Established by the federal government in 1965 to improve the health of low-income Americans, Medicaid is the national health insurance plan funded jointly by state and federal governments.
Washington state Medicaid is called Apple Health. It provides free health services including long-term care to 22% of all residents, and 74% of seniors and people with disabilities qualify for coverage.
Adults age 64 and under with an income at or below 133% of the federal poverty level who aren’t entitled to Medicare automatically qualify for Apple Health’s modified adjusted gross income coverage. The current MAGI maximum monthly income limits are $1,436 for a single person and $1,945 for a two-person household.
Seniors 65 and older receiving Supplemental Security Income may also qualify for free Apple Health coverage under the categorically needy designation. Those with incomes above the SSI rate can seek free Apple Health services through the Medically Needy program, which is a Medicaid spend-down program with terms of three or six months.
For more information about Apple Health coverage options, contact the Washington Healthplanfinder at (855) 923-4633.
Community Options Program Entry System
Seniors 65 and older who need help performing two or more activities of daily living and have a low income and few countable assets may qualify for COPES, a Home and Community-Based Services waiver. COPES is a Medicaid program that gives seniors services and supports to live at home or in an assisted living residence to prevent or delay nursing home placement.
To qualify for COPES enrollment, seniors must have a monthly income of $2,313 or less from all sources including pensions, alimony payments and rental income. They must also own no more than $2,000 in countable assets such as stocks and bonds, bank account balances and real estate, with the exception of their principal residence. In some extraordinary cases these income and asset limits may be waived, particularly if the senior has ongoing medical expenses they pay for directly.
If approved for COPES coverage, seniors may be provided with one or more of the following services:
- Adult day health services
- Access to durable medical equipment
- A personal emergency response system
- Assistance with transportation
- Home care
- Skilled nursing care
- Case management
COPES currently has a statewide enrollment limit, and eligible seniors may be placed on a waiting list.
For more information about COPES, Auburn seniors living in King County can contact
King County Home and Community Services at (206) 341-7600. Pierce County seniors can contact the
Tacoma HCS at (253) 476-7200.