Medicare Supplement Plans in the District of Columbia (Washington D.C.)

Summary: Medicare Supplement plans in the District of Columbia help those who qualify save money on healthcare costs. Also known as Medigap plans in D.C., these coverages pick up where Original Medicare leaves off. However, there are other coverages also available to help you cut costs. Estimated Read Time: 13 mins

Table of Contents:

1. Best Medicare Supplement Plan in Washington D.C.
2. Who is Eligible for Medicare Supplement Plans in the District of Columbia?
3. How Much Do Medigap Plans Cost in Washington D.C.?
4. Medicare Supplement Carriers in Washington D.C.
5. Medicare Supplement Plans Under 65 in Washington, D.C.
6. Medicare Supplement Rating Methods in Washington D.C.
7. Medigap Guaranteed Issue Protections in the District of Columbia
8. When to Enroll in Medicare Supplement Plans in the District of Columbia
9. Additional Medicare Coverage for Beneficiaries in Washington D.C.
10. How To Enroll in Medicare Supplement Plans in the District of Columbia

Medicare Supplement plans in the District of Columbia pay secondary to Original Medicare. Also known as Medigap plans, these secondary insurance options cover the costs for which Medicare Part A and Part B (Original Medicare) would otherwise leave the beneficiary responsible.

When enrolled in a Medigap plan in D.C., you can use your coverage nationwide. These plans do not require a network of doctors or referrals for coverage. However, the cost and other factors of the Medicare Supplement plans in the District of Columba can vary slightly depending on carrier and location.

Additionally, all health benefits for each Washington D.C. Medicare Supplement plan are standardized by federal regulations. This means no matter where you reside – or which carrier you choose – plan benefits will be the same for each lettered plan.

There are ten different lettered plans and two high-deductible plan options. But how do you know which one is right for you? Everyone has different healthcare needs and budgets, and while benefits remain the same from carrier to carrier, premiums will not. Below, we review Medigap plans in D.C. available for beneficiaries, how their benefits can help you save on healthcare costs, and much more.

Best Medicare Supplement Plan in Washington, D.C.

Beneficiaries have the option to enroll in one of 12 different Medicare Supplement plans in the District of Columbia. So, how do you know which is the best Medicare Supplement plan in Washington, D.C.?

Medicare Supplement plans in D.C. include ten lettered plans, A through N, and two high-deductible plans. Of the 12 plans available, three stand out as the most popular:

• Medicare Supplement Plan F in Washington D.C.
• Medicare Supplement Plan G in Washington D.C.
• Medicare Supplement Plan N in Washington D.C.

Deciding which of these three plans is best for you depends on your healthcare and budget needs. Take a look at each of the most popular Medicare Supplement plans below to better understand how each level of benefits helps you cover healthcare expenses.

Medicare Supplement Plan F in Washington D.C.

If you visit the doctor or a hospital facility multiple times each month or have a chronic condition and want your medical needs to be covered at 100%, a Medicare Supplement Plan F in Washington, D.C., might be the best option for you. However, while providing the highest level of benefits, Medicare Supplement Plan F in Washington D.C. also comes with the highest monthly premium of the three plans. Here are the benefits you’ll receive when enrolling:

• Deductibles for both parts of Original Medicare
• Coinsurance and copayments for Original Medicare
• Medicare Part B excess charges (when applicable)
• Skilled nursing facility coinsurance costs
• Foreign travel emergency expenses (lifetime benefit limits will apply)

While you’ll receive more benefits enrolling in Medigap Plan F in D.C. than any other lettered plan, it’s important to note that this coverage is only available to beneficiaries eligible for Original Medicare before January 1, 2020.

Medicare Supplement Plan G in Washington D.C.

If you are eligible for Original Medicare on or after January 1, 2020, Medicare Supplement Plan G in Washington, D.C., may be the right option for you. With Medigap Plan G in D.C., you’ll receive almost the exact same coverage as Plan F. The only difference is that beneficiaries are responsible for the Medicare Part B deductible. After the deductible is satisfied, your plan completely covers the remainder of costs after Original Medicare pays.

Medicare Supplement Plan N in Washington D.C.

Suppose you’re looking for an even lower premium and do not mind paying additional out-of-pocket costs, including copayments at the doctor and hospital. In that case, the Medicare Supplement Plan N in Washington, D.C. may be best for you. Medigap Plan N in Washington D.C. provides the ease of supplemental coverage without breaking the bank.

You are responsible for paying your Medicare Part B deductible and excess charges when they pop up. You’ll also need to cover $20 copayments when seeing a doctor or specialist and $50 copayments if you aren’t admitted into an emergency room. Still, even with these expenses, beneficiaries can save on expensive healthcare costs.

Who is Eligible for Medicare Supplement Plans in the District of Columbia?

Anyone eligible for Original Medicare benefits (Medicare Parts A and B) can enroll in Medicare Supplement plans in the District of Columbia. A Washington D.C. Medicare supplement is going to do just that, supplement your Original Medicare benefits. Therefore, you’ll need Original Medicare in order to enroll. Here’s who qualifies for Original Medicare:

• If you’ve turned 65 and are a U.S. citizen or legal resident of five years or more.
• Disabled persons under the age of 65 years old can qualify once they have received two years of Social Security Disability Income (SSDI) payments.
• You become eligible when you receive your diagnosis of amyotrophic lateral sclerosis (ALS).
• You become eligible after four months of receiving dialysis if you receive a diagnosis of end-stage renal disease (ESRD).

How Much Do Medigap Plans Cost in Washington, D.C.?

Determining how much Medigap plans cost in Washington, D.C., can be tricky because many different factors will affect premiums. This includes looking at your age, gender, tobacco usage, ZIP Code, the number of benefits you receive, the carrier you choose, and more.

To better understand what Medicare Supplement plans in the District of Columbia cost on average, we’ve gathered data from Medicare.gov. Below, we examine both 65-year-old and 75-year-old men and women. Everyone used in these examples lives in the same D.C. ZIP Code and abstains from tobacco:

* If eligible for Medicare before 1/1/2020

Remember, the benefits in each lettered plan will be the same no matter which company you sign up with. However, your premiums will vary. To find the right coverage for you, comparing carriers in your area is vital. Working with a licensed insurance agent can help you find the information you need and save time and money as a result.

Medicare Supplement Carriers in Washington D.C.

When shopping among Medicare Supplement carriers in Washington, D.C., the price will inevitably be on your mind. But there are other important metrics you will also want to consider.

You need to be sure that your carrier is top-rated and capable of handling its financial responsibilities to cover the cost of your healthcare. Independent credit agencies, such as A.M. Best or S&P, help consumers better understand where their carriers stand.

Furthermore, you’ll also want to be sure that any Medigap carriers in D.C. you sign up with have good customer service. This will help you gauge how each carrier deals with issues and claims. The Better Business Bureau (BBB) is a significant public resource that can help you better understand how each company operates.

Below, we haven’t captured everybody, but you can find many top-rated Medicare Supplement carriers in Washington, D.C., along with their credit ratings and BBB ratings:

Medicare Supplement Plans Under 65 in Washington, D.C.

Typically, the age of eligibility for Medicare is 65. However, if you receive Social Security Disability Income for 24 months and are under age 65, you are eligible for Medicare. Many states require Medicare Supplement carriers to offer at least one plan to those under 65. However, since Washington, D.C. is not a state, they do not regulate Medicare Supplement plans in the District of Columbia.

The federal government does not require Medicare Supplement plans in D.C. to be available to those under 65. Thus, our nation’s Capital does not require carriers to offer plans to those on disability. However, some carriers in Washington, D.C., voluntarily offer Medicare Supplement plans to those under 65.

Keep in mind that availability is obviously limited, and for the plans that are available, expect to pay a higher premium. For many, it may be beneficial to enroll in a Medicare Advantage plan until turning 65 years old. Disabled persons receive another Open Enrollment Period and can find Medicare Supplement plans in the District of Columbia at normal rates.

In addition to being disabled, you may also qualify for Medicare Supplement plans in D.C. if you are under 65 years old if you have one of the following diagnoses:

• As soon as you are found to have amyotrophic lateral sclerosis (ALS), you are eligible to enroll in Original Medicare.
• Those diagnosed with end-stage renal disease (ESRD) may also qualify for Medicare benefits. However, you’ll first have to undergo dialysis for at least four months before eligibility.

Medicare Supplement Rating Methods in Washington D.C.

Among the various factors that may affect your premiums are Medicare Supplement rating methods. Each has its own stipulations that carriers use to calculate how much you’ll pay for coverage. In Washington, D.C., carriers can use two of the three Medigap rating methods available. Here’s how they affect your premium:

• An attained age rating is going to look at the age you are rather than the age you are at enrollment. In other words, calculations are based on whatever age you are in the present. As you age, you’ll pay higher premiums.
• Plans based on an issue age rating look at the age you are when your benefits are issued. If you are younger, you’ll pay lower premiums. This is why it’s important to sign up at age 65 and avoid higher premiums down the line.

Medigap Guaranteed Issue Protections in the District of Columbia

Signing up for Medicare Supplement plans in the District of Columbia outside of your Medigap Open Enrollment Period complicates things. Most notably, you can be denied coverage or enroll with elevated premiums after facing medical underwriting questions. However, there are qualifying life events that provide guaranteed issue protections, or guaranteed issue rights, that allow you to enroll without dealing with medical underwriting:

• If you leave Medigap for Medicare Advantage the first time, so long as it’s within a year, you can return to a Medicare Supplement plan in D.C. due to your trial right.
• Another trial right can be granted to those switching from Medicare Advantage at age 65 to a Medigap plan in D.C. within the first year of enrollment.
• If you move out of the area where your Medicare Advantage benefits are offered or if your plan is no longer covering you where you live, you will be provided a guaranteed issue right.
• Should you move outside of the service area of your Medicare SELECT plan, you’ll have guaranteed issue protection.GI rights are provided to those who have employer coverage supplementing Medicare benefits that stop doing so.
• If your carrier doesn’t follow the rules or misleads you in any way, you’ll receive a guaranteed issue right.

Finally, if the company providing you with a Medicare Supplement plan in the District of Columbia goes bankrupt, you will also receive a guaranteed issue right.

When to Enroll in Medicare Supplement Plans in the District of Columbia

Enrolling in a Medicare Supplement plan in the District of Columbia is very straightforward. There are only certain times you can enroll in a Washington D.C. Medicare Supplement plan without answering underwriting questions. The first is the Medicare Supplement Open Enrollment Period. This enrollment period begins on the first day of the month you turn 65. It allows beneficiaries six months to enroll in a Medicare Supplement plan in D.C.

The second opportunity you have to enroll in a Medicare Supplement plan without underwriting health questions is when using a guaranteed issue right. The most common scenario is if you delay Medicare Supplement enrollment due to creditable coverage paying secondary to Medicare, then that coverage ends.

If you are outside of your Open Enrollment Period and do not qualify for guaranteed issue rights, you are still eligible to enroll in a Washington D.C. Medicare Supplement plan. However, you will be subject to answering underwriting health questions. This means a carrier can deny your application due to pre-existing health conditions.

Additional Medicare Coverage for Beneficiaries in Washington D.C.

While you may benefit from Medicare Supplement plans in D.C., remember, healthcare needs vary for everyone. This is why it’s essential to explore all of your options. Furthermore, there are some healthcare needs that Medigap plans in D.C. may not cover because Original Medicare benefits don’t cover them.

The good news is that there are alternatives available and additional coverage options that can help you cover healthcare costs. Working with a licensed agent can help you gain a larger scope of your options. These include the following:

Medicare Advantage plans are also available as an alternative to Medicare Supplement plans in the District of Columbia. You can’t have both simultaneously, so you must determine which option is right for your needs before enrolling.

While Medicare Advantage plans can help you cover the same healthcare costs as Original Medicare, it’s worth noting that there are network restrictions to contend with. This means you may be limited in your access to healthcare, and referrals may be needed when receiving care from a specialist.

Prescription drug costs are also an essential consideration for your health and budget, but Original Medicare won’t cover these expenses. There are Medicare Part D prescription drug plans available, however.

You will want to familiarize yourself with each plan’s formulary before enrollment. Offered by private insurance companies, Medicare Part D plans each use their formulary to determine coverage for prescription drugs. The formulary is a list of medications covered by a specific plan. Understanding whether a Part D plan covers your medication is critical for choosing the proper coverage.

Finally, there are some healthcare services Original Medicare doesn’t cover, save for a few exceptions that are far from the norm. Dental, hearing, and vision coverages can be crucial, especially as you age, and standalone policies are available to help you mitigate these costs.

How To Enroll in Medicare Supplement Plans in the District of Columbia

You shouldn’t have to enroll in a Washington D.C. Medicare supplement alone. At MedicareFAQ, our licensed agents are here for you. We take the time to educate you on each option available to you and even guide you through the enrollment process.

To start with an agent today, contact us at the number above or click the compare rates button to receive personalized quotes for Medicare Supplement plans in the District of Columbia.

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