Apple Health for Kids

Apple Health for Kids may also provide free medical coverage to non-citizen children under the age of 19 with family income at or below 200% Federal Poverty Level (FPL), who are not eligible for Medicaid because of their immigration status. The income amounts below are effective April 1, 2008.

Number of people in family	Countable Income per Month
1	1,734
2	2,334
3	2,934
4	3,534
5	4,134
More	Add $600 or each additional family member

Apple Health for Kids may also provide premium based medical coverage to non-citizen children under the age of 19 with family income over 200% FPL, but not over 250% of FPL. The premium is $15/mo per child, but no more than $45/mo per family.

Number of people in family	Countable Income per Month
1	2,167
2	2,917
3	3,667
4	4,417
5	5,167
More	Add $750 or each additional family member

How do I apply?

Complete, print, sign and return the application for Apple Health for Kids.

English Application; Spanish Application; Russian Application; Vietnamese Application - If you don't have Adobe Acrobat Reader to view this file, download it free.

Please include proof of your income with your application. Mail your application to:

                    MEDS
                    PO BOX 45531
                    Olympia, WA 98599-5531

How to order applications.
English, Spanish and Russian applications are now available to order in bulk from the DSHS fulfillment center.

For questions or to order on line go to: http://fortress.wa.gov/dshs/maa/CustomerPublications/.

To the left are selections so you can learn more about our program and the services offered. Call
1-877-KIDS-NOW (toll-free 1-877-543-7669) for more information.

For comments or questions regarding (your program here), email contact us.

Page modified: November 2009

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