For Consumers

Medicare and the health insurance Exchange FAQs

The Affordable Care Act (www.hhs.gov) required states to establish a health insurance Exchange. Our state's Exchange is called the Washington Healthplanfinder (www.wahealthplanfinder.org) 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 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.ssa.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.

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.

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 send us a message.

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?

If you are over age 65 and are not entitled to premium-free Medicare Part A, you can buy a plan in the Exchange.

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.