Apple Health Medicare Connect, explained

Washington's name for a type of Medicare plan built for people who have both Medicare and Apple Health. Here is what it actually is, and what to check before joining one.

This page explains how the programme works. It does not describe any particular plan, and it does not list benefits, costs or which plans operate in which county — those change by year, by plan and by where you live, and they belong in a conversation about your specific situation rather than on a web page.

What it is

Apple Health Medicare Connect is the name Washington uses for its Dual-Eligible Special Needs Plan programme. A Dual-Eligible Special Needs Plan, usually shortened to D-SNP, is a kind of Medicare Advantage plan limited to people who have both Medicare and Medicaid.

The idea is straightforward: if you have two programmes paying for your care, having them talk to each other should be easier than managing both yourself.

What “coordinate” actually means

You will see the word “coordinate” used a lot about these plans. In practice it usually means the plan is responsible for organising your Medicare services and works alongside your Apple Health coverage, so that fewer things fall between the two.

For some people that is a genuine improvement, particularly if they see several specialists or manage a long-term condition. For others it makes little practical difference. It depends on how much care you actually use.

Who these plans are for

They are for people who have both Medicare and Apple Health. Which kind of dual eligibility you have affects whether you can join, which is why knowing whether you are a full or partial dual matters before anyone starts talking to you about plans.

It is still a Medicare Advantage plan

This gets lost, and it is the most important thing on this page.

A D-SNP is a Medicare Advantage plan. That means it has a provider network, and your doctors have to be in it. Joining one changes how you receive your Medicare — it is not something added on top of what you already have.

In Clark County that carries a specific complication. A great many people here see specialists across the river in Portland, and plans differ enormously in how they handle that. “The plan is available in your county” is not the same as “your Portland cardiologist is covered.”

Network contracts also move. If a clinic changed hands, the organisation holding the contract behind your doctor may not be the one you assume. That is worth verifying by physician name, not by clinic name.

Questions to ask before joining one

Is every doctor I see in this plan's network, by name?
What about my specialists, including any on the Oregon side?
Which hospital would I use, and is it in network?
Are all my prescriptions on this plan's drug list, at what tier?
Is my pharmacy in this plan's network?
What happens to my current coverage if I join, and can I go back?
What would I pay in a year where I need a lot of care, not an average year?

If somebody cannot answer those about a specific plan, that is your answer about whether to enrol through them.

What it is not

It is not extra Medicaid. Joining does not increase your Apple Health coverage, and declining does not reduce it.
It is not free money. If an advertisement leads with a card, an allowance or an amount, it is selling you a plan, not explaining a programme.
It is not automatic. Being dual eligible does not enrol you in anything. Nothing changes unless you choose it.
It is not required. You can have Medicare and Apple Health and never join one of these plans.

If someone called you about this

People with dual eligibility get a lot of calls, and the ones that lead with benefits rather than questions are the ones to be most careful with.

Never give your Medicare number, Social Security number, Medicaid number or bank details to someone who contacted you first. Not to us either. If a plan sounds worth exploring, hang up, look the company up yourself, and call a number you found on your own.

How to find out if you can join

Your dual eligibility category determines it, and Washington determines your category. Ask them rather than a caller.

Ask DSHS: 877-501-2233 Free SHIBA counselling: 800-562-6900

SHIBA counsellors give free, unbiased Medicare help and do not sell insurance. If you want a second opinion on anything a salesperson tells you, that is who to ask.

Questions people actually ask

Is this a new Medicaid program?

No. Apple Health Medicare Connect is Washington's name for a category of Medicare Advantage plan built for people who have both Medicare and Apple Health. Your Apple Health is a separate thing you already have or do not have. Joining one of these plans does not give you Medicaid, and leaving one does not take it away.

Do I have to join one?

No. If you have both Medicare and Apple Health you can keep receiving your Medicare the way you do now. These plans are an option, not a requirement, and nobody at the state will penalise you for declining.

Will my doctors still be covered?

That is the question to answer before anything else, and it is not automatic. These are Medicare Advantage plans and they have provider networks. Check every doctor, specialist and hospital you use, by name, against the specific plan's directory before you enrol. In Clark County that includes checking how the plan handles providers across the river in Portland.

Someone told me I qualify for one. Should I believe them?

Check it yourself. Whether you can join depends on which kind of dual eligibility you have, and a caller does not know your status — Washington HCA and DSHS do. If someone contacted you first, do not give them your Medicare number, Social Security number or Medicaid number under any circumstances.

Can I change my mind after joining?

People in these categories often have opportunities to change coverage outside the usual enrollment windows, but the specific rules depend on your situation and the time of year. Ask before you enrol, not after — and get the answer from the plan or from Medicare rather than from whoever is signing you up.

Official sources

Already approved for Apple Health or a Medicare Savings Program?

Tim can help you review what that means for your Medicare coverage — starting with your doctors and prescriptions rather than with a plan. Whether one of these plans fits is a question that comes after that, not before.

Talk With Tim About Medicare: (360) 472-4261

This line is recorded, as Medicare requires for plan conversations.

Last reviewed September 2026. American Senior Choices does not determine eligibility for government assistance programs. Eligibility is determined by the appropriate government agency. Plan availability, benefits and rules vary by plan, county and year, and can change.

Disclaimer: American Senior Choices is not affiliated with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent 5 organizations which offer 33 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.