Finding health coverage in Washington State can feel overwhelming. With so many programs, applications, and eligibility rules, it’s not always clear where to start. Once you understand the main options and what you qualify for, enrolling gets much simpler. This guide walks through Washington’s primary non-employer health coverage programs: Apple Health (Medicaid) and the Washington Health Benefit Exchange (Washington Healthplanfinder™) - along with Delta Dental of Washington options.

Health Coverage in Washington

If you don’t have coverage through an employer or need help paying for insurance, Washington offers two main state-supported options:

• Apple Health (Medicaid) – free or low-cost coverage for eligible residents.
• Washington Health Benefit Exchange (Washington Healthplanfinder™) – the state’s Affordable Care Act marketplace where you can shop for plans with possible discounts or tax credits.

Both programs are designed to make healthcare more accessible and affordable. Which one you qualify for depends on your income, family size, and other factors.

Option 1: Apple Health (Medicaid)

What is Apple Health?

Apple Health is Washington State’s Medicaid program, offering free or low-cost coverage for residents who meet income and eligibility requirements.

Who is Apple Health for?

Washington residents without employer coverage who need low- or no-cost healthcare based on income.

Eligibilty factors for Apple Health include:

• Type of coverage you need (general care, in-home support, nursing home care).
• Income level (typically a set percentage below the federal poverty line; e.g., for a single adult applying for standard coverage, income must be under about $2,000 per month).
• Marital status (income limits vary for single vs. married applicants).
• Assets (usually liquid assets like savings or investments—not your home or car).

You can check eligibility through the federal Medicaid site or Washington’s Healthplanfinder™.

When to enroll in Apple Health

Apple Health is open for enrollment year-round (note: this could change in 2026).

Q: Are Medicaid and Medicare the same thing?

A: No - although similar in name, Medicaid and Medicare are different programs. Medicaid is a joint federal and state program open to all individuals and families who meet certain income requirements whereas Medicare is a federal program for seniors 65+ who need help with the cost of their medical care.

Option 2: Washington Healthplanfinder™ (Health Benefit Exchange)

What is the Washington Healthplanfinder™ (Health Benefit Exchange)?

If you don’t qualify for Apple Health and don’t have insurance through an employer, you can shop for a plan through Washington Healthplanfinder™, the state’s official health insurance marketplace.

Who is the Washington Healthplanfinder™ (Health Benefit Exchange) for?

Individuals and families who don’t qualify for Medicaid but still need affordable coverage. You may also qualify if your employer coverage costs more than 9.5% of your household income.

Eligibility factors for Washington Healthplanfinder™ include:

• Martial status
• Family size
• Household income
• Employer-sponsored coverage costs

Depending on your situation, Washington Healthplanfinder™ may offer:

• Qualified Health Plans with different coverage levels
• Premium tax credits to lower monthly payment
• Apple Health coverage if you meet Medicaid requirements

When should I enroll in Washington Healthplanfinder™

• Open Enrollment for 2026 plans: November 1, 2025 – January 15, 2026
• Special Enrollment: Available if you experience a qualifying life event (losing a job, moving, marriage, birth of a child, etc.).

Delta Dental on the Washington Health Benefit Exchange

Delta Dental of Washington offers two plans through the Washington Health Benefit Exchange:

• 1. Delta Dental Individual and Family™ – Washington Family plan:

This plan is tailored for family coverage. Adults 19 and up are eligible for coverage as well as adults plus their children. You can enroll your whole family on this plan.

• 2. Delta Dental Individual – Washington Kids plan:

This plan is for adults who want to get coverage for their children, ages 0-18. The Washington Kids plan is best if you’re covered somewhere else but still need to find coverage for your children.

Financial Help and Eligibility

Through the Washington Healthplanfinder™, many people qualify for assistance that makes coverage more affordable:

• Premium tax credits lower your monthly payments.
• Cost-sharing reductions help reduce copays, deductibles, and other out-of-pocket costs

Read our step-by-step guide that walks through the basics of how to enroll in a Delta Dental of Washington Health Benefit Exchange plan during open enrollment here.

Other Coverage Options

If you don’t qualify for Apple Health or financial assistance through Washington Healthplanfinder™, you can also:

• Buy individual or family health plans directly from private insurance companies.
• Use employer-sponsored insurance, if offered.

Tips for Choosing a Plan (Including Dental Coverage)

When selecting health or dental coverage, think about your whole health:

• 1. What services will I need?

Consider doctor visits, prescriptions, preventive care, and dental or vision services.

• 2. Are my providers in-network?

Check if your doctors and dentists are covered. Out-of-network visits often cost more.

Even if your health plan offers limited dental coverage, a standalone dental plan can help cover routine checkups, cleanings, and other care that supports your overall health.

Free Help is Available

You don’t have to navigate this alone:

• Call: 1-855-WAFINDER (1-855-923-4633)
• Visit: WashingtonHealthplanfinder.org
• Hours: Monday – Friday

Trained representatives can walk you through your options, confirm eligibility, and help you apply for coverage that fits your needs.