Medicare: Preparing for 65


At YWCA Health Access, we believe that access to health care is a right, and that an important component of health care access is having coverage.

Across the country and in Washington state, the number of people 65 and over is growing. The 65+ population in Washington is expected to be 13.9 next year, and is expected to rise to 18.1 by 2030. As our population ages, it becomes more and more important that seniors understand the services available to them and know how to access them. Most people 65 and older have at least one medical health condition – like diabetes or high blood pressure – so it becomes especially important to receive regular health care to stay on top of these chronic conditions.

MyLocalHealthGuide.com recently published information on Medicare and what is important to know as you approach age 65. Below are some key pieces of information about Medicare. Read the full, original article here, and pass on the information to others in your life who may benefit.

Remembering the difference among Medicare plans can be difficult. Here are the different options available.

  • Original Medicare (Parts A and B) is a federal insurance program that offers basic coverage for hospital care and medical expenses and no coverage for prescriptions. Beneficiaries typically must pay a premium for Part B coverage. Many find they need additional coverage for services not covered by Original Medicare.
  • Medicare Supplement plans pay some of the costs that Original Medicare doesn’t cover, including deductibles and coinsurance. Beneficiaries must pay an additional premium.
  • A Medicare Prescription Drug Plan (PDP), or Medicare Part D, provides prescription drug coverage, helps lower prescription drug expenses and protects against higher costs in the future. Beneficiaries must pay an additional premium.
  • Medicare Advantage (Part C) typically provides extra benefits, services and often prescription drug coverage. Beneficiaries may or may not pay an additional premium.

Did you know there are certain times when you can enroll in Medicare plans? To get coverage starting in 2015, seniors must review plan options and enroll during the window October 15-December 7, 2014. But if you are turning 65 before October, you’re able to enroll earlier in the year. There’s a special Initial Enrollment Period when you can enroll: this window includes the three months before your 65th birthday, the month of your birthday, and the three months following.

For more information about Medicare, how to enroll and other considerations, check out these resources:

Medicare & the Health Benefit Exchange


With all the changes coming out of the Affordable Care Act and the new Health Benefit Exchanges across the country, it can be difficult to stay informed and up-to-date. What has already changed and what changes are coming later? What does this mean for me? What will it mean for my family?

The Washington State Office of the Insurance Commissioner put out some FAQs related to Medicare and the Health Benefit Exchange. (Thanks to the Crisis Clinic for sharing it via their e-newsletter!) I hope the questions and answers below will help you feel more informed. If so, pass on the information to people in your life who would benefit from it!

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 new health insurance Exchange. It’s for people under age 65. People with Medicare, who want to make Medicare coverage changes, should make sure they review Medicare plans and not Exchange options.

Will I lose my Medicare coverage due to health reform and the Exchange?
No. Health reform and the Exchange do not affect your Medicare coverage. You’ll still have the same benefits and security you have now with Medicare.

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 is not part of the new Exchange, so you don’t need to do anything.

Will people on Medicare receive a fine for not buying a health insurance Exchange plan?
No. In fact, it’s against the law for someone who knows you have Medicare to sell you an Exchange plan.

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 Exchange.

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

  • 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.

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 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. Note: Any plan you buy in the Exchange between Oct. 1 and Dec. 31, 2013, won’t take effect until Jan. 1, 2014.

Medicare enrollees can review, compare and join a 2014 plan through December 7, 2013.

Upcoming Events on how the Affordable Care Act impacts Medicare


This month, the State Health Insurance Benefit Advisors (SHIBA) and Senior Housing Assistance Group (SHAG) are partnering to hold four presentations on the Affordable Care Act and its impact on Medicare. Plus – there will be a free lunch for seniors!

DSHS staff will also attend so that individuals can sign up for services that day.

Caregivers are invited to attend and bring their family members who have questions about these topics.

Upcoming Events
Friday, March 15 from 10am-1pm at Tukwila Community Center (12424 42nd Avenue South, Tukwila)

Tuesday, March 26 from 10am-1pm at La Quinta Inn in Tacoma (1425 E. 27th Street, Tacoma)

Thursday, March 28 from 10am-1pm at Bethel Lutheran Church (17418 8th Avenue NE, Shoreline)

Friday, March 29 from 10am-1pm at Steel Lake Presbyterian (1829 S. 308th Street, Federal Way)

SHIBAflyer

Click here to access flyers for each event.

Medicare’s Legacy


As a young woman in my 20s, I’ve always known that Medicare has been around for a while – but I never quite knew when it started or why. Turns out, it’s not been around as long as I thought!

The Kaiser Family Foundation put together a video showing Medicare’s timeline – from rising hospital costs and low life expectancy after the Great Depression, President Truman’s failed attempt to bring national health insurance to the United States in 1945, and the passing of Medicare in 1965.

Give the video below a watch – and see how Medicare came about, how it’s changed over time, and our challenges for the future.

Understanding Health Care Reform


Gilma Reid is an Advocate in the YWCA’s Health Care Access program. She has spent more than 10 years in the human services field, serving low-income women, men and their families and providing them with access to health care services. Over the next few months, she will be sharing information with us about health care reform, and what it means for different populations.

We are all hearing and talking about health care reform just about everywhere in our daily life: in the media, in hospitals, at work, at family reunions, and sometimes even in our place of worship.

The big question is: What does the law mean for each of us?  The Patient Protection and Affordable Care Act (PPACA) itself is very long and complicated. Many of us are still confused and need a little help to understand the law and its implications. 

The new law affects everyone who is a US resident, and whether or not you have medical coverage – including Medicare, Medicaid, employer insurance, small businesses, and people who are moderate- or low-income and people who are uninsured.

We are already seeing some parts of the law being implemented.  For example, children with pre-existing conditions can no longer be denied coverage, the creation of temporal coverage for individuals (adults) with pre-existing conditions (High Risk Pools) until 2014, coverage for adult-children until age 26, the gradual termination of Medicare’s “donut hole,” and Medicare’s elimination of copayment for  annual and prevention check-ups.

The new implementation of this law is meant to provide coverage to 40 million Americans without medical insurance.  For the most part, this will be done by expanding  Medicaid or other coverage subsidies for moderate- or low-income individuals and families, or through state insurances exchanges (private insurances plans) for self-employed or others who are currently uninsured.

Over the coming months, we will take a closer look at how the health care law will affect different groups of people and the role of state and federally support health coverage programs. Stay tuned!

-Gilma Reid