Medicare

Very few government programs will help pay your long-term care expenses. Those that do, have strict eligibility requirements and limits on what is covered.

You should not count on Medicare to pay for your long-term services and supports needs. Medicare pays little or nothing for help with activities of daily living for long periods of time. Medigap insurance (supplemental insurance for Medicare) is not intended to meet long-term services and supports needs; it covers very few long-term services and supports.

What is Medicare?

Medicare is health insurance available to the following individuals:

• People 65 or older
• People under 65 with certain disabilities
• People of any age with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant)

For more information about Medicare coverage and costs:

• Visit the official U.S. government Medicare website.
• Visit the Medicare Coverage: Long-term Care webpage on the Medicare.gov website
• Call 1-800-MEDICARE (1-800-633-4227) for around-the-clock help on coverage options. TTY users should call 1-877-486-2048. Multilingual counseling is available.
• Review the Medicare & You handbook.
• Visit the Medicare information website sponsored by the Washington State Office of the Insurance Commissioner and the Statewide Health Insurance Benefits Advisors (SHIBA).
• Visit the Social Security Administration website to apply for Medicare online.
• See the video, Do you have Medicare and need financial assistance with your health insurance? Sponsored by the National Council on Aging (NCOA)

Resources to help navigate Medicare

Statewide Health Insurance Benefits Advisors (SHIBA)

Do you need help comparing Medicare medical and drug plan coverage? Statewide Health Insurance Benefits Advisors (SHIBA) program counselors give one-on-one help with:

• Understanding Medicare
• Selecting a Medicare prescription drug plan
• Comparing Medicare Advantage plans and Medicare supplement plans
• Applying for Medicare savings programs, including Extra Help with Medicare prescription drug coverage.

Call SHIBA toll-free at 1-800-562-6900 or visit the program’s website to find a local SHIBA office.

Community Living Connections

The CLC’s can provide one-on-one assistance for persons with more complex needs or who are unable to leave their homes with applying for Medicare Savings Programs, including Extra Help with Medicare Prescription Drug Coverage. Find the CLC in your area.

Senior Medicare Patrol (SMP)

The Senior Medicare Patrol (SMP) programs help people receiving Medicare and/or Medicaid, avoid, detect and prevent health care fraud. They protect older adults and help preserve the integrity of the Medicare and Medicaid programs.

You can reach the Program by calling 1-800-562-6900 or email SHIBA.