$1,835 or $2,982? Washington Medicaid Income Limits 2026

Two numbers decide most Apple Health cases in Washington: $1,835 a month for a single adult under the 138% federal poverty level standard, and $2,982 a month as the Special Income Level for long-term care, both confirmed in the Washington Apple Health eligibility overview and current as of 2026. If your monthly income sits under the figure for your household size and pathway, you likely qualify. The next step is figuring out which of those two tracks applies to you.

TL;DR:

Washington’s Health Care Authority (HCA) publishes separate income ceilings for each Apple Health program, and they don’t move in lockstep. Adults, pregnant patients, and kids fall under different percentages of the federal poverty level, while long-term care uses a flat dollar figure that has nothing to do with household size at all.

Apple Health for adults ages 19 to 64 uses 138% of the federal poverty level. Effective April 1, 2026, that limit is $1,835 a month for one person and $3,795 for a family of four, according to HCA’s eligibility overview. Pregnant patients and those on After Pregnancy Coverage qualify at a higher threshold, 215% FPL, and kids’ coverage runs in tiers up to 215% and 317% FPL depending on age band, per the HCA coverage brochure.

Long-term care runs on a different system entirely. The Special Income Level is set as a fixed monthly amount effective January 1, 2026, and it applies regardless of household size because most long-term care applicants are assessed as a household of one, per HCA’s income and resource standards. That same document lists the SSI/CNIL standards and Medicare Savings Program thresholds that come into play for seniors and people with disabilities who don’t need nursing-level care but still qualify through a non-MAGI pathway.

Pro Tip: Bookmark the HCA income standards PDF directly rather than saving a screenshot or a third-party chart. HCA revises these tables on a schedule, and a saved link updates automatically while a screenshot goes stale the day the numbers change.

Before you compare your income to any chart, figure out which counting method governs your case. Washington sorts Medicaid applicants into two systems, and mixing them up is one of the most common reasons people think they don’t qualify when they actually do, or vice versa.

MAGI stands for Modified Adjusted Gross Income, and it’s the federal standard used for most adults, children, and pregnancy-related coverage. It follows the same household and income rules the IRS uses for tax filing, and critically, it carries no asset test . Two households with identical income but wildly different savings accounts qualify the same way under MAGI, according to Medicaid .

Non-MAGI pathways cover seniors, people with disabilities, and anyone applying for long-term care or SSI-related Medicaid. These categories use older income-counting rules and add a resource test on top. A retired homeowner with modest income but a paid-off house and savings might sail through a MAGI screen but get stopped by a non-MAGI asset limit.

Here’s a quick way to self-check which pathway likely fits your situation:

The most common misclassification error happens when an adult child helps an aging parent apply and assumes the same MAGI rules that covered the rest of the family will apply to grandma. They won’t. A Medicaid eligibility policy built for seniors triggers the asset and resource review, even if the parent’s income alone would pass a MAGI test.

The Special Income Level of $2,982 a month, effective January 1, 2026, is the ceiling most people run into when a parent or spouse needs nursing home care or an in-home waiver program, according to HCA’s income and resource standards. Cross that number and you’re not automatically disqualified. You’ve moved into territory where the asset side of the equation, and possibly a trust arrangement, starts to matter as much as income.

Non-MAGI programs pair the income test with a resource limit. Washington generally caps countable assets for SSI-related Medicaid at levels far below what many retirees have saved, and the state also enforces a home equity limit that changes periodically within the same HCA standards document. Not everything counts against you, though:

For someone whose income lands above the Special Income Level but who still needs nursing home care, Washington recognizes a planning tool called a Qualified Income Trust, often called a Miller trust. Excess income gets deposited into the trust each month instead of counting toward the SIL, which can bring an applicant back under the threshold. A Personal Needs Allowance and patient liability calculation still determine how much of a resident’s own income goes toward care costs even after qualifying. These trusts carry legal requirements that vary by circumstance, so this is a case where talking to a Medicaid planning attorney or an elder law resource through DSHS pays for itself.

Getting the math right starts with household size, and the rule changes depending on which pathway you’re in.

Errors usually come from forgetting a income source, like a small pension or irregular freelance income, not from the arithmetic itself.

Washington doesn’t update every Medicaid income figure on the same day. Most MAGI-based tables, tied to the federal poverty level, take effect April 1 each year, once the federal government finalizes new FPL guidelines. Long-term care values like the Special Income Level typically adjust on January 1 , following a separate federal Social Security cost-of-living schedule.

That split explains why you might see one number update in your search results and not another, even mid-year. The gap isn’t an error. It’s two federal calendars running independently.

To stay current, check these sources directly rather than relying on summaries:

Every official HCA PDF lists an effective date in its header or footer. If a chart you’re reading doesn’t show one, treat the numbers as unverified until you can confirm them against an HCA source.

Once you know your pathway and you’re reasonably confident you fall under the right threshold, the application itself moves fast if you come prepared.

Local assistance is also available through community navigators and county health resources if the paperwork feels like more than you want to tackle alone.

A directory exists to help families navigate licensed adult family homes across Washington, and Medicaid eligibility is often the first fork in that road. Knowing whether a loved one clears the Special Income Level, or needs a Qualified Income Trust to get there, determines which homes are even worth calling.

Not every adult family home accepts Medicaid clients, and payment arrangements vary home to home. The directory aggregates official DSHS license records and inspection history so families can filter by payment type before they spend hours on the phone. Understanding the SIL and asset rules covered above turns a vague search into a targeted one: you already know your number, so you can ask providers the right question immediately instead of discovering a mismatch three calls in. For deeper reading on how Medicaid payment actually works inside adult family homes, Afhcircle’s Medicaid and adult family homes guide walks through billing arrangements in more detail.

— DanMic

There is a free, searchable directory of licensed Washington homes, pulled straight from official DSHS records instead of a sales-driven referral network.

The typical workflow works in two steps. Confirm your Medicaid pathway and income number first, using the tables and calculations above. Then filter the listings by payment options, location, and care type to find homes that actually fit your situation, checking license status and inspection history before you ever pick up the phone. There are no referral fees baked into the process and no middleman steering you toward a particular provider. If you’re ready to see what’s available, start browsing licensed adult family homes in Washington and contact homes directly once you’ve narrowed the list.

This article is general information, not a substitute for advice from a qualified financial advisor. Consult a qualified financial professional about your own circumstances before acting on anything here.