What Apple Health Is
Apple Health is the umbrella brand for Washington's Medicaid programs, administered by the Washington Health Care Authority and DSHS. For seniors, the relevant pieces are Apple Health for Aged, Blind, and Disabled (ABD) and the related long-term care waivers like COPES.
Apple Health covers medical care: doctor visits, hospital stays, prescriptions, mental health services, durable medical equipment. The long-term care waivers cover personal care and supervision in adult family homes, assisted living facilities, and in-home settings.
Income and Asset Limits
For most seniors applying for long-term care coverage in 2024, the income limit is roughly $2,742/month (300% of SSI). If income exceeds the limit, a Qualified Income Trust ("Miller Trust") can often bring eligibility into reach.
The asset limit is $2,000 for a single applicant, $3,000 for a married couple where both apply. Exempt assets include the primary home (with limits), one vehicle, household items, and a prepaid burial plot or contract up to $1,500. Read more on spend-down →
What Apple Health Covers for Senior Care
Through the COPES waiver, Apple Health pays a daily rate to DSHS-contracted adult family homes that have an open Medicaid bed. It also funds in-home personal care, assisted living facility contracts, and adult day programs.
The rate paid to AFHs typically runs $80–$140/day, depending on the resident's assessed care level. The home accepts that rate as payment in full — you can't be charged extra for routine care.
Spend-Down: Becoming Eligible Legally
Many seniors arrive at Apple Health by spending down assets to the limit. "Spend down" doesn't mean giving money away — it means using your assets on legitimate, allowable expenses until you're eligible.
Common legal spend-down uses: paying for care while still private pay, paying off the mortgage, home improvements and accessibility upgrades, prepaying a burial contract, buying a more reliable car. Don't give money to family — Washington has a five-year lookback period, and transfers will trigger a penalty.
How to Apply
You can apply for Apple Health two ways: online through Washington Healthplanfinder for medical-only coverage, or through your local DSHS Home and Community Services (HCS) office for long-term care coverage. For seniors who need care funding, always go through HCS — they handle both medical and long-term care together.
Call 1-855-797-5662 to find your local HCS office. Approval typically takes 30–45 days for medical-only and 4–8 weeks when long-term care services are also requested.
Apple Health vs. Medicare
This is one of the most common confusions in senior care. Medicare is federal health insurance for people 65+ and certain disabilities. Medicaid (Apple Health) is income-based assistance, jointly funded by the state and federal government.
Medicare covers hospital stays, doctor visits, short-term skilled nursing rehab, and some home health. Medicare does not cover long-term residential care. Medicaid is what pays for AFH and assisted living when the savings are gone. Many seniors have both — Medicare for medical, Apple Health for long-term care. Full comparison →
Frequently Asked Questions
Q: Can my parent keep their house and still qualify? A: Yes, the home is exempt while occupied or while the applicant intends to return. Estate recovery may apply after death.
Q: How long until we get approved? A: 30–45 days for medical coverage; 4–8 weeks if a CARE assessment is also required.
Q: What about the at-home spouse? A: Washington applies spousal impoverishment protections — the community spouse keeps a minimum monthly income allowance and a share of the couple's assets.
Q: Can we appeal a denial? A: Yes, within 90 days. Most denials are financial-document issues and are often fixable.