Popular questions about Medicare and the Exchange

The Affordable Care Act required states to establish a health insurance Exchange for people by Jan. 1, 2014. Our state's Exchange is called the Washington Healthplanfinder and it's designed to help people shop for and enroll in an individual health plan. If you have health coverage through Medicare, you don't need to do anything. It will not affect your coverage. Below are some common questions we receive from consumers.

I'm currently on Medicare

Do I need to re-enroll in my Medicare plan through the new health insurance Exchange?

No. Medicare’s open enrollment is not part of the Washington Healthplanfinder, our state's Exchange. People with Medicare, who want to make Medicare coverage changes, can do so during the Medicare Open Enrollment Period that occurs annually from Oct. 15 through Dec. 7. People enrolling in Medicare for the first time, should contact the Social Security Administration (www.socialsecurity.gov).

Will I lose my Medicare coverage due to health reform and the Exchange?

No. Medicare is not part of the Washington Healthplanfinder, our state's Exchange.

Do I need a new Medicare card due to health reform?

No. But some people may try to convince you otherwise. Don’t listen to them. Protect your Medicare card just like you would a credit card or your Social Security card.

Will seniors on Medicare have to buy additional insurance due to health reform?

No. Medicare meets the federal government's individual mandate to have health insurance coverage, so you don’t need any additional health insurance.

Will people on Medicare have to pay a fine for not buying health insurance using the Washington Healthplanfinder?

No. Medicare meets the federal government's individual mandate to have health insurance coverage.

Can I go to the Exchange and get the subsidy to help pay for any of my Medicare coverage?

No. People on Medicare are not eligible for the subsidy through the Washington Healthplanfinder, our state's Exchange.

What should I do if someone contacts me about signing up for an Exchange plan and I’m on Medicare?

It's against the law for someone who knows you have Medicare to sell you an Exchange plan.

  • Do Not sign up for an Exchange plan!
  • Do Not share your Medicare number or other personal information with anyone who knocks on your door or contacts you uninvited to sell you a health plan.
  • Do try and get the person’s contact information, such as their name, company they work for, phone number and email.
  • Do report the incident to SHIBA (Statewide Health Insurance Benefits Advisors) at 800-562-6900 or email us.

I'm currently not on Medicare

What if I’m over age 65 and don’t qualify for Medicare – can I buy a plan in the Exchange? And if so, can I get a subsidy?

If you are over age 65 and aren’t eligible for Medicare (you’ve been in the U.S legally for less than 5 years), you may buy a plan in the Exchange. However, you will not receive a subsidy.

I’m about to turn age 65 in a few months and will be eligible for Medicare, should I buy a plan in the Exchange?

If you’re about to turn 65 and you currently don’t have health insurance, you can buy a health plan in the Exchange. However, when you officially enroll in Medicare, you’ll need to drop your Exchange plan.

Updated 08/01/2014

See also

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