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Income Guidelines for Medicaid Eligibility in Washington State

Washington State Medicaid is a health-care option for low-income residents. You must be a United States citizen or legal alien to receive full benefits. However, undocumented aliens may qualify for pregnancy or emergency coverage if they meet other Medicaid requirements. Medicaid income limits depend on your age, qualifying dependents and health. Eligibility is calculated based on your family size after allowable deductions.

  1. Adults With Dependents

    • As of 2010, adults with children under age 19 may receive Medicaid if their net monthly income is at or below $562 for a family of three. Income limits increase with additional family members. Families eligible for or enrolled in the Temporary Assistance for Needy Families (TANF) program are categorically eligible for benefits.

    Pregnancy and Family Planning

    • Pregnant women may be eligible for Medicaid throughout the pregnancy and postpartum period if their incomes do not exceed 185 percent of the Federal Poverty Level (FPL). Men and women of childbearing age qualify for Medicaid family planning services if their income does not exceed 200 percent of the FPL.

    Children

    • Infants up to age one are automatically eligible for Medicaid during their first year if the mother received benefits during pregnancy. Children up to age 19 may qualify for Medicaid coverage at no cost if the household income does not exceed 200 percent of the FPL. In families with incomes between 200 to 300 percent of the FPL, children qualify for fee-based health care. The maximum amount a family will pay for premiums is $60 monthly.

    Disabled and Aged

    • Individuals receiving Supplemental Security Income (SSI) are eligible for Medicaid. As of 2009, Adults 65 and older or disabled may receive Medicaid if their monthly incomes do not exceed $1,011 for a family of two. Working disabled applicants may qualify if their incomes do not exceed 220 percent of the FPL. Washington Medicaid provides assistance with Medicare co-pays, premiums and deductibles if your income is between 100 to 200 percent of the FPL.

    Medically Needy

    • If you are not eligible for traditional Medicaid based on your income, you may qualify for the Medically Needy Medicaid plan if your monthly income is at or below $674 for a family of three. The Medically Needy program allows members to "spend down" their income on medical expenses to qualify for health care.

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