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COFA Islander Health Care
The Compact of Free Associations (COFA) is an economic and military treaty between the United States and the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau. Individuals from these nations can come and go freely from the United States without work permits nor visas.
Washington Apple Health-Medicaid
The Consolidated Appropriations Act, 2021, (Sec. 208) restored Medicaid benefits for individuals from the Republic of Palau, the Federated States of Micronesia, and the Republic of the Marshall Islands.
COFA islanders receive Apple Health (Medicaid) as qualified non-US citizens who are exempt from the 5-year bar.
Income eligibility for individuals under 65 and without Medicare
| 2026-2027 Income Eligibility for Washington Apple Health | |||||
|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | |
| APPLE HEALTH FOR ADULTS (adults age 19 up to age 64) (138%) |
$1,835 monthly |
$2,490 monthly |
$3,142 monthly |
$3,795 monthly |
$4,449 monthly |
| APPLE HEALTH FOR PREGNANT PEOPLE (198%) |
N/A | $3,879 monthly |
$4,896 monthly |
$5,913 monthly |
$6,932 |
| APPLE HEALTH FOR KIDS (free for children up to age 19) (215%) |
$2,860 monthly |
$3,879 monthly |
$4,869 monthly |
$5,913 monthly |
$6,932 monthly |
| APPLE HEALTH FOR KIDS with premium ($20 monthly premium per child; $40 family maximum) (265%) |
$3,525 monthly |
$4,781 monthly |
$6,034 monthly |
$7,288 monthly |
$8,544 monthly |
| APPLE HEALTH FOR KIDS with premium ($30 monthly premium per child; $60 family maximum) (317%) |
$4,216 monthly |
$5,719 monthly |
$7,218 monthly |
$8,718 monthly |
$10,220 monthly |
**Age 65 and older or have Medicare must apply for Apple Health via Washington Connection
What if you don't qualify for one of the Apple Health programs (above)?
Washington Healthplanfinder offers health insurance with prices that are based on your income. A special enrollment period is a period of time outside the open enrollment period when you can enroll in a new health insurance plan or change your current plan. There are several circumstances where you may qualify for a special enrollment period. To find out if you qualify, call Community Health Access Program (CHAP) 206-284-0331 or 800-756-5437 or visit our assistance page.
Opportunities to buy low-cost insurance on Washington Healthplanfinder:
- Native Americans and Alaska Natives (who are enrolled in a federally recognized tribe) can enroll at any time.
- COFA Islanders who are income eligible can now enroll in Apple Health at any time.