Apple Health Long-Term Services and Supports (LTSS)

Adult day centers are daytime programs for adults who need some level of supervision and care but not skilled nursing or rehabilitative therapy. Services typically include personal care, social activities, education, routine health monitoring, therapeutic activities, meals and snacks, transportation coordination, first aid, and emergency care.

Adult day health is a daytime program for adults who need skilled nursing care or licensed rehabilitative therapy. Centers provide skilled nursing services, physical/occupational/speech-language therapy, brief psychological or counseling services, plus the personal care, meals, social activities, and health monitoring offered at adult day centers.

"Apple Health" is Washington's name for all of its state medical assistance programs, including Medicaid. "Classic Medicaid" is the part of Apple Health for people who are 65 or older, blind, disabled, or who need long-term care. These programs count your income the same way Supplemental Security Income (SSI) does, rather than using the tax-based rules that apply to younger adults and families. The state Health Care Authority runs most Apple Health programs. The Department of Social and Health Services (DSHS) runs SSI-related coverage, the state-funded Medical Care Services program, and the Medicare Savings Programs that help pay Medicare costs. If you have both Medicare and Apple Health, Apple Health acts as your second layer of coverage and picks up costs Medicare does not, such as deductibles, copays, hearing aids, and dental. It can also pay for long-term care.

Apple Health for Workers with Disabilities lets working adults age 16 or older who are blind or disabled buy into Medicaid. It provides full Apple Health coverage. Unlike most disability-based Medicaid, it has no asset test and no upper income limit. You qualify based on your disability (using the federal disability rules) and being employed, full or part time, including self-employment. You pay a monthly premium that goes up with income but never goes above 7.5% of your total income. American Indians and Alaska Natives pay no premium. While you are enrolled, you can put earnings into a separate designated account that will not count toward your eligibility for other Medicaid programs.