How Updates to Apple Mail in iOS 18 May Impact Your Healthcare Marketing Efforts

The latest Apple Mail updates in iOS 18 will directly impact how healthcare organizations engage clinicians via email. With Apple accounting for over 55% of all email engagement by operating system, it’s essential that healthcare marketers adapt to these platform changes quickly and effectively.

At HealthLink Dimensions, we deploy compliant, high-performing email campaigns to more than 1.5 million U.S. clinicians each month—delivering messages that are not just timely, but truly relevant. As Zack Aab, Email Deliverability Specialist at HealthLink, puts it: “The right message in front of the wrong person is not the right message. Success in email requires active collaboration between creative and data.”

Here’s what these iOS updates mean for healthcare marketers—and how to stay ahead.

Three Apple Mail Changes That Could Disrupt Your Campaign Performance 

1. Branded Mail: BIMI Comes to Apple Mail 

Apple now supports Brand Indicators for Message Identification (BIMI), which displays your verified logo next to your sender name and email address. For healthcare marketers, this is a valuable opportunity to: 

• Reinforce credibility with busy medical professionals 
• Increase brand trust and recognition at a glance 
• Differentiate messages from anonymous or unverified sources 

We recommend prioritizing BIMI to activate your branded logo—and ensure it aligns with the trust clinicians place in your communications. 

2. Apple Introduces Inbox Categories

Apple Mail now sorts incoming messages into four tabs: Primary, Transactions, Updates, and Promotions. While this creates a cleaner inbox for users, it risks burying high-value clinical or operational messages in secondary tabs. For example:

• CE/CME invitations, clinical trial updates, or formulary notices may be classified as Promotions 
• Critical campaign messages could miss peak visibility periods

Although these messages may not appear in the Primary tab, there is no indication that the new Apple Inbox Categories will send them to spam or junk folders. It is also important to note that Apple uses a complex algorithm, in addition to user feedback, to determine which emails get sent to the Primary tab. Attempts to game the system may result in negative effects to campaign performance and hurt your sender reputation. 

3. Brand Message Grouping

Apple Mail will now bundle all emails from the same brand together. While this may declutter the inbox, it can unintentionally: 

• Hide timely messages in a thread view 
• Delay visibility for new content, such as trigger-based follow-ups or product announcements 

For campaigns leveraging HealthLink Dimensions’ behavioral triggers (e.g., follow-up emails based on HCP engagement), this update underscores the importance of clean creative, sharp subject lines, and coordinated deployment cadence. 

AI in Apple Mail: Three New Changes to Navigate 

Apple’s new Apple Intelligence AI tools will reshape how emails are interpreted and displayed. Here's what you need to know: 

1. Pre-Open AI Summaries Replace Preheader Text 

Apple now replaces the preview made from your preheader text with a two-line AI-generated summary of your message. Emails that rely on preheader text or graphic-heavy content may lose impact. To avoid misrepresentation: 

• Use text-based HTML with strong introductory copy 
• Make sure the plaintext versions of your html emails are cleanly formatted and easy to read 
• Make your call to action visible early and in text—not just in an image