In Washington, the D-SNPs for people with both Medicare and Apple Health are now called Apple Health Medicare Connect, and joining one does not change what Medicare or Apple Health covers. A Washington D-SNP (dual eligible special needs plan) is a Medicare Advantage plan with Part D drug coverage that the state contracts with for your physical health care, and the Washington State Health Care Authority (HCA) says enrollment is open to every dual-eligible client, including people whose Apple Health only pays Medicare cost-sharing. According to HCA, what a Washington Apple Health Medicare Connect plan adds is one plan for your Medicare and Apple Health coverage, care coordination, and in some plans extra benefits that vary by plan.

In This Guide

What Changes When You Join, and What Doesn't

HCA renamed Washington's D-SNPs Apple Health Medicare Connect. Each one is a Medicare Advantage plan that the state contracts with to provide physical health coverage for people enrolled in both Apple Health (Washington's Medicaid) and Medicare. HCA says enrolling does not change what Medicare or Apple Health covers; it improves care coordination and makes it easier for your providers to make referrals and plan your treatment.

Question What HCA says
Are there extra benefits? Some plans add supplemental benefits beyond what Medicare and Apple Health cover, and these vary by plan
What's the main benefit? One plan for your Medicare and Apple Health coverage, so providers only need to accept one plan
Is drug coverage included? Yes, the plans offer Part D drug coverage

The order of payment stays the same. For a dual-eligible client, HCA says Medicare is your primary coverage for physical health care and Apple Health is your secondary coverage. Long-term care is the exception: HCA's coordination-of-benefits sheet says Medicare does not cover long-term care in your home or another community setting, and Apple Health is the primary payer for it. Our guide to Washington Medicaid HCBS waivers covers how that in-home care is approved.

The Washington State Department of Social and Health Services (DSHS) adds that D-SNPs offer everything Original Medicare offers plus supplemental benefits and services Original Medicare doesn't cover, and that D-SNPs are the only Medicare Advantage plans with both state and federal oversight. For a specific plan's extra benefits, premium and copays, read its Summary of Benefits or ask SHIBA.

Who Can Join a Washington D-SNP

HCA says Apple Health Medicare Connect enrollment is open to all dual-eligible clients, and that a person whose Apple Health only covers Medicare cost-sharing can still enroll. HCA defines the two groups this way:

  • Full-benefit dual eligibles: Medicare clients who qualify for all Apple Health benefits.
  • Partial-benefit dual eligibles: Medicare clients who are also enrolled in a Medicare Savings Program through Apple Health.

Washington's Medicare Savings Programs have no resource test, and in 2026 the Qualified Medicare Beneficiary (QMB) program takes countable monthly income up to $1,463 for one person or $1,984 for a couple, effective April 1, 2026. QMB pays the Medicare Part A and Part B premiums and Medicare coinsurance, copayments and deductibles for Part A, Part B and Part C (Medicare Advantage), subject to state limits, and federal rules bar Medicare providers from billing a QMB enrollee for services and items Medicare covers, including deductibles, coinsurance and copays. That protection applies to Medicare Advantage providers too, so a D-SNP doctor can't bill a QMB member Medicare cost-sharing. Our guide to Washington Medicare Savings Programs covers every tier and how to apply.

People with full Apple Health, people whose Part B premium is paid through a Medicare Savings Program, and people on Supplemental Security Income (SSI) also get Extra Help with Part D drug costs automatically, without a separate application.

Your BHSO Plan and Aligned Enrollment

Washington contracts with its D-SNPs for physical health coverage. HCA says that if you join a D-SNP, your behavioral health care is still covered by your Apple Health Behavioral Health Services Only (BHSO) plan.

You can pick the same company for both, or one company as your D-SNP and another as your BHSO. HCA calls matching them aligned enrollment, and it's an option if you live in a county that offers it. HCA's service area guide has an aligned enrollment map showing the counties where D-SNPs and BHSOs offer aligned enrollment. That guide also notes that Humana does not offer BHSO coverage, so a Humana D-SNP can't be matched with a Humana BHSO plan.

American Indians and Alaska Natives: HCA says a dual-eligible American Indian or Alaska Native can enroll in an Apple Health BHSO or receive Apple Health behavioral health coverage without a plan, and that tribal health clinic and urban Indian clinic staff can help with that choice.

The Six Washington D-SNP Companies

HCA lists six companies offering Apple Health Medicare Connect plans in 2026.

Company What HCA's service area guide says about BHSO
Community Health Plan of Washington Check the guide's aligned enrollment map for your county
Coordinated Care (WellCare) Check the guide's aligned enrollment map for your county
Humana Humana does not offer BHSO coverage
Molina Healthcare of Washington Check the guide's aligned enrollment map for your county
UnitedHealthcare Community Plan of Washington Check the guide's aligned enrollment map for your county
Wellpoint Washington Check the guide's aligned enrollment map for your county

Plans differ by county. The Washington State Office of the Insurance Commissioner (OIC) says Medicare Advantage and special needs plans can vary by county, and HCA's service area matrix shows which D-SNP is in each county.

How to Enroll in Apple Health Medicare Connect

1
Step 1

Check your county

Open HCA's service area guide to see which D-SNPs serve your county and whether aligned enrollment is offered there.

2
Step 2

Check your doctors

HCA says to consult your providers to see which plans they accept.

3
Step 3

Compare plans

Use the Medicare Plan Finder, or call SHIBA for free, unbiased help with Medicare.

4
Step 4

Enroll at an allowed time

HCA says you can enroll during the regular Medicare Advantage enrollment period, and each plan may recommend its own steps. Full-benefit dual eligibles also have a monthly option, explained in the next section.

5
Step 5

Decide about your BHSO plan

HCA says you may change your BHSO plan to match your D-SNP, or keep one company as your D-SNP and another as your BHSO.

What "Highly Integrated" Means for Appeals and Switching

Federal rules define more integrated D-SNP tiers, the highly integrated (HIDE) SNP and the fully integrated (FIDE) SNP, and they are not the same thing. In a FIDE SNP, one company holds both the Medicare Advantage contract with CMS and the Medicaid managed care contract with the state. CMS's contract year 2026 integration-status file lists Washington among the states with highly integrated (HIDE) special needs plans and coordination-only D-SNPs, but not among the states with fully integrated (FIDE) plans or applicable integrated plans, and it marks each of its 9 Washington HIDE plan packages as not an applicable integrated plan. This guide doesn't assign a tier to any named plan; ask the plan or SHIBA about a specific one.

Two practical consequences follow for Washington:

Appeals stay on two tracks. Under federal rules, the single combined Medicare and Medicaid grievance and appeal process belongs to applicable integrated plans: FIDE SNPs, HIDE SNPs with exclusively aligned enrollment, and D-SNPs that state policy limits to members of an affiliated Medicaid plan. Because CMS marks none of Washington's HIDE packages an applicable integrated plan, a Washington D-SNP member shouldn't expect one combined appeal.

The monthly Integrated Care Special Enrollment Period still works, with a condition. Since January 1, 2025, a full-benefit dual eligible can join a FIDE SNP, a HIDE SNP or an applicable integrated plan once a month, effective the first day of the next month. The move must align your D-SNP with your Medicaid managed care plan; partial-benefit dual eligibles and people with only Extra Help can't use this Special Enrollment Period, and a coordination-only D-SNP can't be reached through it. A separate monthly Special Enrollment Period lets full-benefit and partial-benefit dual eligibles and Extra Help enrollees switch to Original Medicare with a standalone Part D drug plan, unless a Part D drug management program has identified them as a potential at-risk or at-risk beneficiary., Our guide to Medicare special enrollment periods covers the other change windows.

Nationally, most D-SNP members are in the least integrated plans: the Medicare Payment Advisory Commission (MedPAC) found that in 2024, 15 percent of all dual eligibles were in HIDE SNPs and 3 percent in FIDE SNPs, while 27 percent were in coordination-only D-SNPs.

If You Lose Apple Health While in a D-SNP

A D-SNP depends on your Medicaid. When a special needs plan expects a member who lost eligibility to requalify within six months, federal rules treat that member as still eligible for a period the plan chooses, from one to six months, and the plan should send a disenrollment notice at least 30 days before ending coverage. Ask your plan how long its period is, and renew Apple Health on time. Our guide to keeping Washington Apple Health covers the renewal process.

What Changes in 2027

Under a federal rule, from 2027 a D-SNP whose company also runs a Medicaid managed care plan for full-benefit dual eligibles in the same area must limit new enrollment to people in, or enrolling in, that company's Medicaid plan; from 2030 it may only enroll or keep those members, and existing members who aren't aligned can stay until 2030. A fee-for-service exception lets a company enroll full-benefit dual eligibles in Medicaid fee-for-service into a coordination-only or HIDE D-SNP, where the state doesn't require Medicaid managed care for all full-benefit dual eligibles and the state contract allows it. Ask SHIBA or your plan whether these limits affect the plan you're in or considering.

Free Help With Washington D-SNPs

The Statewide Health Insurance Benefits Advisors (SHIBA) program gives free, unbiased and confidential help with Medicare. Call 800-562-6900, 8:30 a.m. to 4:30 p.m., Monday through Friday, and ask to be connected with your local SHIBA office; the TDD line is 360-586-0241. Our Washington SHIBA guide explains what a counselor can do for you.

Frequently Asked Questions

Will I still use my ProviderOne card after joining?

Yes. DSHS says a dual-eligible person enrolled in an Apple Health Medicare Connect D-SNP will have a Medicare Advantage D-SNP card and an Apple Health card in addition to their ProviderOne Services card. Expect to carry all three.

My mother only has a Medicare Savings Program. Can she join a D-SNP?

Yes. HCA says a person whose Apple Health covers only Medicare cost-sharing can still enroll in Apple Health Medicare Connect. She can't use the monthly Integrated Care Special Enrollment Period, which is for full-benefit dual eligibles only, so she'd join during a regular Medicare Advantage enrollment period or another window she qualifies for.,

How can I tell whether a specific Washington D-SNP is highly integrated?

CMS's D-SNP integration page carries the current-year list of integrated D-SNPs, and CMS's annual Landscape File records each plan's FIDE, HIDE or applicable integrated plan status alongside its service area. If those files are hard to read, ask the plan directly or call SHIBA at 800-562-6900.

Can I switch from my D-SNP to a regular Medicare Advantage plan mid-year?

Not through the monthly Special Enrollment Periods for dual eligibles, which don't allow enrollment into a Medicare Advantage plan that isn't a D-SNP. You can choose any Medicare Advantage plan during your Initial Enrollment Period, the Open Enrollment Period, the Medicare Advantage Open Enrollment Period, or another Special Enrollment Period you qualify for.

Learn More

MedicareIntegrated Medicare-Medicaid Plans by StateWhether you can get one plan for Medicare and Medicaid depends on your state, sometimes your county. See how each state's integrated dual plans work in 2026. MedicareMedicare and Medicaid Together: Dual Eligibility ExplainedWhat dual eligible means: how Medicare and Medicaid coordinate, full vs. partial duals, QMB cost protection, automatic Extra Help, and integrated D-SNP plans. MedicareMedicare Plans and Coverage in Washington StateMedicare in Washington for 2026: Parts A and B, Medicare Advantage, Part D, the year-round Medigap switching rule, Apple Health MSPs, and free SHIBA help. MedicareWashington SHIBA: Free Medicare CounselingWashington's SHIBA program gives free, unbiased Medicare help. Call 800-562-6900 and ask for your local SHIBA office, or see its help with costs and appeals. MedicaidWashington Medicare Savings ProgramsWashington Medicare Savings Programs 2026: QMB, SLMB, and QI income limits, no asset test, what Apple Health pays, Part D Extra Help, and how to apply. MedicareMedicare Special Needs PlansMedicare Special Needs Plans restrict enrollment to specific groups. Learn the three types, C-SNP, D-SNP, and I-SNP, who qualifies, and how to enroll in 2026.

Find personalized help choosing a Washington dual eligible plan at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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