Medicare Supplement plans in Washington state pick up where Medicare leaves off. Instead of paying several medical bills, you pay a premium, and the company pays the bills.

Medigap coverage is flexible, reliable, and consistent. You can see any doctor in the United States that accepts Medicare, without a referral.

If Medicare pays, the plan must also pay. Also, Medigap Plan N in Washington is the same coverage as Medigap Plan N in Florida. The only difference will be in the premium.

Washington Medicare Supplement Plans

Medicare Supplement plans are Medigap plans; they cover some out-of-pocket costs such as deductibles and copays that you would pay with standard Medicare.

Washington can provide up to 10 Supplement plans. These plans are all identifiable by a letter ranging from A through N. Without Medigap coverage; beneficiaries are financially at risk for high medical bills.

Let’s say Christina has basic Medicare with prescription coverage. Well, like many people, she thinks this coverage is adequate. However, Christina could quickly put a dent in her savings account with one hospitalization.

See, Medicare doesn’t cover 100% of the expenses; some deductibles and coinsurances quickly add up. Christina develops a heart valve disorder; this becomes an unbearable cost for her without Medigap.

The average cost for a heart valve issue is over $40,000, Christina has deductibles as well as 20% responsibility. If her retirement fund could cry, it would; she could’ve had protection against this expense by enrolling in a supplement.

Medigap Plan F would cover her in full; the deductibles and coinsurances Medicare won’t cover will be the plan’s responsibility.

Christina would pay the Plan F premium and forget the rest. If Medicare covers a service, the plan also covers the benefit. This makes coverage consistent and easy to understand.

Washington Medigap Eligibility Under 65

In certain situations, people receive Part A and Part B before turning 65. Some states require carriers to offer Medicare supplement plans to those on disability under 65.

Washington doesn’t require insurance companies to offer Medigap to beneficiaries under 65. However, some carriers still make coverage available.

The premium for beneficiaries under age 65 is likely to be higher than those turning 65. Please call us for more information on plans available to people under 65 on disability.

Medicare Advantage Plans Washington State

Medicare Advantage plans are an alternative for people that don’t qualify for Medigap or can’t afford Supplement coverage. These plans have limitations and often don’t cover you outside the coverage area.

In 2019, 32% of enrollees in Washington chose a Medicare Advantage plan.

While MA policies have lower premiums, the out of pocket expenses can be comparable to Medicare. The most significant difference is an Advantage policy has a Maximum Out Of Pocket, and Medicare doesn’t.

The MOOP is a safety net that protects you from spending over a certain amount of money during the year.

So, if the MA plan has a MOOP of $6,700, then the most out of pocket expense possible is $6,700.

Medicare doesn’t offer this spending cap to beneficiaries; with Medicare, you can spend tens of thousands of dollars and still be required to pay 20%.

For the most complete coverage, fill out a Medigap application and have coverage with little out of the pocket expense.

Washington Medicare Part D Prescription Plans

Because Original Medicare and Washington Medicare Supplement Plans don’t offer drug prescription coverage, it’s recommended that you purchase a Medicare Part D prescription plan.

This policy covers most medications that your doctor will prescribe, except for any over-the-counter medications.

Enroll in Part D as soon as Medicare begins to prevent a late enrollment penalty. Beneficiaries that delay enrollment will pay more when they purchase a policy in the future. The longer someone goes without coverage, the more they pay to maintain future coverage.

Part D plans are available for about $15 a month; however, the cheapest monthly premium isn’t always the most affordable.

Christina has the $15 policy and pays $110 a month in copayments; her total expense each month is $125. Now, if she enrolls in the $40 policy, her copayments will only cost $50; this means she saves $35 a month by choosing a higher premium policy.

A low premium can be suitable for people with no medications or certain generics. Others should compare plans with an agent to better understand the total medication cost analysis for each plan.

Medicare Resources in Washington

The Medicare Savings Program helps beneficiaries with lower incomes. Recipients that don’t qualify for the MSP could still be eligible for Extra Help paying for prescriptions. Those with MSP automatically qualify for Extra Help.

All recipients should follow CMS Newsroom for information about Medicare.

Washington State Health Insurance Pool (WSHIP) will benefit those that are too high risk to enroll in Medigap coverage.

Premiums for Washington Medicare Supplement Plans

State laws require insurance carriers to rate policies based on a community price. So, age won’t affect the premium. Instead, things like Guarantee Issue, or level of coverage can impact premium costs.

Rates increase based on inflation; community rating can be cheaper than in the long.

Christina could pay $180 a month, and her husband on the same policy will pay the same as her, even if he’s several years older. That’s just an example to illustrate better how community rating works.