FAQ | Medicare & Medicaid

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Will Evergreen pay for Medicare?

  • Evergreen can pay your Medicare Part D Prescription Drug Plan (PDP) monthly premiums. Medicare Part D Prescription Drug Plans are provided through private insurance companies.
  • Evergreen can not pay Medicare Part B premiums or Medicare Advantage Drug Plan (MA-PD) premiums.

Can Evergreen help me if I have Medicaid?

The short answer:

  • If you are eligible for Medicaid or a state-funded medical program operated by DSHS, you are not eligible for Evergreen premium assistance – except to pay for your Medicare Drug Plan or your Healthcare for Workers with Disability (HWD) premium. Please contact the Coordination of Benefits Section of the Medical Assistance Administration of DSHS at 1-800-562-6136 if you have Medicaid and are looking for help with your non-Medicare insurance premiums.

The longer answer:

  • If you have Medicare and Medicaid, we may be able to pay the premium for your Medicare Prescription Drug Plan (PDP) if there is one.
  • We can also pay Healthcare for Workers with Disabilities (HWD) premiums for Medicaid clients who qualify for our program.
  • Evergreen clients who do not have Medicare and become eligible for Medicaid may be able to have their insurance premiums paid by DSHS-Coordination of Benefits (COB). Please contact the Coordination of Benefits Section of the Medical Assistance Administration of DSHS at 1-800-562-6136 to see if you qualify.
  • If you have a spenddown to meet, the Washington State Department of Health may be able help you. Evergreen cannot help with a spenddown.

I have Medicare and a group plan at work. Do I have to enroll in Medicare Part D?

  • No, if your group plan at work is as good as or better than the coverage you could get through Part D, you do not have to enroll in a Medicare Drug Plan.
  • You can ask an Evergreen insurance advocate for information about how to obtain an exemption from enrolling in Medicare Part D by getting a Letter of Creditable Coverage from your plan at work. Please keep a copy of this letter – you will need it when your work coverage eventually ends.

I have Medicaid, so do I have to have Medicare D?

  • If you have Medicaid only, but do not have Medicare, then you do not qualify for Medicare Part D.
  • If you have both Medicaid and Medicare, you will be automatically enrolled in Medicare Part D by DSHS.

What's the difference between Medicaid and Medicare?

  • MEDICAID is limited health coverage you qualify for based on your assets and level of income and your health status. Medicaid is a Washington State program that receives state and federal funding.
  • MEDICARE is federally funded health coverage you are automatically enrolled in if you are retirement age or receive federal disability insurance benefits or other social security payments for more than 24 months. Medicare Part A (hospital) and Part B (medical) are the same throughout the country. Medicare Part D (prescriptions) is offered by private insurance companies and differs from region to region.