Work or a qualifying exception
Beginning January 1, 2027, affected adults must meet an activity or income pathway, or qualify for an exemption or exclusion.
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A Washington Apple Health resource
Medicaid is changing in 2027.
Let’s help you prepare.
Understand what is changing, know where to get help, and take the next step to protect your access to care.
HCA guidance reviewed October 14, 2026
Looking ahead togetherYour coverage.
Your next steps.
Your next steps.
The essentials
Three changes to keep on your radar.
H.R. 1, the federal law enacted in July 2025, changes some Washington Apple Health eligibility rules.
More frequent renewals
Most Apple Health for Adults members move from yearly to six-month renewals at their first renewal in 2027.
Less time to cover earlier bills
From January 1, 2027, retroactive coverage generally drops to one month for Apple Health for Adults and two months for other programs.
More than one way to qualify
“Work requirements”
doesn’t only mean a job.
HCA lists several ways to meet the new requirement. Its current guidance includes:
- Income: at least $580 in monthly household income.
- Education: enrollment at least half-time.
- Activities: 80 hours of qualifying work, a work program, community service, or a qualifying combination.
The $580 figure is a work-requirement pathway, not the maximum income limit for Apple Health. Other eligibility rules still apply.
Source: Qualifying activities · HCA PDF (opens in a new tab)
A little preparation now
Your coverage checklist.
You do not need to figure this out alone. Start with the information and help already available.
Make sure notices can reach you.
Update your mailing address, email, and phone number in your coverage account. Check your message center and mail regularly.
Find your Apple Health account → (opens in a new tab)Know your program and renewal date.
Look at your latest eligibility letter. Add its deadline to your calendar and respond when information is requested.
See where to find these details · PDF → (opens in a new tab)Ask which pathway applies to you.
Talk with HCA or an enrollment helper about activities, income, exemptions, or exclusions. Keep copies of notices and anything you send.
Explore the official requirements → (opens in a new tab)Get help before a gap in coverage.
If a letter is confusing or your coverage may end, contact the agency on it promptly. Tell your Arcadia care team if a change could affect your therapy.
Find enrollment support → (opens in a new tab)
Answers to common concerns
Questions you may be asking.
Plain-language answers grounded in HCA’s current guidance. Open a question for details and its official source.
Implementation details can change. Use your latest eligibility notice and HCA’s current instructions.
Will I lose Apple Health on January 1, 2027?
Not automatically. For existing Apple Health for Adults members, HCA says the new rules begin at your first renewal in 2027. Your own notice explains the action and deadline that apply to you. Keep checking your account and mail.
How do I know whether I have Apple Health for Adults?
Look at your latest eligibility letter in the Washington Healthplanfinder message center, or call HCA at 1-800-562-3022. Your insurance company’s name alone does not identify your Apple Health eligibility program.
Do I have to work exactly 80 hours every month?
There are several qualifying paths, including income, work, half-time education, training, community service, or a qualifying combination. HCA also lists exemptions and exclusions. The applicable reporting period differs for an application and a renewal; follow HCA’s instructions for your situation.
What if my mental health or another condition makes working difficult?
Ask HCA about the medically frail exclusion. Its criteria include a disabling mental disorder, substance use disorder, and certain serious medical conditions or disabilities. Being in therapy alone does not establish eligibility for this exclusion. Discuss your circumstances with HCA and your treating provider.
Will I have to provide medical documentation immediately?
HCA currently says it will accept self-attestation of medically frail status without additional proof through 2027. Verification requirements begin in January 2028. Check the current HCA guidance before reporting; procedures may change.
What if I care for a child, am pregnant, or receive food assistance?
HCA lists several exclusions, including qualifying caregivers of a child under 14 or a person with a disability, pregnancy/postpartum circumstances, and people meeting the applicable SNAP or TANF work rules. Receiving benefits alone is not a substitute for checking the exact criteria.
Will renewal still happen automatically?
HCA says the system will continue trying to renew coverage automatically before asking you to act. For most Apple Health for Adults members, certification periods become six months at the first 2027 renewal. If a notice asks for information, respond by its deadline even if you renewed automatically before.
Are American Indian and Alaska Native members affected the same way?
No. HCA’s fact sheet says American Indian and Alaska Native individuals are excluded from both the work requirements and the shorter six-month certification periods. Ask HCA how the rules apply to your enrollment.
Can Apple Health still cover bills from before I applied?
Retroactive coverage is becoming shorter. Starting January 1, 2027, the maximum look-back is generally one month for Apple Health for Adults and two months for other Apple Health programs, subject to eligibility. Ask about help with recent bills when you apply.
What if I receive a notice ending my coverage?
Read the reason and deadlines right away and contact the agency listed on the notice. Ask about correcting information, other eligibility pathways, and appeal rights. Do not assume a missed notice or an eligibility decision cannot be reviewed.
Can I simply switch to a subsidized Marketplace plan?
Do not assume federal premium assistance will be available. HCA’s sample notice says people losing Apple Health for Adults because they do not meet work requirements or an exemption are not eligible for federal premium tax credits. A Healthplanfinder enrollment helper can explain your other options.
Who can help me complete the steps or understand a letter?
Washington Healthplanfinder can help with your account, application, and renewal at 1-855-923-4633. Ask for language assistance or a local enrollment helper. HCA answers Apple Health questions at 1-800-562-3022. Arcadia can discuss continuity of your therapy, but HCA determines coverage eligibility.
Save these resources
Official information, within reach.
These links open Washington HCA resources in a new tab. PDFs are hosted by HCA so you can access their current versions.
Work requirements & renewals
HCA’s printable overview of who is affected, exemptions, and renewal changes.
Read the HCA PDF (opens in a new tab)What your notice may look like
A sample letter explaining timing, reporting, exclusions, and coverage options.
View the sample notice PDF (opens in a new tab)Retroactive coverage
How the shorter look-back periods can affect help with earlier medical bills.
Read the HCA PDF (opens in a new tab)Official updates & translations
Use HCA’s current guidance and fact sheets in multiple languages.
Find translated HCA handouts (opens in a new tab)A person can help
Take the next step
with support.
For eligibility, notices, and exemptions, start with HCA. For an application or renewal, contact Washington Healthplanfinder.
Washington HCA
1-800-562-3022HCA client guidance ↗ (opens in a new tab)Washington Healthplanfinder
1-855-923-4633Free enrollment help ↗ (opens in a new tab)Already working with Arcadia? If a coverage change may affect your sessions, contact information@arcadiawa.com so we can discuss next steps. Please do not email medical records or personal eligibility documents.
About this guide
Prepared by Arcadia Psychotherapy for Washington clients and families. Last reviewed October 14, 2026. This is general educational information, not an eligibility determination or a guarantee of coverage. Washington HCA and your official notices are the sources to follow for your situation.
Primary sources: HCA work requirements (opens in a new tab), HCA client overview (opens in a new tab), work requirements and renewals fact sheet (opens in a new tab), sample client notice (opens in a new tab), retroactive coverage fact sheet (opens in a new tab), and Apple Health account guidance (opens in a new tab).
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