Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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Washington program

Free health insurance for your child (Apple Health for Kids)

Washington’s Medicaid plan for children under 19. Free, and it can sit behind the insurance you already have.

What it is

Washington’s Medicaid plan for children under 19. Free, and it can sit behind the insurance you already have.

Apple Health for Kids is free for children under 19 whose household income is under the state’s published line for its size, judged on this month’s income. Having insurance through work does not change that. The state decides who counts in your child’s household and which income counts.

Eligibility rules
  • Income: wages before tax and unemployment count. Self-employment counts profit. Child support you receive and SSI do not count.
  • Who is counted: Apple Health counts your child’s own household using tax-filing rules (its “MAGI household”). That is not always everyone at your address. The household-size figure above is only a screen; the application determines the child’s household.
  • Which month: the state judges this month’s income. A yearly figure divided by 12 is only an estimate, especially after a pay cut.
  • Age: under 19, and the income line is the same at every age.
  • Immigration status does not affect a child’s eligibility in Washington. A cancer diagnosis is not required.
  • Free-coverage limit by household size, per month, from HCA’s published table (April 2026 to March 2027): 1: $2,860 · 2: $3,879 · 3: $4,896 · 4: $5,913 · 5: $6,932 · 6: $7,949 · 7: $8,966.
  • The usual published decision standard is 45 calendar days; some applications are decided sooner, and cases needing more information can take longer.
Why families who already have insurance still look at this
  • Any insurance you have gets billed first. For covered, properly authorized care from a clinic enrolled with Apple Health, the clinic generally cannot bill you that plan's deductible, coinsurance or copay, even when Apple Health's own payment is $0.
  • There is no premium, so it costs nothing to hold.
  • It fills gaps: dental, vision and rides to appointments, and it is the door to home nursing help if your child ever needs it.
  • If the work insurance ends, your child is not uninsured, and bills from up to three months before you applied can be covered.
  • Once approved, the state can look at paying you back for the work-plan premium (Premium Payment Program, below).
What it does not do
  • Not every clinic is enrolled with Apple Health or handles second-insurer billing well. Before adding or changing coverage, ask the hospital to check both plans’ billing, authorizations, pharmacy rules and coverage of your child’s providers, and which Apple Health managed-care plans it accepts.
  • It is a second insurer to keep straight: give both cards every time and report income changes.
  • It does not pay for care Apple Health does not cover, and it does not make an unrelated bill disappear.
What you get
  • Hospital stays, chemotherapy, clinic visits, prescriptions and lab tests, with no premium, no deductible and no copays.
  • Dental and vision care for your child.
  • Help with rides to appointments once your child is enrolled.
  • Bills from up to three months before you apply can be covered (through 2026).
Coverage in full
  • Hospital and cancer care, doctor visits, prescriptions, lab tests, dental, vision.
  • Rides to covered appointments are arranged through a regional broker after enrollment. Nursing at home needs a separate assessment of your child’s needs.
  • Billing protection: when a clinic makes a billing or approval mistake, the bill does not automatically become yours. Ask billing to review any unexpected charge before paying. Care Apple Health does not cover has different rules, including a signed agreement in advance.
  • Worked example (illustrative figures): work-plan deductible $3,000 unmet; a covered service with a $1,000 work-plan allowed charge and a $600 Apple Health allowed amount. The work plan pays $0, Apple Health pays $600, the clinic writes off $400, and you owe $0, not $1,000.
If you decide to apply
  2. Have recent pay stubs, everyone’s birth dates and any insurance card ready. If pay has changed, the latest stubs show it.
  3. If you already have insurance, keep it in place while the state decides; Apple Health can sit behind it.
After you apply
  • Ask the financial counselor whether a trained hospital worker can assess your child for temporary Apple Health coverage (hospital presumptive eligibility) while the regular application is completed. It starts on the day of that assessment. Without a full application in time it generally ends on the last day of the following month; when the full application is submitted in time, it continues until the regular decision.
  • Before choosing an Apple Health plan, confirm your child’s hospital and oncology team accept it.
  • Earlier bills: through 2026, up to three months before the application month, for months your child was eligible. From January 2027, two months for children.
  • Renewal: children approved before age 6 keep coverage through the month of their sixth birthday; older children generally have 12 months. Exceptions include moving out of Washington and reaching 19.
Good to know

Your work insurance stays in place while the state decides. It gets billed first, and for covered care the clinic generally cannot bill you the rest, whether Apple Health pays anything or not. Give both cards to every clinic and pharmacy.

Keeping or dropping work insurance
  • Keeping both keeps the doctors and hospitals your work plan covers, at the cost of the premium and two insurers to manage.
  • Apple Health alone can work if it covers your child’s treatment team. Have the financial counselor check the exact plan against your hospital, oncology group, pharmacy and planned treatment first.
  • Ask your employer what removing your child would actually save, and when you could add them back. A family premium may not change if other dependents stay on.

Federal background: Medicaid · Using Apple Health with insurance you already have · Ask Apple Health to review needed care (EPSDT).

Official sources
Ask your social worker

“Could Apple Health for Kids fit our child on what we earn now, and how would it work alongside any insurance we have? Do you recommend we apply, and if so, could you help us?”

Why I’m asking: We want treatment covered with as little out of pocket as possible, and we want to understand what a second insurer means for us.

More background and detailed requirements

How this could help

Apple Health is Washington’s Medicaid health insurance. Covered care includes hospital stays, cancer treatment, doctor visits, prescription medicines and lab tests. It also covers dental and vision care. Help getting to covered appointments is available; nursing at home requires a separate assessment of your child’s medical needs.

With work insurance, that insurer is normally billed first. Apple Health can protect you from covered medical bills even when it sends the provider no additional money. Give providers both cards. If a bill arrives, ask billing to distinguish the insurer’s payment calculation from what the provider may legally collect from you.

Should I drop our insurance through work?

Keep your current insurance while you apply. You can decide about keeping both plans after you know your child’s Apple Health coverage and start date.

Keeping both can preserve access to the doctors and hospitals your work plan covers while Apple Health helps with covered costs. The tradeoff is paying the work-plan premium and managing two insurers. Give the hospital and pharmacy both insurance cards so they can bill correctly.

Apple Health alone can be a reasonable choice if it covers your child’s care. Before removing your child from work coverage, have the hospital’s financial counselor check the exact Apple Health plan against your current cancer team, hospital, pharmacy and planned treatment, including any approvals needed. Covered care has no deductible or copays in the free children’s program, but coverage does not mean every bill from any provider will be paid.

Ask your employer how much removing your child would actually save and when you could add them back. A family premium may stay the same if other dependents remain covered. Also check the Premium Payment Program: after Apple Health approval, HCA can review whether it will reimburse a qualifying private premium.

What to know before you apply

  • The income limit depends on the household Apple Health counts, which is not always everyone at the same address. For example, the current free-coverage limit for three people is $4,896 a month.
  • The application checks current monthly income. A yearly amount divided by 12 is only an estimate, especially after a pay cut or one-time payment.
  • Wages before taxes and unemployment generally count. For self-employment, allowable business expenses are deducted. Child support received and SSI do not count for this income test. Other disability benefits can be treated differently.
  • Children under 19 who live in Washington can qualify regardless of immigration status. A cancer diagnosis is not required for this coverage.
  • Ask about earlier bills: through 2026, eligible months up to three months before the application month may be covered. Starting January 2027, this becomes two months for children.

Your next steps

  1. Ask the hospital’s financial counselor to help you apply through Washington Healthplanfinder, or apply yourself online.
  2. Have current income information, dates of birth, insurance details and earlier medical bills ready. Explain any recent change in pay.
  3. Before choosing an Apple Health plan, confirm that your child’s hospital and oncology team accept it. Ask whether the hospital can provide temporary coverage while the application is reviewed.

Covered bills and provider mistakes

For fee-for-service, when private insurance pays at least the Apple Health rate for a covered service, an additional Apple Health payment can be zero without making the family owe the difference. Managed-care payment arrangements differ, but covered-service billing protections also apply.

A provider’s missing authorization or billing error does not automatically transfer the bill to you. Genuinely noncovered care and specified private-pay choices have different rules, including required advance informed agreements. Check unexpected charges before accepting the primary insurer’s patient-responsibility figure as final.

Household and care transitions

Each applicant has an individual Apple Health household. Relationships, who claims the child on taxes, parents filing separately, guardianship versus adoption and pregnancy can change the calculation. A single household headcount is a preliminary screen only.

Before changing coverage, confirm the exact facility, oncology group, lab, pharmacy, medicines and authorizations. Temporary transition arrangements do not guarantee permanent access to every provider. Planned distant treatment can require specific HCA approval even when work insurance pays first.

The effective no-cost income standard is 215% of the federal poverty level after the five-percentage-point disregard. Published state dollar cells are used where available.

Income and household rules are MAGI rules. Social Security dependent benefits for a child are excluded under WAC 182-509-0360; adult Social Security disability benefits generally count. SSI is different and is excluded.

Approved children under six generally keep free coverage through their sixth-birthday month; older children generally receive 12 months, subject to program exceptions. Services must meet coverage, provider and authorization requirements.

Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Apply on Healthplanfinder with this month's income, name the months that already have bills, and pick a plan the oncology group takes.

Your social worker

The oncology social worker or financial counselor helps you file, asks the hospital to open temporary coverage the same day, and chases the decision.

The care team

Nothing is needed from the doctor for the ordinary children's coverage.

Who decides
The Health Care Authority decides through Washington Healthplanfinder. The Apple Health plan you pick then runs the coverage.
Ask your social worker
“Could my child get free Apple Health as well as our current insurance? Could you help us apply and check that the oncology team accepts both?”

How to apply

First step: Ask the hospital’s financial counselor to help you apply through Washington Healthplanfinder, or apply yourself online.

  1. Apply on Washington Healthplanfinder this week, or call 1-855-923-4633.
  2. Ask the hospital counselor today about temporary coverage opened by the hospital while the state decides.
  3. List the months that already have bills so the three-month look-back covers the admission.
  4. Before you pick a plan, check that the hospital and the oncology group take it.

Official application / program page ↗

Where it starts: Apply at wahealthplanfinder.org or call 1-855-923-4633. Ask the hospital's financial counselor the same day about temporary coverage while the application is decided.

What to gather

  • Your child's date of birth and Social Security number if there is one
  • A Washington address
  • This month's income for each adult in the tax household
  • Insurance cards, if any
  • A list of the months in the last three that already have hospital bills

How long: The published standard is 45 days, and Healthplanfinder can decide in the same session. Coverage then reaches back up to three months before the month you applied.

What a yes looks like

A notice with coverage dates and a choice of Apple Health plan. Check the hospital and the oncology group take that plan before choosing. Twelve months of coverage follows, or to the end of the sixth-birthday month for a child under six.

What a no looks like, and the next move

Read whether the no was about income, a missing document or the category. If it was income, ask about the premium tier, which runs to 317% of poverty, and appeal by the date on the notice.

Watch out

  • The application checks current monthly income. A yearly amount divided by 12 is only an estimate, especially after a pay cut or one-time payment.
  • Wages before taxes and unemployment generally count. For self-employment, allowable business expenses are deducted. Child support received and SSI do not count for this income test. Other disability benefits can be treated differently.

Dates that change this

2026-04-01: Washington puts the new poverty guideline on these programmes on April 1 each year; the next change is April 1, 2027.

2027-01-01: Starting January 1, 2027, retroactive coverage changes to one month for Apple Health for Adults and two months for other Apple Health programs. Through 2026, up to three prior months may qualify.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Free full coverage at or under 210% of the federal poverty level, 215% once the state's five-point allowance is applied. Bills from up to three months before you apply can be covered.

  • $210/month — No-cost children's income standard, before the allowance
  • $5/month — Income allowance added to every standard
  • $3 — Months of backdated coverage before the application month
  • $45 — Published decision standard

Covers: Hospital and clinic care · Chemotherapy and prescriptions · Anything medically necessary for a child, even when it is not on the covered list · Private duty nursing at home when the child's needs meet the test · Rides to appointments, with meals and lodging for distant care · Dental and vision

Legal protection: No premium and no copay for a child · Coverage continues for twelve months, or to the end of the sixth-birthday month for a child under six

What it costs the family: Nothing. No premium, no copays for a child.

The eligibility facts, as published

Age
age 18 or younger
Age max exclusive
19
Income
MAGI household; at or under 210% of the federal poverty level, with a five-percentage-point reduction applied (WAC 182-505-0100(6)(a), WAC 182-509-0300(4))
Insurance status condition
none: coverage sits behind other insurance and the provider bills the other insurance first (WAC 182-501-0200)
Residency
Washington; children can apply regardless of immigration status
Continuous eligibility
to the end of the sixth-birthday month for a child under six, otherwise twelve months
Retroactive months
up to 3
Processing standard
45 calendar days, or 60 where a disability decision is needed (published rule, text predating 2024)

Decisions this site cannot make: Health Care Authority MAGI determination through Healthplanfinder · Hospital presumptive eligibility opened by a participating hospital

Expect friction on: Choosing an Apple Health plan the oncology group is in

The trap: Keep existing insurance while applying. Ask the hospital to confirm that providers can bill both plans. Apple Health may help with covered copays, deductibles and services, but it does not pay every unpaid private-insurance bill. Use the current HCA published income table.

Where I read this

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