Healthcare Assistance for Single Mothers in Washington
Washington Healthcare Assistance for Single Mothers: Medicaid, CHIP & More [2025]
Last updated: September 2025
This is your no‑fluff, get‑it‑done guide to Apple Health (Medicaid), Apple Health for Kids (CHIP), pregnancy and postpartum coverage, and other real help single moms in Washington can use today. You’ll find exact income limits, what to submit, who to call, and what to do when things don’t go as planned.
Quick Help Box (save this)
- Apply or renew Apple Health online: Washington Healthplanfinder — official application portal • Customer Support: 1‑855‑923‑4633 (TTY 1‑855‑627‑9604) • Weekdays 7:30 a.m.–5:30 p.m. PT. (wahealthplanfinder.org)
- Apple Health client services (benefits, cards, eligibility follow‑up, appeals): 1‑800‑562‑3022 • HCA Apple Health client contacts and forms. (hca.wa.gov)
- Pregnant now or recently pregnant (within 12 months)? Apply for Apple Health for Pregnant Individuals and After‑Pregnancy Coverage (APC) up to 210% FPL: HCA pregnancy coverage page. (hca.wa.gov)
- Kids’ coverage (Apple Health for Kids/CHIP): Free up to posted limits; low‑cost premiums above that. See income charts and premiums at Apple Health for Kids. For application help in any language, call WithinReach/Help Me Grow Hotline 1‑800‑322‑2588. (hca.wa.gov, withinreachwa.org)
- Non‑Emergency Medical Transportation (NEMT) for Apple Health appointments: Find your county broker and phone number: HCA transportation services directory. Book early (ideally 7–14 days before appointments). (hca.wa.gov)
- Hospital bills/financial aid (Charity Care): WA law requires free or discounted hospital care for families up to 400% FPL depending on hospital tier. Learn how to apply: WA Department of Health — Hospital Charity Care. (doh.wa.gov)
- Behavioral health, substance use, or gambling help (24/7): Washington Recovery Help Line 1‑866‑789‑1511 • Text available M–F • warecoveryhelpline.org. Call 988 for suicidal crisis. (warecoveryhelpline.org)
- Postpartum mental health peer support: Perinatal Support Washington Warm Line 1‑888‑404‑7763 • Call or text for free support and referrals statewide: Perinatal Support WA Warm Line. (perinatalsupport.org)
- Consumer help with insurance bills/denials (non‑Medicaid): Washington Office of the Insurance Commissioner Consumer Hotline 1‑800‑562‑6900 • How to file a complaint or appeal. (insurance.wa.gov)
Who qualifies for what (fast overview)
Washington’s Medicaid program is called Apple Health. Apple Health for Kids (CHIP) is children’s coverage with free and low‑cost options. Eligibility is based on Modified Adjusted Gross Income (MAGI), and Washington updates income limits each April.
2025 income thresholds you can actually use
Table: 2025 Apple Health & related income thresholds (monthly) — common single‑mom scenarios
Program (see linked page for full chart) | Household size counted | Monthly income limit | Notes |
---|---|---|---|
Apple Health for Adults (age 19–64) | Your tax household | 1,800∗∗(1‑person)•∗∗1,800** (1‑person) • **2,433 (2‑person) • $3,065 (3‑person) | Up to 138% FPL. If over, check QHPs at Healthplanfinder. (hca.wa.gov) |
Apple Health for Pregnant Individuals | Includes unborn(s) | 210% FPL: e.g., 2‑person 3,790∗∗,3‑person∗∗3,790**, 3‑person **4,775, 4‑person $5,760 | Available regardless of immigration status; continuous during pregnancy. (hca.wa.gov) |
After‑Pregnancy Coverage (APC) | Same as pregnancy | Same as above (210% FPL) | Up to 12 months postpartum even if income changes. (hca.wa.gov) |
Apple Health for Kids (free) | Child’s household | Examples: 2‑person 3,790∗∗,3‑person∗∗3,790**, 3‑person **4,775, 4‑person $5,760 | Continuous coverage through the month a child turns 6; 12‑month continuous for 6–18. (hca.wa.gov) |
Apple Health for Kids with Premiums (CHIP) | Child’s household | Tier 1 (to ~260% FPL): see CHIP table below • Tier 2 (to ~312% FPL): see table | Premiums are 20∗∗or∗∗20** or **30 per child, with family caps. (hca.wa.gov) |
Reality check: if your income is close to a limit, apply anyway. The state uses a 5% income disregard for many MAGI groups, which can nudge you under the line. The online system can also check eligibility for other household members automatically. (hca.wa.gov)
What to do if this doesn’t work:
- Try a local assister (navigator/broker) for free help: Find local assistance by language/zip. Or call 1‑855‑923‑4633 and ask for an interpreter. (wahealthplanfinder.org)
Apple Health for Pregnant Individuals (prenatal through delivery)
Most important step first: apply as soon as you know you’re pregnant (you can self‑attest pregnancy), even if your income fluctuates or you’re between jobs. Coverage is available up to 210% FPL and does not depend on immigration status. Household size includes the unborn baby(ies). (hca.wa.gov)
What you get:
- Full major medical coverage, prenatal visits, ultrasounds, labs, medications, labor and delivery (hospital, birthing center, or planned home birth with licensed provider), dental, behavioral health, and transportation to appointments when needed. (hca.wa.gov)
- First Steps enhanced services like Maternity Support Services (nurse/dietitian/behavioral health team), Infant Case Management, and childbirth education classes at no cost. Start early for best results. (hca.wa.gov)
- Breast pumps are covered; ask your plan for details and network suppliers. (hca.wa.gov)
How to apply fast:
- Online: Washington Healthplanfinder or the WAPlanfinder mobile app. Phone: 1‑855‑923‑4633. Paper option available; teens can use a paper application for confidential services. (wahealthplanfinder.org, hca.wa.gov)
- Coverage begins the first day of the month you applied once found eligible; retroactive coverage up to three months may be possible in some cases. Expect your ProviderOne card within about 7–10 days. (hca.wa.gov)
Real‑world example:
- You’re a single mom‑to‑be with one child at home (household of 3) earning 4,500/month∗∗.You’reunderthe∗∗4,500/month**. You’re under the **4,775/month pregnancy limit for 3 people. Apply online and pick a plan; your First Steps team can help with prenatal education and referrals. (hca.wa.gov)
Reality checks and tips:
- Don’t wait for a bill or a plan card to seek prenatal care. Once approved, you’re covered. If the plan card hasn’t arrived, most providers can verify with your name/DOB/ProviderOne number. (hca.wa.gov)
- Keep reporting pregnancy status (estimated due date and when the pregnancy ends) so your postpartum coverage starts on time. (hca.wa.gov)
What to do if this doesn’t work:
- If your income is above 210% FPL, ask about the Medically Needy (spenddown) pregnancy program to cover high bills; or look at a Qualified Health Plan with savings. (hca.wa.gov)
After‑Pregnancy Coverage (APC): 12 months of full coverage
If you were on Apple Health during pregnancy, you’ll transition automatically to APC for up to 12 months starting the month after the pregnancy ends — even if your income goes up or your household changes. If you weren’t on Apple Health during pregnancy, you can still apply for APC any time in that 12‑month window if your income is within 210% FPL. Immigration status does not affect APC eligibility. (hca.wa.gov)
- Covered services include physical health, dental, behavioral health, postpartum follow‑ups, and medications. Use this time to complete checkups, address blood pressure/diabetes, and get mental health support if needed. (hca.wa.gov)
- Postpartum mental health: In addition to plan behavioral health benefits, call Perinatal Support WA 1‑888‑404‑7763 for peer support and local resources. If you’re in crisis, call 988. (perinatalsupport.org)
What to do if this doesn’t work:
- If APC isn’t showing, contact your plan or HCA right away to update the pregnancy end date, or file an appeal if needed. Apple Health client line: 1‑800‑562‑3022. (hca.wa.gov)
Apple Health for Kids (Medicaid & CHIP) — free and low‑cost coverage
Priority action: Apply for all kids in your home. Children get continuous coverage (see below), comprehensive medical, dental, and mental health services, and transportation when needed. (hca.wa.gov)
Free Apple Health for Kids (typical monthly limits):
- 2‑person 3,790∗∗,3‑person∗∗3,790**, 3‑person **4,775, 4‑person $5,760. Younger kids (under 6) who qualify for free coverage keep it through their 6th birthday month regardless of income changes. (hca.wa.gov)
Low‑cost Apple Health for Kids with Premiums (CHIP):
- If your income is above free coverage levels, kids may qualify with a small monthly premium. Premiums resumed in 2023.
Table: 2025 CHIP premiums and income ranges (monthly)
Premium tier | Monthly premium | Family cap | Example household monthly income to qualify |
---|---|---|---|
Tier 1 | $20 per child | $40 max per family | 2‑person to 4,672∗∗•3‑personto∗∗4,672** • 3‑person to **5,886 • 4‑person to $7,099 |
Tier 2 | $30 per child | $60 max per family | 2‑person to 5,589∗∗•3‑personto∗∗5,589** • 3‑person to **7,041 • 4‑person to $8,492 |
Source: Apple Health for Kids — income charts & premium tiers. Pay premiums online via Secure Access Washington or by mail after you receive your invoice. For payment help, Office of Financial Recovery: 1‑800‑562‑6114 (Option 1). (hca.wa.gov)
Key stability protections (2025):
- Continuous eligibility through age 6 for kids on free Apple Health; and 12‑month continuous eligibility for kids age 6–18 (and for CHIP enrollees). CMS approved continuous coverage through age 6 for CHIP in January 2025. (hca.wa.gov, content.govdelivery.com)
Dental for kids: fully covered through Apple Health. Ask for an ABCD dentist for ages 0–6; they’re trained for little ones and can often see children sooner. Start by 12 months of age. (hca.wa.gov, abcd-dental.org)
What to do if this doesn’t work:
- If you miss a CHIP premium, you usually have time to catch up before closure (90 days for CHIP). If you lose coverage at renewal, call WithinReach 1‑800‑322‑2588 or HCA 1‑800‑562‑3022 to fix it. (content.govdelivery.com)
Adults (not pregnant): Apple Health for Adults and Apple Health Expansion
Apple Health for Adults covers Washington residents age 19–64 with income up to 138% FPL (examples: 1,800∗∗forone,∗∗1,800** for one, **2,433 for two, $3,065 for three). Apply any time of year through Healthplanfinder. (hca.wa.gov)
Apple Health Expansion (state‑funded) helps certain adults who don’t qualify for federally funded Medicaid because of immigration status but meet other requirements, up to 138% FPL. Enrollment may be capped based on funding—check the current program page for availability and plan options. (hca.wa.gov, hca.wa.gov)
If your income is above Medicaid levels:
- Check Marketplace plans with federal premium tax credits (and cost‑sharing reductions if income ≤250% FPL) at Washington Healthplanfinder. Note: state‑funded Cascade Care Savings is closed to new customers for plan year 2025; existing recipients keep assistance for 2025. (wahealthplanfinder.org, wahbexchange.org)
What to do if this doesn’t work:
- If you’re over income but have high medical bills, ask about Medically Needy (spenddown) coverage; if you have a disability and work, see Apple Health for Workers with Disabilities (HWD) below. (hca.wa.gov)
Special programs single moms use a lot
Apple Health for Workers with Disabilities (HWD)
If you have a disability and you’re working (including self‑employment), HWD lets you keep Medicaid with a monthly premium that’s never more than 7.5% of your income. No asset limits. Apply via Washington Connection or by mail; DSHS HWD line: 1‑800‑871‑9275. (hca.wa.gov)
- Premiums are set by a state formula and adjust when your income changes; the rule was updated June 3, 2025. (hca.wa.gov)
What to do if this doesn’t work:
- If you’re also eligible for another zero‑premium Apple Health category, use the cheaper option; HWD is often best when you’d otherwise face a spenddown. (hca.wa.gov)
Family Planning Only (confidential birth control & STI services)
Income up to the posted amounts (roughly to 260% FPL). Available regardless of immigration status; you can use it even if you have other insurance and need confidential services. Includes contraceptives, tubal/vasectomy, STI screening/treatment when clinically appropriate, and HPV/Hep B vaccines. Apply via Healthplanfinder or at participating clinics. (hca.wa.gov)
What to do if this doesn’t work:
- If you’re pregnant or think you might be, switch to Apple Health for Pregnant Individuals to get full coverage. (hca.wa.gov)
Alien Emergency Medical (AEM) — for life‑threatening emergencies if you don’t qualify based on immigration status
Covers emergency hospital services (and some cancer/dialysis/transplant‑related items) for people who meet income rules but not Medicaid immigration rules. Apply after an ER/inpatient event; hospitals often help submit the documentation. (hca.wa.gov, dshs.wa.gov)
What to do if this doesn’t work:
- Ask the hospital’s financial counselors about charity care (see below) and request an AEM evaluation in writing. (doh.wa.gov)
Hospital bills: Washington Charity Care (financial assistance)
Washington law requires hospitals to give free or discounted care to eligible patients:
- Tier 1 (large systems/large hospitals): Free care up to 300% FPL and discounts up to 400% FPL; Tier 2 (smaller hospitals): Free up to 200% FPL, discounts up to 300% FPL. Hospitals must screen patients and post policies. Proof of income is required. (atg.wa.gov, doh.wa.gov)
2025 reference chart (annual FPL shown for simplicity is posted by DOH; hospitals translate to sliding discounts). See DOH page for the full table and what discount applies at your hospital’s tier. (doh.wa.gov)
Real‑world tips:
- Apply even if you have insurance; charity care applies to your out‑of‑pocket portion (deductibles/coinsurance/copays).
- If denied, appeal to the hospital and, if needed, contact the Attorney General’s office or the Office of the Insurance Commissioner for guidance on next steps. (insurance.wa.gov)
What to do if this doesn’t work:
- Ask for an itemized bill and a reasonable interest‑free payment plan for any non‑covered portion. If collections start, request charity screening in writing; hospitals must consider it. (doh.wa.gov)
Your Apple Health health plan: choose it, use it, change it
Washington delivers most Apple Health services through managed care. You can choose or change your plan anytime; changes usually take effect the following month.
Table: Apple Health managed care plans (client services)
Plan | Member Services |
---|---|
Community Health Plan of Washington (CHPW) | 1‑800‑440‑1561 |
Coordinated Care | 1‑877‑644‑4613 |
Molina Healthcare of Washington | 1‑800‑869‑7165 |
UnitedHealthcare Community Plan | 1‑877‑542‑8997 |
Wellpoint Washington (formerly Amerigroup) | 1‑833‑731‑2167 |
Source: HCA — Apple Health managed care. (hca.wa.gov)
- Dental for adults and kids is covered by Apple Health (fee‑for‑service). To find a dentist who accepts Apple Health, use DentistLink’s free referral service (phone/text 844‑888‑5465). (hca.wa.gov)
- If you lose or never got your ProviderOne card, request a replacement or pull a digital card in the WAPlanfinder app. You can also call 1‑800‑562‑3022 to request a replacement. (hca.wa.gov)
What to do if this doesn’t work:
- If you can’t get a doctor appointment, call your plan’s member services to ask for an in‑network PCP accepting new patients or for help with care coordination. If problems persist, file a grievance and call the HCA client line for help. (hca.wa.gov)
Getting to appointments: Non‑Emergency Medical Transportation (NEMT)
If you have Apple Health and no way to get to covered appointments, the state pays for the lowest‑cost appropriate ride (bus fare, mileage reimbursement, gas vouchers, taxi, wheelchair van, ferry, airfare in limited cases). Call your county broker; book ideally 7–14 days ahead.
Table: NEMT broker quick numbers (selected counties)
County | Broker | Phone |
---|---|---|
King | Hopelink | 1‑800‑923‑7433 |
Snohomish | Hopelink | 1‑855‑766‑7433 |
Pierce | Paratransit Services | 1‑800‑925‑5438 |
Spokane/Stevens/Whitman/Asotin/Ferry | Special Mobility Services | 1‑800‑892‑4817 |
Yakima/Benton/Chelan/Douglas/Columbia/Walla Walla | People for People | 1‑800‑233‑1624 |
Full statewide directory (including TTY/Spanish lines) here: HCA — Transportation services (nonemergency). (hca.wa.gov)
What to do if this doesn’t work:
- Ask your plan for care management; they can coordinate with brokers. If a ride doesn’t show, call the broker’s status/cancellation line immediately (each broker lists one on its page). (hopelink.org)
If you don’t qualify for Medicaid and premiums are too high
- Check if federal premium tax credits and cost‑sharing reductions lower your monthly cost and deductibles at Washington Healthplanfinder. For 2025, Washington’s state subsidy program (Cascade Care Savings) is closed to new customers but continues for members already receiving it. (wahealthplanfinder.org)
- Use the state’s free prescription discount card (ArrayRx). Anyone in WA can enroll online; typical savings are up to 80% on generics. Customer Service 1‑800‑913‑4146. Learn more: HCA — Get help paying for prescriptions (ArrayRx). (hca.wa.gov, arrayrxcard.com)
What to do if this doesn’t work:
- Community Health Centers provide care on a sliding fee scale regardless of insurance. See the statewide CHC network listings and call your nearest clinic. (chnw.chpw.org)
Dental, vision, and maternity extras you should use
- Dental for adults and kids is covered by Apple Health. Start kids by age 1 and use ABCD dentists (ages 0–6). Find ABCD via your county public health site or ABCD Dental. (abcd-dental.org)
- First Steps extras (Maternity Support Services, Infant Case Management, Childbirth Education) are at no cost; ask your plan or see the county directory. (hca.wa.gov)
- Doulas: Washington implemented an Apple Health doula benefit in 2025; check with your plan about local doulas and coverage details. (connections.hca.wa.gov)
What to do if this doesn’t work:
- If you can’t find a dentist taking Apple Health, text or call 844‑888‑5465 (DentistLink) to get a referral within your travel limits. (hca.wa.gov)
Behavioral health and postpartum supports
- You can self‑refer for therapy, psychiatric care, and substance use treatment. Call your plan or the Washington Recovery Help Line 1‑866‑789‑1511 for options near you. (warecoveryhelpline.org)
- For postpartum depression/anxiety support and local groups, call or text Perinatal Support WA 1‑888‑404‑7763. Interpreters available. (perinatalsupport.org)
- In any mental health emergency, dial 988 (24/7).
What to do if this doesn’t work:
- If you can’t get an in‑network appointment in a reasonable time, ask your plan for “network access assistance” and out‑of‑network authorization if needed, then escalate with a grievance if delays continue. See plan contacts above. (hca.wa.gov)
How to apply (and what happens next)
Table: Application timeline & what to expect
Step | What happens | Timeframe |
---|---|---|
Submit application (online/phone/paper) | Real‑time eligibility for many MAGI cases; some cases pend for verification | Often instant to a few days |
Coverage start date | If eligible, coverage starts the first day of the month you applied (exceptions for AEM/spenddown) | By rule; retroactive coverage may apply |
ProviderOne services card | Mailed automatically; digital card available in WAPlanfinder app | 7–10 days |
Pick your managed care plan | Choose online or you’ll be auto‑assigned; you can change plans any time | Next month if changed after 15th |
First appointment | Use your plan card & ProviderOne card; call your PCP and schedule | As soon as you receive eligibility |
Sources: HCA “Apply or renew coverage,” “When coverage begins,” and “Enrollment next steps.” (hca.wa.gov)
Required documents (you may not need all)
- Proof of income (recent pay stubs or self‑employment records; the system also checks databases — you may be asked for verification if numbers don’t match). (hca.wa.gov)
- Social Security numbers (if you have them). Immigration information only if it applies — many programs do not require specific status. (hca.wa.gov)
- Pregnancy due date (you can self‑attest). (hca.wa.gov)
- For CHIP premiums: wait for your billing statement; then pay online via Secure Access Washington or by mail. (hca.wa.gov)
Application checklist (print/skim)
- Photo ID (not always required for eligibility, but helpful at clinics)
- Proof of Washington residence (lease, mail, etc.)
- Last 30 days of income (pay stubs, letter from employer, or self‑attestation if appropriate)
- Tax household info (who you claim/are claimed by)
- Pregnancy details (EDD); newborn info when baby arrives
- Prior coverage info (if any)
- Preferred clinic/PCP names (to match a plan network)
Appeals, grievances, and where to get help
- If you disagree with an eligibility decision or renewal closure, request an appeal. Start with the HCA MAGI team via 1‑800‑562‑3022 or the secure contact forms on the HCA site. (hca.wa.gov)
- If your plan denies or delays care, file a grievance or appeal with the plan; they must accept oral or written grievances and resolve within required timeframes. If unresolved, request an Administrative Hearing. (app.leg.wa.gov)
- Problems with a commercial plan (not Medicaid)? Call the Insurance Commissioner at 1‑800‑562‑6900 or file a complaint online. (insurance.wa.gov)
Common mistakes to avoid
- Applying late in pregnancy. Apply as soon as you know you’re pregnant (self‑attestation allowed) to start First Steps services early. (hca.wa.gov)
- Not reporting the pregnancy end date. This can delay your 12‑month After‑Pregnancy Coverage. Report changes right away. (hca.wa.gov)
- Missing verification letters (Post‑Eligibility Reviews). If the state asks for proof, respond by the deadline so your coverage isn’t interrupted. (hca.wa.gov)
- Forgetting to pick a managed care plan. You’ll be auto‑assigned, but you might prefer another plan that your current clinic takes. Switch anytime. (hca.wa.gov)
- CHIP premium not paid. After you get the invoice, set up online payments so you don’t forget; nonpayment can lead to closure. (hca.wa.gov)
- Waiting until the last minute to book rides. NEMT works best when scheduled 7–14 days before the appointment. (hca.wa.gov)
Quick Reference Cheat Sheet
Table: Numbers & links you’ll use
Need | Where to go | Phone |
---|---|---|
Apply/renew Apple Health or QHP | Washington Healthplanfinder | 1‑855‑923‑4633 (TTY 1‑855‑627‑9604) |
Apple Health client services (cards, benefits, eligibility follow‑up) | HCA Apple Health client contacts | 1‑800‑562‑3022 |
CHIP/HWD premium payments (OFR) | Pay my Apple Health premium | 1‑800‑562‑6114 (Option 1) |
Transportation to appointments | NEMT broker directory | County‑specific |
Children’s coverage help | Apple Health for Kids info | WithinReach: 1‑800‑322‑2588 |
Find an Apple Health dentist | DentistLink — find a dentist | 844‑888‑5465 |
Perinatal mental health peer support | Perinatal Support WA Warm Line | 1‑888‑404‑7763 |
Insurance complaints/appeals (non‑Medicaid) | Office of the Insurance Commissioner | 1‑800‑562‑6900 |
Diverse Communities: tailored help and protections
- LGBTQ+ single mothers: Washington’s reproductive health and gender‑affirming care are protected under state law. Family Planning Only services are available regardless of immigration status and can be used confidentially. Ask your plan for culturally competent providers; many Community Health Centers specialize in LGBTQ+ care. (hca.wa.gov)
- Single mothers with disabilities or caring for a child with disabilities: Consider HWD if you work and need Medicaid. For kids with intensive needs, ask your provider about referrals to Apple Health programs like WISe (Wraparound with Intensive Services). (hca.wa.gov)
- Veteran single mothers: If you also use a Marketplace plan or Apple Health, you can still call the OIC for help with billing denials or appeals related to non‑VA coverage. (insurance.wa.gov)
- Immigrant/refugee single moms: Pregnancy and postpartum Medicaid (APC) and Apple Health for Kids are available regardless of immigration status (within program income limits). If you don’t qualify for full‑scope Medicaid and have an emergency, ask the hospital to screen you for AEM. (hca.wa.gov)
- Tribal members and AI/AN families: You can receive Apple Health and still use IHS/tribal clinics. Ask your plan about AI/AN cost‑sharing protections and coordination of care; many CHCs partner with tribal health. (See plan contacts above.) (hca.wa.gov)
- Rural single moms with limited access: Use NEMT, ask your plan for telehealth options, and check Community Health Centers near you (some have mobile units and school‑based clinics). (chnw.chpw.org)
- Single fathers raising kids: The same Medicaid, CHIP, and APC (if the pregnancy was yours) rules apply. Check the kids’ coverage first, then your own eligibility. (hca.wa.gov)
- Language access: Free interpreters are available at Healthplanfinder, HCA, and your health plan. Ask on the call; they’ll connect an interpreter. (wahealthplanfinder.org)
Local organizations and clinics (trusted starting points)
- Community Health Centers statewide (sliding‑fee care, help enrolling in coverage): See the Community Health Network of Washington clinic list and the Washington Association for Community Health. (chnw.chpw.org, wacommunityhealth.org)
- WithinReach / Help Me Grow WA (statewide navigation for Apple Health, WIC, clinics, more): 1‑800‑322‑2588, withinreachwa.org. (withinreachwa.org)
- Washington 211 (find local resources, including church/charity clinics, diapers, food): Dial 211 or visit wa211.org. (wa211.org)
- Free/charitable clinics directory: Washington Healthcare Access Alliance — find clinics. (wahealthcareaccessalliance.org)
Realistic timelines
- Eligibility: often instant; some cases pend for verification. Coverage starts the first day of the application month once approved (special rules for spenddown/AEM). ProviderOne card arrives in 7–10 days. (hca.wa.gov)
- Appointments: first PCP visit timing depends on provider availability — ask your plan to help schedule and to find openings. (hca.wa.gov)
- Transportation: call your broker as soon as you have an appointment — brokers recommend 7–14 days advance notice. (hca.wa.gov)
- CHIP premiums: you can use coverage once approved; pay when the invoice arrives. Set up online payments to avoid missing the due date. (hca.wa.gov)
Tables you can screenshot
Table — Pregnancy & Postpartum income (monthly)
Household | Pregnant Individuals (≤210% FPL) | After‑Pregnancy Coverage (≤210% FPL) |
---|---|---|
2 | $3,790 | $3,790 |
3 | $4,775 | $4,775 |
4 | $5,760 | $5,760 |
Source: HCA program pages. (hca.wa.gov)
Table — Adults (non‑pregnant) Apple Health income (monthly)
Household | Income limit (≤138% FPL) |
---|---|
1 | $1,800 |
2 | $2,433 |
3 | $3,065 |
Source: HCA Adult eligibility page. (hca.wa.gov)
Table — CHIP premiums (see earlier section for full ranges)
Tier | Premium per child | Family cap | Example (4‑person) income ceiling |
---|---|---|---|
Tier 1 | $20 | $40 | $7,099 |
Tier 2 | $30 | $60 | $8,492 |
Source: HCA Children page. (hca.wa.gov)
Table — Managed care plans (phone numbers)
Plan | Phone |
---|---|
CHPW | 1‑800‑440‑1561 |
Coordinated Care | 1‑877‑644‑4613 |
Molina | 1‑800‑869‑7165 |
UnitedHealthcare | 1‑877‑542‑8997 |
Wellpoint | 1‑833‑731‑2167 |
Source: HCA managed care page. (hca.wa.gov)
Table — NEMT quick numbers (selected counties)
County | Broker | Phone |
---|---|---|
King | Hopelink | 1‑800‑923‑7433 |
Snohomish | Hopelink | 1‑855‑766‑7433 |
Pierce | Paratransit Services | 1‑800‑925‑5438 |
Spokane et al. | Special Mobility Services | 1‑800‑892‑4817 |
Yakima et al. | People for People | 1‑800‑233‑1624 |
Source: HCA transportation directory. (hca.wa.gov)
“What if none of this works for me?”
- Try a Community Health Center (sliding scale), ask about payment plans, and apply for hospital charity care for big bills.
- Use ArrayRx for prescription savings if you’re uninsured or between plans: Enroll here or call 1‑800‑913‑4146. (hca.wa.gov)
- Call 211 to find local, faith‑based, and nonprofit help (gas cards to get to appointments, diapers, counseling). (wa211.org)
10 Washington‑specific FAQs
- Do I need to be a U.S. citizen to get pregnancy Medicaid in WA?
No. Apple Health for Pregnant Individuals and APC are available regardless of immigration status if you meet income limits. (hca.wa.gov) - When does Apple Health coverage start?
The first day of the month you applied once you’re approved (some exceptions for spenddown or AEM). (hca.wa.gov) - How fast will I get proof of coverage?
Your ProviderOne card arrives in about 7–10 days; you can use a digital card via the WAPlanfinder app. (hca.wa.gov) - What if my income changes during pregnancy?
Pregnancy coverage is continuous through the end of the month the pregnancy ends; income changes don’t cut off your pregnancy coverage. (hca.wa.gov) - How long is postpartum coverage?
APC lasts 12 months after the pregnancy ends, up to 210% FPL. (hca.wa.gov) - Can my kids keep coverage if I get a raise?
Yes — continuous eligibility rules keep kids covered (through age 6 if free Apple Health; 12‑month continuous eligibility for 6–18 and for CHIP). (hca.wa.gov, content.govdelivery.com) - I can’t afford the pediatric dentist I found. Are there Apple Health dentists?
Yes. Dental is covered; use DentistLink (844‑888‑5465) to find a clinic taking Apple Health near you. (hca.wa.gov) - I need a ride to my OB visit. Who do I call?
Your county’s NEMT broker. For example, King Co.: Hopelink 1‑800‑923‑7433; Snohomish: 1‑855‑766‑7433. Full list: HCA NEMT directory. (hca.wa.gov) - I got a hospital bill I can’t pay. Is there help?
Apply for hospital charity care; WA requires free/discounted care up to 300–400% FPL depending on hospital tier. (doh.wa.gov) - My plan denied a service. How do I appeal?
File a plan grievance/appeal (they must accept oral or written submissions), and if needed request a state hearing. For non‑Medicaid plans, call the Insurance Commissioner 1‑800‑562‑6900. (app.leg.wa.gov, insurance.wa.gov)
What we covered that many guides miss
- Exact 2025 income numbers for pregnancy, adults, kids, and CHIP — with links to official state charts.
- Postpartum APC at 210% FPL, continuous coverage rules for young children, and CHIP premium payment steps.
- Managed care phone numbers, NEMT county brokers, how to replace your card, and who to call for appeals.
- Real‑world supports: First Steps, ABCD dental, free clinics, behavioral health warm lines, ArrayRx.
These details come straight from Washington HCA, DOH, Healthplanfinder, and other official sources linked throughout this page. We verify and update numbers after state changes each April and as program bulletins are issued. (hca.wa.gov)
About This Guide
Compiled by the ASingleMother.org Editorial Team
This guide uses official sources from the Washington Health Care Authority (HCA), Washington Department of Health (DOH), Washington Health Benefit Exchange, and established nonprofits. We follow our Editorial Standards: we cite only official program pages or recognized statewide nonprofits, verify links at publication, and update promptly after confirmed policy changes. We are independent researchers, not government employees; we do not provide legal advice or guarantee individual outcomes. Last verified September 2025, next review April 2026. If you see an error, email info@asinglemother.org and we’ll investigate within 48 hours.
Editorial policy highlights: primary sources only; cross‑verification; link testing and archiving; 48‑hour policy change updates and reader‑reported corrections. (hca.wa.gov)
Disclaimer
Program rules, income limits, premiums, and plan lineups can change. Always confirm with the relevant agency or your health plan before acting on this information. This site provides general information and is not a substitute for advice from HCA, DOH, your health plan, legal counsel, or a licensed navigator/broker.
Security note: For your privacy, never post your SSN, full DOB, or ProviderOne number in public forums. Use only official phone numbers and websites linked above when sharing sensitive documents or making payments.
Sources (selected)
- HCA — Pregnant Individuals and APC eligibility; pregnancy income increase to 210% FPL; application routes and confidentiality. (hca.wa.gov)
- HCA — Adults (138% FPL), Apple Health Expansion details and income charts. (hca.wa.gov)
- HCA — Children (Apple Health for Kids) income charts and CHIP premium tiers; continuous eligibility. (hca.wa.gov)
- HCA — Pay my Apple Health premium (OFR online/mail); premium timelines. (hca.wa.gov)
- HCA — Managed care plans contact numbers; ProviderOne card and replacements; enrollment next steps. (hca.wa.gov)
- HCA — NEMT county broker directory and booking timeframe guidance. (hca.wa.gov)
- DOH — Hospital charity care rules and 2025 FPL ranges. (doh.wa.gov)
- Dentistry resources (DentistLink/ABCD). (hca.wa.gov, abcd-dental.org)
- Behavioral health hotlines (Washington Recovery Help Line; Perinatal Support WA). (warecoveryhelpline.org, perinatalsupport.org)
- Exchange — Cascade Care Savings 2025 status. (wahealthplanfinder.org)
- First Steps (MSS/ICM/CBE) and pregnancy services. (hca.wa.gov)
If a link is down, try again later or call the associated phone number listed above; agencies sometimes update URLs during maintenance windows.
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