WPS Health Insurance Blog

Medicare and the Marketplace: A tale of very distant, not really related, cousins

Posted by Marie Puissant

Feb 25, 2014 9:04:00 AM

Medicare isn’t part of the MarketplaceHealth care reform has led to lots of questions and some confusion with plans now being offered on the Marketplace. But it might seem like there hasn’t been a lot of discussion about how the Marketplace has affected Medicare. I think it’s time we answer that question.

What about Medicare?!?

Good news, Medicare beneficiaries! While your younger siblings, children, and grandchildren are scrambling to find footing in the new health care arena, known as the Marketplace, you do not have to worry. Medicare is not a part of the Marketplace. You don’t have to look for new plans or worry about changes to your current one.

You should still be aware of the deadline for Medicare’s open enrollment period. It runs from Oct. 15 to Dec. 7. During this time, you are able to shop for a private health plan, known as Medicare Advantage, buy a supplemental Medigap plan, or pick a prescription drug policy. For more information on your health insurance options for open enrollment, read about them in this blog post.

Just understand that if you currently have coverage, then you’re covered! That might seem redundant, but it can be confusing with all the warnings about open enrollment for the Marketplace ending in March. But your benefits aren’t changing and the reform doesn’t require you to do … anything!

In fact, health care reform adds to your benefits. Health care reform helps you pay for drugs when you reach the coverage gap, or the “donut hole,” in Medicare prescription drug coverage. Currently, there is a 52.5% discount on brand-name discount drugs and a 28% discount on generic drugs. The discount will increase every year until 2020, where you will only have to pay 25% of the cost of your drugs. For more information on the donut hole and other benefits of health care reform, check out our great brochure Health Care Reform, Medicare, and You.

Basically, what we’re saying is don’t change a thing. You’re doing great! For the majority of seniors, your Medicare coverage and benefits are a much better deal and more affordable compared to those on the Marketplace.

Still not sure? Check out the Healthcare.gov site. They have a section on Medicaid, CHIP, and Medicare. In the Medicare section it asks, “What if I have Medicare?” The answer shouldn’t be a surprise. The site states, “Medicare isn’t part of the Health Insurance Marketplace, so you don’t need to make any changes. If you have Medicare, you are considered covered.”

So what about Medicare? Sit back, relax, and enjoy the benefit of not changing a thing.

Topics: health insurance, Seniors