Medicare Supplement Plans in Washington State

Summary: Washington State offers Medicare Supplement (Medigap) plans consistent with the plans offered across the United States. However, Washington offers unique rules for Medigap enrollment. Estimated Read Time: 9 min

Medicare Supplement plans in Washington State are available to help cover the costs left behind by Original Medicare. Those enrolled in Medicare in Washington State have several options when it comes to Medicare Supplement plans (Medigap). Washington provides unique opportunities and resources to ensure residents have their choice of Medicare coverage.

Below, we help you better understand how Medicare Supplement plans work in Washington and which combination of coverage would be best for you.

Medicare Supplement Plans Washington 

The choices for Medicare Supplement plans in Washington State are the same as those throughout the country. In Washington State, beneficiaries can choose from ten standardized letter plans and two high-deductible options. The benefits of Medicare Supplement (Medigap) plans are the same across the country, but prices vary.

The most popular Medicare Supplement plans in Washington are Medicare Supplement Plan F, Plan G, and Plan N. These plans are popular due to their high coverage and low out-of-pocket costs.

When you enroll in a Medicare Supplement plan in Washington, you will be able to receive care from any doctor or hospital that accepts Original Medicare regardless of the carrier you enroll through. Since Medicare is still your primary coverage, your Medigap plan will follow suit.

Since Medicare Supplement plans have standardized benefits across each plan letter, choosing the best carrier is essential. Carriers do not have to standardize pricing, so it is vital to research plan costs before enrolling with a carrier. Often, monthly premium costs vary significantly from one carrier to another. Hence, the importance of doing your research before enrolling.

State laws in Washington require insurance carriers to rate policies based on a community price for those over 65. This means age will not affect your Medicare Supplement plan premium. Instead, factors such as the level of coverage impact premium costs.

Best Medicare Supplement Plans in Washington

The best Medicare Supplement plan in Washington is dependent on the policyholder who will utilize the benefits. Since every person has a different health background, the necessary benefits for each person vary.

For example, if Sally goes to the doctor twice a month for pain injections and Karen visits the doctor once a year for her annual wellness check, the two women would not need the same benefits. Therefore, the best Medigap plan for Sally would likely not be the best for Karen.

Still, the best plan for most beneficiaries can be found in Medicare Supplement Plan N, Plan G, or Plan F. These plans are the most popular because of their comprehensive coverage and relatively low monthly premiums. One of these three plans can fit almost everyone’s healthcare needs.

Medicare Supplement Plan F Washington State

Medigap Plan F in Washington State covers 100% of your costs after Original Medicare pays its portion. This means you will not pay anything out of pocket for your healthcare, regardless of the cost.

This is a great plan for those who wish to keep their out-of-pocket spending low. However, this plan does have the highest monthly premium. Keep in mind you can only enroll in this plan if you were eligible for Original Medicare before January 1, 2020. If you received Medicare after this date, you’ll need to enroll in a different Medigap plan.

Medicare Supplement Plan G Washington State

In Washington State, Medicare Supplement Plan G is similar to Plan F, yet there is no restriction on who can enroll, and you are responsible for minimal out-of-pocket spending. With Plan G in Washington, you must cover the Medicare Part B deductible before your plan kicks in. Once you meet this annual deductible, you will be covered at 100% by your plan.

Medigap Plan G is popular among new Medicare enrollees due to its low costs and comprehensive out-of-pocket coverage. This plan is the best option for someone living in the Evergreen State who frequently visits the doctor or hospital and wishes to have the most well-rounded coverage possible.

Medicare Supplement Plan N Washington State

Lastly, Medicare Supplement Plan N is an option best suited for those who wish to have coverage in case of an emergency yet wish to keep their monthly premiums low. With this plan, you will cover the Medicare Part B deductible, copayments when you receive care, and excess charges if applicable.

Physicians in Washington State are not restricted from utilizing excess charges if they do not accept Medicare Assignment. To avoid these additional costs, you should speak with your doctor before receiving care. Additionally, if you receive care in a state that does not allow excess charges, you will not be charged the additional fee.

Washington State Medigap Eligibility

In Washington State, the eligibility criteria for Medigap plans are consistent with the requirements set by the federal government for all states. Thus, you must be at least 65 years old and enrolled in Original Medicare, or you must qualify and be enrolled in Original Medicare due to a qualifying disability. You must also reside in the state of Washington to qualify for a Washington Medigap plan and the unique perks that come with the coverage.

It’s important to note that eligibility criteria can vary slightly among insurance companies, so it’s advisable to check with specific insurance providers to understand their requirements and available Medigap plans in Washington State. Additionally, keep in mind that Medigap plans do not cover prescription drugs, so if you want prescription drug coverage, you will need to enroll in a separate Medicare Part D prescription drug plan.

How Much Do Medicare Supplement Plans in Washington Cost?

The cost of a Medicare Supplement plan in Washington is different for each enrollee based on different demographic factors. Your age, health, gender, and tobacco-use status are major indicators of the price you will pay for your Medigap plan in Washington.

However, because this state is community rated, your individual demographics do not play as large of a role as your group demographics. This means regardless of your gender, you will pay the same price as someone else your age in the state of Washington. 

The chart below compares the cost of 65 and 75-year-old men and women non-tobacco users living in the same Washington ZIP Code.

* If on Medicare before 1/1/20

Medicare Supplement Carriers in Washington

As you know, Medigap plan benefits in Washington are standardized. This means benefits do not vary from carrier to carrier. However, choosing the right carrier is an essential step in the enrollment process. Choosing the wrong carrier can be a costly mistake as premiums and rate increases are not standardized, and each carrier can create their own guidelines surrounding your monthly costs.

A few popular carriers in Washington include:

• Aetna
• Cigna
• Mutual of Omaha
• Premera Blue Cross Blue Shield
• State Farm
• United Healthcare
• USAA

Medigap Plans Available to Those Under 65 in Washington

If you become eligible for Medicare Part A and Medicare Part B before turning 65 due to disability, you might question which Medicare policy is best for you. Some states require carriers to offer Medigap plans for disabled individuals under 65. But Washington State does not require Medicare Supplement plan carriers to offer Medigap to those under 65. Yet, some carriers still make this coverage available.

Even if a carrier offers Medigap to beneficiaries under 65 in your area, the premium cost may be higher due to your age and disability status. Premiums for beneficiaries under age 65 are likely to be higher than those who age into the program. So, many Medicare recipients under 65 enroll in a Medicare Advantage plan until they turn 65 and are eligible for community-rated Medicare Supplement premiums.

Medicare Supplement Rating Method in Washington

Washington Medicare Supplement plans are Community Rated. This means that the plan’s premium does not change based on your gender or age. This means that everyone who purchases the same Medigap plan pays the same premium, regardless of whether they are 65 years old or 85 years old.

The purpose of Community Rated Medigap plans is to promote fairness and affordability. It ensures that older beneficiaries are not disproportionately burdened with higher premiums solely based on their age or health status. It also provides stability and predictability in premium costs as individuals age.

You will see an annual rate increase each year when you enroll in a Medigap plan in Washington. However, rather than this being due to age, it will likely be due to outside factors such as inflation.

Medicare Supplement Guaranteed Issue Rights in Washington

Washington allows Medicare beneficiaries special privileges after they enroll in a Medicare Supplement plan. This includes a year-round guaranteed issue right that enables beneficiaries to switch to equal or lesser benefit plans after 90 days of enrolling in a Medicare Supplement plan.

If you wish to change Medigap plans, you can do so at any time without going through medical underwriting. However, this perk is only available to those already enrolled in a Medicare Supplement plan. Washington does not allow beneficiaries without a Medigap plan to join a plan without underwriting unless they are in their one-time Open Enrollment Period or qualify for a Special Enrollment Period.

To qualify, you must be on your current plan for at least 90 days to use this benefit. Once the 90 days are complete, you can switch your Medicare Supplement plans.

Additional Medicare Coverage Options in Washington

In addition to Medicare Supplement plans, Washington also offers an array of additional benefits. If you are not looking for the comprehensive coverage of a Medicare Supplement plan, Medicare Advantage (Medicare Part C) plans are also available.

Additionally, Medicare Part D plans are available to help cover the cost of prescription drugs. If you are taking prescription drugs, having a Medicare Part D plan will help cover your financial burden.

How to Enroll in Medicare Supplement Plans in Washington

Applying for a Medicare Supplement plan in Washington State does not have to be complicated. Having a knowledgeable, licensed Medicare agent by your side can make a difference when choosing your coverage.

At MedicareFAQ, our agents have access to top Medicare Supplement plans and carriers in your area. Thus, we can compare rates for multiple plans simultaneously. This is convenient for the beneficiary and helps agents understand your needs and wants.

Contact us today at the number above to learn more about Medicare Supplement plans in Washington State or use our online rate form.

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