Medicare Disability Benefits in the State of Washington

If you're disabled, a major concern is securing health insurance coverage. Once you've qualified for Social Security disability and have been on it for two years, you qualify for Medicare, which is federally funded health insurance. Washington has approved several Medicare Supplement, or Medigap, plans that work in conjunction with Medicare, as well as Medicare Advantage plans. Washington also provides assistance to low-income disabled Medicare beneficiaries.

Medicare Overview

• Once you've received Social Security benefits for the required 24 months, you are eligible for Medicare Parts A and B. Medicare Part A covers you if you are hospitalized or if you receive skilled nursing or hospice care. There is no monthly premium for Part A. Part B covers your other medical costs, including visiting your doctor, lab tests and durable medical equipment. There is an ongoing monthly premium for Part B. Both parts have out-of-pocket costs that can be offset by other health insurance. Medicare is federally regulated, so the benefits are the same whether you're in Washington or another state.

Medicare Advantage Plans

• If you're disabled, you also have the option of enrolling in a Medicare Advantage (MA) plan, also known as Medicare Part C. MA plans replace Medicare, although you keep your rights as a Medicare beneficiary. MA plans have lower premiums than other supplemental plans, such as a Medigap policy. MA plans typically include your prescription coverage (also known as Part D) and other benefits for which you can opt in, such as dental and vision coverage. You must have Medicare A and B to enroll in an MA plan, and there is a monthly premium. MA plans are regional; Washington state has approved all plans being sold in the state for its residents.

Part D

• Part D plans are also regional. Washington's Office of the Insurance Commissioner has approved more than 30 plans for its residents. Part D plans are offered through private companies, not Medicare itself. Once you have qualified for Medicare, you have the right to a Part D plan. These plans, though state-approved, aren't standardized, so formularies (drug lists) and plan designs vary. Check with each company as to whether your prescriptions are covered and whether your pharmacy is part of its network.

Other Coverage

• If you have access to group coverage through a family member or through your employment, you can continue that, even when you qualify for Medicare as a result of disability. If you are struggling financially, you may apply for Medicaid, which provides comprehensive, low-cost health care to impoverished seniors and the disabled. This is funded jointly by the federal government and Washington state. You can apply for Medicaid through your local social services office.