Helping Patients Stay Connected to Care During Upcoming Apple Health Changes

Washington Apple Health (Medicaid) will begin implementing new federal requirements over the coming months and years. While many implementation details continue to evolve, Valley is launching a proactive education campaign to help patients understand what to expect and where to find assistance.

Most changes will occur when patients reach their next scheduled coverage renewal after new requirements take effect, meaning not everyone will be affected at the same time. Some patients—particularly those managing chronic conditions or receiving ongoing treatment—may have questions about maintaining their coverage and avoiding interruptions in care.

Timeline for changes:

• 2026: Eligibility changes will affect certain refugee, asylum-seeking, and other non-citizen adults
• 2027: New work/community engagement, renewal, and retroactive coverage requirements take effect:
  • Most adults enrolled in Apple Health for Adults will be required to work, train, or do 80 hours of community engagement per month, with some exceptions.
  • Those enrolled in Apple Health for Adults will be required to renew coverage every six months instead of every twelve months.
  • Retroactive coverage for Apple Health for Adults will be shortened from three months to one month. All other Apple Health programs will have retroactive coverage shortened to two months.
• July 2027 and beyond: Some adults may begin losing coverage if new rules, re-enrollment not followed
• 2028: Apple Health for Adults will have cost-sharing of up to $35 for many services

Clinicians are not expected to provide detailed insurance guidance or interpret eligibility requirements. Instead, when appropriate, encourage patients to watch for renewal notices, respond promptly to requests from Washington Apple Health or Washington Healthplanfinder. You can direct patients to connect with Valley's Financial Advocacy team at 425.690.3442 or FinancialAdvocates@valleymed.org if they have questions about their coverage.

Helping patients address potential coverage issues early supports continuity of care and reduces the risk of treatment interruptions.

Additional Resources:

• WA Health Care Authority – Changes Coming to Apple Health resource page
• Valley's Apple Health resource page (Encourage patients to learn more at valleymed.org/applehealth)
• Scripting and talking points for conversations with patients
• Roadmap for health insurance changes from Public Health