Miss a renewal notice and you can lose your Washington Apple Health (Medicaid) coverage even if you still qualify. Federal law requires the state to try an automatic renewal from data it already holds before it asks you for anything, but when a packet does reach you, it has to come back on time. This guide explains how the Washington Medicaid recertification and renewal cycle works, which of the state's two renewal portals is yours, and the 90-day window to recover coverage if you miss the deadline.

Renew MAGI coverage at Washington Healthplanfinder: 1-855-923-4633 · Classic and long-term-care renewals through DSHS: 1-877-501-2233

In This Guide

Recertification is the most consequential moment in your relationship with Medicaid. Eligibility is set at initial application, but under federal Medicaid rules it is redetermined every 12 months thereafter, and a missed renewal can end coverage even for someone who still qualifies. A procedural closure usually hits someone who remained eligible and simply did not return the packet in time, which is what the 90-day reconsideration window below is built to fix.

Washington's version of Medicaid is Apple Health, administered by the Washington State Health Care Authority (HCA), with long-term-care eligibility processed by the Department of Social and Health Services (DSHS) Home and Community Services. Washington differs from most states in renewing different populations through two separate systems.

How the Washington Medicaid renewal cycle works

Federal rules set the standard Medicaid renewal cycle at once every 12 months for most enrollees. Your renewal month is fixed when you are first approved: approved in October, you renew every October.

Washington splits renewals into two procedural tracks, and which track you are on determines both the rules and the portal:

The MAGI income thresholds that govern who stays eligible are set by HCA as percentages of the Federal Poverty Level. Effective April 1, 2026, Washington covers children and pregnant enrollees up to 215% FPL (with the 5% income disregard included), the expansion New Adult group up to 138% FPL, and parents and caretaker relatives under a dollar-denominated standard of $511 per month for a single-person household. If your income at renewal is still within your group's threshold, you remain eligible.

Ex parte Washington Medicaid renewal: the federal mandate

The most important rule in modern Medicaid renewal is the ex parte default at 42 CFR 435.916(b)(1): before the agency asks you for anything, it must first try to renew you from reliable data already in your account or otherwise available to it, including electronic data sources. Only when it cannot do so may it request information from you.

In Washington, ex parte renewal pulls from Social Security Administration earnings, retirement, disability (SSDI) and SSI records; federal tax and commercial wage data; Washington Employment Security Department wage records and SNAP, TANF and unemployment-insurance data; and Medicare entitlement data from CMS. If those data confirm you are still within your income threshold and nothing categorical has changed, the renewal processes automatically and you get a notice that coverage continues for another 12 months and no action is required.

MAGI renewals clear ex parte far more often than classic ones, for a structural reason: MAGI groups have no asset test, so wage data alone can usually confirm eligibility. Classic aged, blind, and disabled and long-term-care renewals cannot, because federal law requires the state to verify resources at renewal through an Asset Verification System (Section 1940 of the Social Security Act, 42 U.S.C. 1396w), and income data cannot confirm a bank balance. Those cases usually require bank statements, retirement-account statements, life-insurance documentation, and a signed AVS authorization.

When ex parte fails, the state must send a renewal form with the information it already has, and must give you at least 30 days from the date of the form (42 CFR 435.916(a)(3)) to respond, add missing information, and sign; the form cannot require an in-person interview. That duty, and the 90-day reconsideration window below, cover eligibility based on modified adjusted gross income (MAGI). If you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, Washington may offer the same windows but is not required to, so ask DSHS. Washington sends packets ahead of the renewal month so the response clock closes before coverage would lapse.

How to renew Washington Medicaid: which portal is yours

No one website handles every Washington renewal; the system you use depends on your track.

Population Where to renew Contact
MAGI (kids, pregnancy, parents, expansion adults) Washington Healthplanfinder online wahealthplanfinder.org · 1-855-923-4633
Classic (aged, blind, disabled) Washington Connection online, or DSHS washingtonconnection.org · DSHS 1-877-501-2233
Long-term care and HCBS waivers DSHS Home and Community Services office 1-877-501-2233
General Apple Health questions Health Care Authority 1-800-562-3022

Not sure which track you are in? If your Medicaid is based on age 65+, blindness, disability, or a need for long-term care, you are classic: renew through DSHS and Washington Connection. If it is based on income alone, you are MAGI: renew through Washington Healthplanfinder. A renewal sent to the wrong system does not reroute, so use the right portal from the start.

The 90-day reconsideration window

If your coverage closed because you missed the renewal paperwork, you usually do not have to start over, and many families never learn that before they reapply from scratch.

Under 42 CFR 435.916(a)(3)(iii), if you lose coverage for failure to return the renewal form (a procedural termination, not an eligibility-based one), the agency must reconsider your eligibility on the basis of the late-returned form if you submit it within 90 days of the termination, without requiring a new application (required for MAGI-based coverage; a state option otherwise). If the reconsideration finds you still eligible, your coverage is restored; whether that restoration reaches back to the termination date is state-dependent, and the rule does not itself promise it.

The 90-day clock starts on the termination date, not the notice date, so read your closure notice carefully.

To activate reconsideration, resubmit the renewal through your track's portal, MAGI through Washington Healthplanfinder or classic through Washington Connection or DSHS at 1-877-501-2233, and note the closure date so the case routes correctly.

Children, pregnancy, and postpartum renewals

Children and new parents carry protections that override the ordinary renewal math.

Section 5112 of the Consolidated Appropriations Act, 2023 requires every state to give children under age 19 enrolled in Medicaid or CHIP (Apple Health for Kids in Washington) 12 months of continuous eligibility from the date of enrollment, effective January 1, 2024. Once a child is enrolled, coverage is locked in for 12 months regardless of changes in family income. If a parent loses Medicaid mid-year because household income rose, the children stay covered until their next annual renewal. Mid-year coverage ends only in narrow circumstances, chiefly turning 19 or moving out of state.

Report an income increase anyway: it protects you from later fraud allegations, and your children keep coverage regardless.

For pregnancy, Washington covers pregnant enrollees up to 215% FPL and continues "after-pregnancy" coverage once the pregnancy ends. Federal law makes the 12-month postpartum extension a permanent state option rather than a nationwide requirement (Section 1902(e)(16) of the Social Security Act); where a state has taken that option, the postpartum period runs to its end without a mid-period income redetermination. Your after-pregnancy approval notice states the end date of your own coverage, so go by the date printed on it.

Long-term care and waiver renewals

Apple Health long-term care, in a nursing facility or through a home and community-based waiver, renews in two independent components, both of which must stay current.

Financial redetermination

DSHS conducts the financial review on the annual 12-month cycle, including the asset test federal law requires it to run through the Asset Verification System. Washington's institutional and waiver financial rules for 2026:

  • Asset limit: $2,000 in countable resources for a single applicant ($3,000 for a legally married couple). The home is excluded subject to the equity limit below, and one vehicle is excluded regardless of its value when it is used to provide transportation for you or a member of your household. Burial funds in a revocable contract or account are excluded up to $1,500 each for you and a spouse, and an irrevocable burial arrangement set aside solely for burial and related expenses is not counted as a resource at all.
  • Income (Special Income Level): $2,982 per month, equal to 300% of the SSI federal benefit rate. Someone living in a medical institution whose gross nonexcluded income is above that limit can still qualify for institutional services through the medically needy spend-down, by incurring medical and care expenses against the excess; the Medically Needy Income Level is $994 per month for one person. That medically needy route is written for institutional care. COPES and other waiver applicants have to qualify under the institutional categorically needy group at the $2,982 Special Income Level instead.
  • Personal Needs Allowance: a resident of a medical institution keeps $108.74 per month, with a $160 monthly maximum in a state veterans home.
  • Home equity limit: exempt primary-residence equity is capped at $1,130,000 for 2026.
  • Spousal impoverishment: for institutionalizations beginning on or after August 1, 2003, Washington allocates to the community spouse the greater of half the couple's combined countable resources (up to the federal spousal resource maximum of $162,660) or Washington's own state spousal resource standard of $72,529. The state floor is the one that matters for most couples: below roughly $145,058 in combined countable resources, the community spouse is protected by the $72,529 standard rather than by the one-half share, so do not assume you are limited to half. On the income side, the community spouse maintenance needs allowance maximum is $4,066.50 per month and the federal minimum is $2,705.00 (effective July 1, 2026), though HCA's April 1, 2026 standards chart still lists the community spouse and dependent allowance at $2,644.

Level-of-care reassessment

Separately, the state re-runs its Comprehensive Assessment Reporting Evaluation (CARE) assessment to confirm you still meet nursing-facility level of care. In Washington, in-home personal care for waiver clients is delivered through Community First Choice (CFC), the Medicaid state plan benefit, while the Community Options Program Entry System (COPES) waiver, which serves over 51,000 clients, adds wraparound services such as adult day health, home-delivered meals, and environmental modifications.

The two reviews are independent: you can pass one and fail the other. If level of care is no longer approved, waiver or institutional coverage ends, but standard classic Apple Health can continue if you are otherwise eligible.

Medicare Savings Program renewals

Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualified Individual (QI) eligibility is redetermined on the same 12-month cycle as other classic Medicaid, with the state attempting ex parte first. Washington's Medicare Savings Programs renew unusually smoothly, because Washington applies no asset test to its MSPs and uses broader income tiers than the federal baseline: QMB up to 110% FPL, SLMB up to 120% FPL, and QI-1 up to 138% FPL. The monthly income standards effective April 1, 2026 are $1,463 for one person and $1,984 for a couple at the QMB level, and for QMB, SLMB, and QI-1 HCA compares those figures against your gross monthly household income after a $20 deduction (one deduction per household), so a household a little over the chart amount can still qualify. With no resource test to verify, Social Security income data alone usually confirms MSP eligibility at renewal. Losing an MSP can also affect the Medicare Part D Low-Income Subsidy (Extra Help), which SSA administers separately, so confirm your Extra Help status with SSA if your MSP ends.

When your mail is returned

The federal rule that required the agency to search for a new address before acting on returned mail, 42 CFR 435.919, was removed effective July 31, 2026. Federal law now says only that the agency may act without advance notice when your whereabouts are unknown (42 CFR 431.213(d)), and that coverage must be reinstated if your whereabouts become known while you are still eligible (42 CFR 431.231(d)). Washington may still apply procedures of its own, so call HCA if your packet has come back.

Washington's Apple Health managed-care plans are Wellpoint (formerly Amerigroup), Community Health Plan of Washington, Coordinated Care, Molina Healthcare, and United Healthcare. Update your address the moment you move: through Washington Healthplanfinder for MAGI, Washington Connection or DSHS at 1-877-501-2233 for classic, with your plan, and with USPS.

Procedural vs eligibility-based termination

This distinction decides whether you have a 90-day reconsideration window (required for MAGI-based coverage; a state option otherwise) or must file a new application.

Termination type Definition Reconsideration available?
Procedural Failure to return the renewal form, missing signature, no documentation, or no response to a request for information Yes; 90 days from the termination date
Eligibility-based The state determined you no longer meet income, residency, citizenship, age, disability, or other categorical rules No; must file a new application

Read the stated reason on your termination notice. Missed paperwork or no response means you have the 90-day window; an income calculation, an asset limit, or a categorical change means your remedy is a new application, an appeal, or both.

Appeals and fair hearings

If your renewal is denied or your coverage terminated, you have a federal right to a fair hearing under Section 1902(a)(3) of the Social Security Act and 42 CFR 431.220. Federal law sets 90 days from the date the notice of action is mailed as the most a state may allow for requesting a hearing, not a minimum you are guaranteed: a state may set a shorter window, and a shorter state deadline is fully enforceable. Washington allows the full 90 days, counted from the date at the top of the notice HCA mailed you, so that is the deadline that binds you; go by the date printed on your own notice, and if you do not request within it you can lose your right to a hearing.

In Washington, hearings are held by the Office of Administrative Hearings (OAH), a separate state agency: an administrative law judge issues an initial order and the HCA Board of Appeals issues the final order. A request can be oral or written and needs no particular form. Use the OAH online form, call OAH at 1-800-583-8271, or request through DSHS (classic) or Washington Healthplanfinder or HCA (MAGI).

Keeping coverage during the appeal (aid paid pending). Federal law continues your Medicaid during an appeal only if you request the hearing before the action takes effect. In Washington, the operational deadline is within 10 days of receiving the notice, or by the end of the month, whichever is later. Two cautions: if you get continued coverage and lose the hearing, you may owe back up to 60 days of that continued coverage (federal rules reach only the services furnished because coverage continued, not everything Medicaid ever paid for you), and continued coverage is not available to challenge the denial of a new application, or where the action was solely due to a change in statute, federal regulation, or rule.

Managed-care appeals come first. If your dispute is with a decision from your Apple Health managed-care plan, you must exhaust that plan's internal grievance and appeal process before you can request an administrative hearing.

Two special situations sit alongside these rules. If the state cannot promptly confirm a declared citizenship or immigration status at renewal, federal law grants a reasonable opportunity period (generally ending at the earlier of verification or 90 days) during which it may not delay, deny, reduce, or terminate benefits for someone it otherwise finds eligible. And dual eligibles renew Medicaid annually while Medicare continues uninterrupted; if Medicaid lapses, Medicare stays but the QMB cost-sharing protections end with it.

What changes after 2026: 6-month renewals

The pandemic-era continuous-enrollment requirement ended in 2023. What matters now is a new federal change, and it reaches Washington more directly than it reaches non-expansion states.

Section 71107 of the 2025 federal budget-reconciliation law (H.R.1, Public Law 119-21) requires states to redetermine eligibility once every 6 months, rather than every 12 months, for the ACA expansion adult population, for renewals scheduled on or after January 1, 2027. Its only exemption covers an Indian or Urban Indian as defined in the Indian Health Care Improvement Act, a California Indian, and anyone otherwise determined eligible as an Indian for the Indian Health Service. Because Washington adopted ACA expansion, its New Adult group (ages 19-64, up to 138% FPL) falls squarely within this change, so a large share of working-age Apple Health enrollees will renew twice a year from 2027.

The same law also shortens retroactive eligibility for applications filed on or after January 1, 2027, to two months before the application month for most enrollees and one month for the expansion group, down from the long-standing three-month default.

Frequently Asked Questions

How often do I have to renew Washington Apple Health?

Once every 12 months for most enrollees. Your renewal month is the same each year, tied to your initial approval date. One change is coming: Washington's ACA expansion adults move to a 6-month cycle for renewals scheduled on or after January 1, 2027.

Where do I renew my Washington Medicaid?

It depends on your track. If your coverage is income-based, you renew through Washington Healthplanfinder at 1-855-923-4633. If it is based on age 65+, blindness, disability, or long-term care, you renew through DSHS at 1-877-501-2233 or Washington Connection.

What happens if I miss my renewal deadline?

Your coverage closes at the end of your renewal month. If the closure was procedural (you did not return the renewal form), you have a 90-day reconsideration window under 42 CFR 435.916(a)(3)(iii) to submit that form and have your eligibility reconsidered without a new application (required for MAGI-based coverage; a state option otherwise); if you are found still eligible, your coverage is restored. Once the reconsideration window has passed, you must file a new application.

My income went up mid-year. Does my child lose Medicaid?

No. Under federal continuous-eligibility rules effective January 1, 2024, children under 19 have 12 months of continuous eligibility from enrollment. Even if your income rises above the threshold, your child keeps Apple Health until the next annual renewal. Exceptions are narrow, chiefly turning 19 or moving out of state.

I am on classic (aged/disabled) Apple Health. Why does my renewal need bank statements?

Classic and long-term-care Medicaid have an asset limit, and federal law (Section 1940 of the Social Security Act) requires the state to verify your assets at renewal through an Asset Verification System, which automated income data cannot do on its own. DSHS reviews recent bank statements, retirement accounts, and life-insurance documentation to confirm you remain under the $2,000 single-person asset limit, and the AVS requires your signed authorization.

Washington Medicaid renewal: contacts and resources

To renew, recover coverage lost in the past 90 days, or appeal a termination, these are the offices that can help.

Washington Healthplanfinder Renew MAGI (income-based) Apple Health and update your address. 1-855-923-4633 wahealthplanfinder.org
DSHS Home and Community Services Classic and long-term-care renewals, packet requests, and address updates. 1-877-501-2233 dshs.wa.gov/altsa
Washington Health Care Authority General Apple Health questions and coverage issues. 1-800-562-3022
Washington Connection Renew classic Apple Health online and check case status. washingtonconnection.org
Office of Administrative Hearings Request a fair hearing on a denial or termination. 1-800-583-8271 oah.wa.gov

If you are unsure whether your renewal has been processed, log into your renewal portal and check your case status, or call DSHS at 1-877-501-2233 or HCA at 1-800-562-3022. The Washington Medicaid hub covers the broader eligibility picture, and Washington Medicaid appeals and fair hearings walks through the OAH process step by step.

Learn More

MedicaidHow to apply for Washington MedicaidHow to apply for Washington Medicaid (Apple Health) in 2026: Washington Connection, the medically needy spend-down, documents, timelines, and how to appeal. MedicaidWashington Medicaid eligibility income limitsWashington Medicaid income limits 2026: 138% FPL and no asset test on the MAGI track, plus the $2,982 special income level and spend-down for long-term care. MedicaidWashington Medicaid appeals and fair hearingsHow to appeal a Washington Medicaid (Apple Health) denial or termination, keep your benefits during the appeal, and request an OAH fair hearing. MedicaidWashington Medicaid long-term care and nursing homesHow Washington Medicaid nursing home coverage works in 2026: Apple Health eligibility, the asset limit, the income standard, spend-down, and estate recovery. MedicaidWashington Medicaid HCBS waiversWashington Medicaid HCBS waivers run mainly through COPES, a 1915(c) waiver for adults at nursing-facility level of care. See who qualifies and how to apply. MedicaidWashington Medicare Savings ProgramsWashington Medicare Savings Programs 2026: QMB, SLMB, and QI income limits, no asset test, what Apple Health pays, Part D Extra Help, and how to apply.

Find personalized help renewing Washington Apple Health 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.

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