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Qualifications
To qualify for AEM, an individual must have or need at least one of the following:
- A qualifying emergent medical condition such as emergency room care, inpatient admission, or outpatient surgery
- A cancer treatment plan
- Dialysis treatment
- Antirejection medication for a postorgan transplant or on long-term care services (LTC)
- Assessment and treatment for the COVID-19 virus
Income qualifications
Income qualifications are determined by the eligibility requirements and income listed below:
Modified Adjusted Gross Income (MAGI) Medicaid, Processed by the Washington State Health Care Authority (HCA)
- Individual is age 19 through 64
- Individual is not eligible for Medicare; and
- Follows MAGI rules established through the Healthplanfinder.
| Total number in family (including yourself) | Monthly income limit for free coverage |
Annual income limit for free coverage |
|---|---|---|
| 1 | $1,780 | $21,597 |
| 2 | $2,433 | $29,187 |
| 3 | $3,065 | $36,777 |
| 4 | $3,697 | $44,367 |
| 5 | $4,330 | $51,957 |
| 6 | $4,962 | $59,547 |
Classic Medicaid, processed by the WA State Dept. of Social and Health Services
- Individual is age 65 or older and is not a caretaker for a child under age 19;
- Individual is eligible for Medicare; or
- Individual is receiving long-term care services and not relatable to a MAGI program.
| Single Eligible | Eligible Couple | |
|---|---|---|
| Income | $967 | $1,450 |
| Resources | $2,000 | $3,000 |