Qualifications for Medicaid in Washington

What are the requirements for Medicaid in Washington when it comes to applying for government-sponsored health care benefits? Those interested in how to qualify for Medicaid in Washington will find there are both personal and financial eligibility prerequisites. Washington Medicaid eligibility requirements for low-cost and free health care coverage vary by medical care program. Who is eligible for Medicaid is determined by the Washington State Health Care Authority. The state decides on Medicaid eligibility by calculating the household income requirements of applicants and comparing medical circumstances with the Medicaid guidelines. The state limits WA Medicaid benefits eligibility to individuals and families who fulfill these requirements. Find out the income requirements for Medicaid in Washington below to save time and apply to the best-suited health program.

To discover the Medicaid application guidelines for eligibility, review the topics below:

  • Who is eligible for Medicaid in Washington?

  • What are the income requirements for Medicaid in Washington?

  • What are the Medicaid application guidelines in Washington?

Who is eligible for Medicaid in Washington?

Washington Medicaid eligibility requirements for applicants not only differ by program but also by category. A candidate who is eligible for Medicaid programs targeted at pregnant women may not be eligible for subsidies designated for parents. Finding out how to qualify for Medicaid programs starts with determining the category in which the Medicaid applicant falls. WA Medicaid benefits eligibility groups include minors, adults, pregnant females, caretakers, senior citizens, non-citizens and individuals with blindness or a disability.

What are the requirements for Medicaid in WA? General Medicaid eligibility requirements include being a U.S. citizen or meeting the immigration requirements of the state. Qualified immigrants include lawful permanent residents, asylum seekers, refugees, conditional entrants, certain trafficking victims and petitioners granted withholding of removal or part of the Cuban-Haitian Entrant Program (CHEP). However, non-emergency Medicaid benefits can only be sought out by lawful permanent residents of the state who have resided for at least five years. To prove Medicaid eligibility, noncitizens must supply immigration paperwork along with Medicaid applications.

Non-citizens can apply for the Alien Emergency (AEM) Program. This program is specifically for immigrants with qualifying medical conditions but do not meet the status requirements. Qualifying medical conditions include cancer treatment plans, dialysis treatment, anti-rejection medication for organ transplants, emergency room care, inpatient admission and outpatient surgery.

To satisfy Medicaid eligibility requirements, Medicaid candidates who apply for programs specific to medical conditions such as blindness and disability must be able to prove their health conditions. Medicaid benefits eligibility for elderly applicants means they must be older than 65 years of age and children must be younger than 19 years of age. While pregnant women must be with child to be eligible for Medicaid health care coverage, women are guaranteed post-partum coverage no matter the results of the pregnancy. Expectant teens qualify for Medicaid pregnancy care as well as a confidential application process.

What are the income requirements for Medicaid in Washington?

Washington Medicaid eligibility requirements include household earnings for almost all health programs. To find out the income requirements for Medicaid, a candidate must refer to the group in which he or she belongs as well as the household size. Both of these components make up the Medicaid application guidelines and help officials determine suitable candidates.

When calculating Medicaid income requirements, applicants must include the entire household income, not just the individual. The applicant will also need to list the Social Security Numbers and dates of birth for each member in the household. Pregnant women should include their unborn children as part of their households.

Medicaid eligibility requirements for adults 20 to 64 requires an income at or below 133 percent of the Federal Poverty Level (FPL) in respect to household size. For instance, to be eligible for Medicaid, an applicant living alone may qualify with a monthly income less than $1,371, while a married couple has the monthly income limit of $1,776. Parents, caretakers and legal guardians living with dependent children younger than 18 years of age have different thresholds. For instance, a single mother with a child has a monthly earnings limit of $658.

Medicaid eligibility for minors younger than 18 years of age means meeting the requirements for free or low-cost Medicaid benefits. Medicaid requirements for minors mean that:

  • $6,420 qualifies for a premium of $30 monthly per child ($60 family max).

  • $5,367 qualifies for a premium of $20 monthly per child ($40 family max).

  • $4,354 qualifies for completely free coverage.

What are the Medicaid application guidelines for in Washington?

Medicaid benefits eligibility must be met by following the above criteria in order for a potential beneficiary to successfully apply for Medicaid. While Medicaid eligibility takes into consideration certain patient groups, the Medicaid application guidelines for each vary. Review the below Medicaid requirements broken down by patient group to prepare for a specific Medicaid application in Washington:

  • Children must be younger than 18 years of age and have a household income less than the threshold for low-cost or free Medicaid benefits.

  • Pregnant women simply need to have an income below the FPL. There are no age, asset or citizenship requirements. Coverage includes 60 days after the end of the pregnancy plus the days remaining in the month. For instance, if the birth occurred on March 15, the coverage continues until May 31.

  • Parents, caretakers and legal guardians must live with dependent children younger than 18 years of age and fulfill the household income requirements for Medicaid.

  • Aged, blind or disabled Medicaid applicants must meet the medical eligibility as well as Medicaid income requirements.

  • Disabled patients may also qualify for Healthcare for Workers with Disabilities (HWD). Workers between 16 and 64 years of age with a disability can earn an income less than 220 percent of the federal poverty level. Enrollees must pay the sliding scale premium that will never be above 7.5 percent.



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