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Clark County providers · Medicare

Sea Mar and Medicare in Clark County

If you have Medicare and Apple Health both, your options are different from most people’s — and something may be changing for 2027.

The short answer

Sea Mar accepts Medicare, Apple Health and most private insurance, and runs a sliding fee scale. Many of its patients have both Medicare and Apple Health, which is called being dual eligible. That opens a category of plan built for exactly that situation — and federal rules for 2027 may narrow which of those plans you can join, so it is worth asking about before Annual Enrollment closes on December 7.

What Sea Mar is

Sea Mar Community Health Centers is a community health organization with clinics across Washington, including in Vancouver. It provides medical, dental, behavioural health and maternal health services, and operates a sliding fee scale, so cost is assessed against what you can pay rather than being a flat price.

  • East Vancouver — 19005 SE 34th St, Vancouver, WA 98683
  • Fourth Plain — 6100 NE Fourth Plain Blvd, Vancouver, WA 98661

Something worth knowing: Sea Mar keeps staff at its clinics whose job is helping patients work out which benefit programs they qualify for. If you are not sure what you are eligible for, that is a real resource and it costs nothing to ask.

Having both Medicare and Apple Health

Apple Health is Washington’s Medicaid program. Plenty of people have Medicare and Apple Health at the same time, and that combination is called being dual eligible. Medicare is your primary coverage; Apple Health helps with costs Medicare leaves behind, which depending on your category can include premiums, deductibles and cost sharing.

It usually also means you qualify automatically for Extra Help, the federal programme that reduces what you pay for prescriptions. A lot of people who qualify never claim it, simply because nobody told them it existed.

There is a category of Medicare Advantage plan built for this situation, called a Dual Eligible Special Needs Plan or D-SNP. The idea is to coordinate the Medicare side and the Medicaid side together rather than leaving you to run two systems in parallel. Whether one fits depends on your providers and your medications, the same as any other plan.

Ask about this one specifically for 2027

Federal rules taking effect for the 2027 plan year push Medicare Advantage and Medicaid managed care toward tighter integration. In practice that may mean some carriers consolidate their dual eligible offerings in a county, or limit enrollment to people already in that carrier’s Apple Health managed care plan.

If that applies where you live, which Apple Health plan you are already in could narrow which dual eligible plans you can join. It is not something to assume either way — find out which Apple Health plan you have before you choose, and raise it explicitly at any review.

Free help that is not selling you anything

Washington runs SHIBA, Statewide Health Insurance Benefits Advisors — free, unbiased Medicare counselling from trained volunteers who do not sell insurance and have nothing to gain from your decision. You can also call 1-800-MEDICARE or use Medicare.gov. We mention this because you should know it exists. Getting a second opinion from someone with no stake is a reasonable thing to do, and anyone who discourages it is telling you something.

How to confirm your plan works at Sea Mar

Network participation changes every year, and it can differ from one physician to the next inside the same organization. Do not rely on any website for this, including ours. Confirm it against a live source before you enroll, and confirm it again if you change plans.

  1. 01

    Check the plan's own provider directory

    Every Medicare plan publishes a searchable directory. Search for your specific doctors by name, not just for Sea Mar. The system can be contracted while an individual provider is not.

  2. 02

    Call the number on the back of your plan card

    Ask them to confirm, on the record, that your named providers are in network for the coming plan year. Ask for a reference number for the call.

  3. 03

    Call Sea Mar billing directly

    Ask which Medicare plans they are contracted with for the coming year. Providers know their own contracts, and they will tell you plainly if something is changing.

Two things that catch people out

The system is not the doctor. A health system can hold a contract with a plan while a particular clinic or physician inside it does not participate. Always verify by provider name.

Directories go stale. Published directories lag behind actual contracting. A phone confirmation from the plan, with a reference number, is worth more than a screenshot.

Or bring me your list and I will check it

Bring your doctors, your prescriptions, and your current plan. I check your specific providers against the plans available to you, using live data rather than a page that could be months old. No cost, and no obligation to change anything.

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Or call (360) 472-4261 · What is changing in 2027

Questions people actually ask

Does Sea Mar accept Medicare?+

Yes. Sea Mar Community Health Centers accept Medicare, Washington Apple Health (the state's Medicaid program), and most private insurance, and they operate a sliding fee scale. Whether a specific Medicare Advantage plan contracts with them is a separate question worth verifying before you enroll.

What does it mean to have both Medicare and Apple Health?+

It is called being dual eligible, and it is common. Medicare is your primary coverage and Apple Health helps with costs Medicare does not cover, which can include premiums, deductibles and cost sharing depending on which category you qualify for. It also usually means you automatically qualify for Extra Help with prescription costs.

Are there Medicare plans made for people who are dual eligible?+

Yes. They are called Dual Eligible Special Needs Plans, or D-SNPs — a category of Medicare Advantage plan designed to coordinate Medicare and Medicaid benefits together instead of leaving you to manage two systems. Whether one is a good fit depends on your situation, your providers and your medications.

Is anything changing for dual eligible plans in 2027?+

Possibly, and it is worth asking about specifically. Federal rules taking effect for the 2027 plan year push toward tighter integration between Medicare Advantage plans and Medicaid managed care. In practice that may mean some carriers consolidate their dual eligible offerings in a county, or limit enrollment to people who are already in that carrier's Apple Health managed care plan. Confirm which Apple Health plan you are in before choosing, because it may narrow your options.

Can I get free help that is not from an agent?+

Yes, and it is worth knowing about. SHIBA — Statewide Health Insurance Benefits Advisors — is Washington's free, unbiased Medicare counselling program, staffed by trained volunteers who do not sell anything. You can also call 1-800-MEDICARE or use Medicare.gov. Sea Mar itself has staff at its clinics who help patients work out which benefit programs they qualify for.

Do I have to pay to work with a broker?+

No. Independent brokers are paid by the insurance carrier, not by you, and your premium is identical whether you enroll through a broker, directly with the plan, or on your own. If cost is a concern, that concern should not stop you getting help.

Related

Last reviewed August 30, 2026. Clinic and service details reflect Sea Mar’s publicly published information. American Senior Choices is not affiliated with Sea Mar. Eligibility for Apple Health, Extra Help and dual eligible plans depends on your individual circumstances and is determined by the relevant agency, not by us — confirm with Washington Health Care Authority, Medicare.gov, or 1-800-MEDICARE.

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 11 organizations which offer 70 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.