-related aged, blind, and disabled (ABD) test applies to people 65 or older, or blind or disabled, and it is the one behind every long-term-care number on this page: the $2,982/month special income level, the $994 medically-needy level, and the $2,000 asset limit.5,6

If you are helping a parent apply for nursing-home or in-home care, the long-term-care sections below are your answer. If you are 64 and looking at your own coverage, or you are working out what a grandchild in the household qualifies for, the MAGI numbers here are.

Washington's 2026 MAGI income limits by group

The Washington State Health Care Authority (HCA) publishes these standards, effective April 1, 2026, in its Apple Health Income and Resource Standards chart:1

Two notes on reading those figures. First, HCA posts each MAGI threshold gross of the 5-percentage-point income disregard federal law applies to MAGI groups, and says so on the chart: the 138% New Adult figure is the statute's 133% base plus the disregard, and the 215% children and pregnancy figure is a 210% base plus the disregard.1,2 The medicaid.gov national table lists Washington's base levels instead (210% for children, 312% for the CHIP top tier, 133% for expansion adults), which is why the same state can appear with two different numbers depending on which chart you are reading. Neither is wrong; the posted HCA figure is the one to compare your income against.1

Second, the Family standard is the exception: it takes no disregard and is denominated in dollars rather than percent of FPL.1

Household size on the MAGI side follows federal income-tax filing relationships rather than who lives under the roof, so which people and whose income get counted can differ from what a family expects.7

No asset test on the MAGI side

Federal law bars a state from applying any assets or resources test to the MAGI groups.4 A 60-year-old Washington adult at 138% FPL qualifies with $50,000 in the bank; the savings are simply not part of the test. That is the sharpest contrast on this page: the long-term-care track described below caps countable assets at $2,000, and the statute expressly excepts the ABD and long-term-care pathways from the no-asset-test rule.4,5

Grandparents raising grandchildren: the parent and caretaker-relative group

Parents and other caretaker relatives are a federally mandatory Medicaid group, but the pathway a state must cover them on is pegged to its old cash-welfare standard: the state's AFDC income standard in effect before the 1996 welfare-reform law, converted to a MAGI equivalent. That federal floor is typically far below the poverty level.8 Washington's Family standard (N01) is $511/month for a one-person assistance unit, and the medicaid.gov national table expresses it as 33% FPL, dollar-based.1 Against a 2026 federal poverty guideline of about $1,330/month for one person, that standard sits well under half the poverty line.3

Where that floor bites hardest is the ten states that have not adopted the ACA expansion, because there the frozen AFDC standard is the only mandatory adult pathway there is.9,8 Washington is not one of them. Because Washington adopted the expansion, a caretaker under 65 who is not enrolled in Medicare is generally reached by the New Adult group at 138% FPL instead, a far higher ceiling than $511.9,2

For an older Washingtonian raising a grandchild, this is the group to ask about, but not one to assume into. Whether a particular grandparent meets the definition of a caretaker relative, and which group HCA will assess them under, is a determination the agency makes on the household's facts. Call HCA at 1-877-501-2233 and ask which group your household is being tested under before you rely on any number here.5

Turning 65 can end coverage when nothing else changed

This is the transition almost no income-limit page names, and it is the one that matters most to the families this guide is written for.

The New Adult group is written for individuals under 65 who are not pregnant and not entitled to or enrolled in Medicare, at an effective ceiling of 138% FPL, with no asset test.2,4 For one person in 2026, that ceiling works out to roughly $1,835/month: 138% of the $15,960/year federal poverty guideline for one person in the 48 contiguous states and DC (Alaska and Hawaii run on separate, higher guidelines).3,2

On the 65th birthday that pathway closes, and the same person is generally assessed on the SSI-related ABD track instead. Two things change at once:2

1. The income yardstick. It stops being 138% FPL and becomes the SSI Federal Benefit Rate, $994/month for an individual in 2026.6
2. An asset test appears. The MAGI groups are barred from applying one; the ABD track is expressly excepted from that bar, and its resource test defaults to the SSI standard of $2,000 for an individual.4,6

So a 64-year-old covered at $1,600/month with $10,000 in savings can be over both tests at 65 without a dollar of income or savings changing. The same door closes early for a person under 65 who reaches Medicare through disability, because the New Adult group excludes anyone entitled to or enrolled in Medicare regardless of age.2

What softens the landing in Washington is the spend-down described next: the state does not shut an over-income ABD applicant out, it sets them a monthly liability instead.5

Children and CHIP, briefly

Washington covers children under 19 through Apple Health for Kids (N11/N31) at 215% FPL as posted, and it uses that single standard across ages 0-1, 1-5, and 6-18 rather than splitting the bands at different levels.1 Federal law makes children's coverage mandatory only to 133% FPL, so Washington's standard is a state election well above the federal floor.10 Above the Medicaid level, Apple Health for Kids with premium (N13/N33) is Washington's separate CHIP program, running two tiers: up to 265% FPL for a $20 monthly premium, and up to 317% FPL for a $30 monthly premium.1

How the Washington Medicaid income limits actually work: spend-down

For long-term-care Apple Health, Washington applies a special income level of $2,982/month, equal to 300% of the 2026 Supplemental Security Income (SSI) Federal Benefit Rate of $994.5,6

Being over that number does not disqualify you. Washington is a medically needy state, so it runs a spend-down at a Medically Needy Income Level of $994/month: if your income is above the line, the excess becomes the amount you must incur in medical and care costs, and once you've incurred that much in a given period, Apple Health covers the rest.5

This is why Washington does not require a Qualified Income Trust, also called a Miller Trust. In strict income-cap states, an applicant even a dollar over the limit is shut out unless they route the excess through a special trust each month. Washington has no such cliff: a higher-income Seattle retiree and a lower-income Spokane widow follow the same spend-down path to Apple Health, just with different monthly liabilities.

The asset limit and what counts

Under WAC 182-513-1350, a single long-term-care applicant is limited to $2,000 in countable assets and a legally married couple to $3,000.5 What makes those figures workable is how much Washington leaves out of the count: your home (subject to the unusually high equity cap below), one vehicle, household goods and personal effects, and prepaid burial arrangements are all exempt. The $2,000 limit applies to liquid holdings like bank accounts, a second car, and investments, not the primary residence.

The five-year look-back

Washington reviews asset transfers made in the 60 months (five years) before a long-term-care application.5,11 Giving away money or property for less than fair market value during that window, signing a house over to a child for a dollar or gifting a grandchild a down payment, can trigger a penalty period during which Apple Health won't pay for long-term-care services, even though you're otherwise eligible.

These transfer rules come from federal Medicaid law, which Washington applies. There are legitimate exceptions (transfers between spouses, transfers to a disabled child, certain caregiver-child home transfers) and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review first. For the broader toolkit, see our guide to Medicaid planning strategies.

Washington's $1,130,000 home-equity limit

Every state caps how much equity you can hold in your home and still keep it exempt for long-term-care eligibility. Federal law gives states a choice between a lower and a higher figure, and most states sit at the lower end. Washington elects the higher federal home-equity limit, $1,130,000 for 2026, tied by WAC 182-513-1350 to the maximum the Centers for Medicare & Medicaid Services (CMS) posts each year.5

In practice, that means a Washington homeowner with substantial equity, the kind of equity that builds up over decades in markets like Seattle or the Puget Sound region, can still qualify for long-term-care Apple Health while keeping the home exempt, where the same equity would push an applicant over the cap in a state that chose the lower limit. The home remains a countable asset only for equity above $1,130,000.5

One thing the equity limit does not change: estate recovery still applies after death (see below). The home being exempt during your lifetime is not the same as the home being shielded from recovery afterward.

Long-term care: what a nursing-home resident keeps

When Apple Health pays for nursing-facility care, the resident contributes almost all of their monthly income toward the cost of care. What they keep is the Personal Needs Allowance (PNA), money reserved for the resident's own small expenses like clothing and personal items. Washington's PNA is about $108.74/month, well above the federal floor of $30 and higher than many states set.5,12

The same $2,000 asset limit applies to nursing-home applicants.5 And because Washington uses spend-down rather than a hard income cap, even a resident with substantial monthly income can qualify; they simply contribute more of it toward care. For the national picture on how the allowance works, see our explainer on the Medicaid personal needs allowance.

Protecting the spouse who stays home

When one spouse needs long-term care and the other remains in the community, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. Washington applies the federal framework for 2026:5

So a married couple is in a very different position from a single applicant. The community spouse can keep half the couple's countable assets, up to $162,660, and hold income within the MMMNA range while the other spouse receives Apple Health-funded care.5

After death: estate recovery

Like every state, Washington runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, the state may seek repayment from the estate, unless the recipient is survived by a spouse or a minor, blind, or disabled child. Federal exceptions and an undue-hardship waiver apply.5,13 For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in Washington

Washington Apple Health is administered by the Washington State Health Care Authority (HCA), and long-term-care financial eligibility is processed by the Department of Social and Health Services (DSHS) Home and Community Services.5 You have three ways to apply:

Long-term-care applicants also go through a functional assessment to confirm they need nursing-facility-level care. Apply even if you think you're over the limit. Between spend-down, the high home-equity allowance, and the spousal protections, many people who assume they're disqualified are not.

Learn More

Find personalized help working through Washington Apple Health eligibility for your family at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.