Aged 65 and older or Medicare eligible

Find information about Apple Health eligibility when you are 65 or older, or are eligible for Medicare. 

Now that I am 65 or older, or I have Medicare coverage, do I still qualify for Apple Health coverage?

You may still be eligible for Washington Apple Health Classic Medicaid coverage, even if you have Medicare coverage. 

This coverage could include free coverage, help paying for Medicare premiums, or long-term services and supports.

Eligibility for Apple Health Classic coverage is determined by your household’s income and resources, except for Apple Health for Workers with Disabilities.

How do I apply for Apple Health Classic Medicaid coverage?

If I have Medicare, do I need other coverage?

While Medicare covers many medical expenses, it does not cover everything. If you meet the income and resource limits, Apple Health may help pay for any expenses Medicare does not.

To get help with information about Medicare in your area, visit www.insurance.wa.gov/medicare.

Once I am receiving Medicare, can I keep my same provider?

Check with your provider to see if they accept your new Medicare coverage. Some providers may not accept your new coverage.

Any Apple Health coverage you are approved for when you are receiving Medicare will work as a secondary insurance to Medicare. This means that Medicare will pay first, and other coverage will pay after that. 

I am not eligible to receive Medicare. Do I have other coverage options?

If you are not eligible for Medicare, you may be eligible to purchase a Qualified Health or Dental Plan through Washington Healthplanfinder. You can explore your options:

What are my coverage options now that I am 65 or Medicare eligible?  

Program

Coverage type

How to apply

Medicare eligible

Not Medicare eligible

Apple Health Medicare Savings Programs

Help paying for Medicare premiums, deductibles, and co-insurance

Washington Connection (DSHS)

YES

NO

Apple Health Long-Term Services

Nursing facility, adult family homes, and in-home care

Washington Connection (DSHS)

YES

YES

Apple Health Aged, Blind, or Disabled

Either full or spenddown Medicaid coverage

Washington Connection (DSHS)

YES

YES

Apple Health for Parent/Caretaker Relative

Coverage for parent/caretakers of children age 19 or under

Washington Healthplanfinder

YES

YES

Health and dental plans

Enroll in health and dental plans

Washington Healthplanfinder

NO

YES

 Note:

  • Apple Health eligibility is determined by income and resource limits
  • You may have other private coverage options such as Medicare Supplemental insurance, Tri-Care or insurance from a former employer. For help deciding on options that may work for you, contact SHIBA at the number below.

    Need Help?

    If you need assistance in understanding your health coverage options, contact:

    • Statewide Health Insurance Benefits Advisors (SHIBA)
      For questions about enrolling in Medicare, or if you have other insurance options and need help deciding what is best for you:
      Phone: 1-800-562-6900
      Online: Visit the SHIBA webpage

    • Health Care Authority 
      For questions about Washington Apple Health:
      Phone: 1-800-562-3022

    • Washington Healthplanfinder   
      For questions about enrolling into a Qualified Health or Dental Plan:
      Phone: 1-855-923-4633  

    • DSHS Community Services Division  
      For help applying for health coverage:
      Phone: 1-877-501-2233
    • DSHS Home and Community Services 
      For questions about long-term services and supports (if you need nursing home or help with personal care needs):
      Phone: 1-800-422-3263