Medicare Supplement Plans in Washington State
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Medicare supplement plans in Washington help Medicare beneficiaries pay some of the health costs not covered by Original Medicare. These Washington Medigap plans cover deductibles, copayments, and coinsurance. There’s a good chance that you will keep the supplement plan you initially choose indefinitely, so it’s important to understand the outline of coverage for each Medicare supplemental plan in Washington, the benefits offered and the way the insurance provider sets its rates.
Overview of Medicare Supplement Plans in Washington State
You buy Medicare supplement plans from private companies. Ten plans are available:
- Plan A
- Plan B
- Plan C
- Plan D
- Plan F
- Plan G
- Plan K
- Plan L
- Plan M
- Plan N
All ten plans pay all or part of the same primary benefits. The basic benefits are:
- Part A hospital and hospice coinsurance or copayments
- Part B coinsurance or copayments
- Part B coinsurance for Medicare preventive care
- First three pints of blood Part A and B
Individual plans may offer additional benefits coverage. Extra benefits include:
- Skilled nursing facility coinsurance
- Part A and B deductibles
- Part B excess charges
- Foreign travel emergency
- Require an out-of-pocket yearly limit
Because Washington Medigap insurance is standardized, Medicare Supplemental Plan N is the same no matter where you reside or which insurance company you buy your policy from. Medicare supplement rates, however, will vary depending on which insurance company handles your policy.
There are 39 counties in Washington. Every county has access to coverage through Medicare supplement plans, but not all plans are offered in each county. For example, Asuris Northwest offers all 10 plans in Chelan County but offers none in Clark County.
Washington State Medicare Enrollment Statistics
Washington has more than 7.17 million residents living in 39 counties. Here are the five largest:
- King, 2.153 million
- Pierce, 859,400
- Snohomish, 789,400
- Clark, 471,000
- Spokane, 499,800
Of the state’s 7.17 million residents, about 12 percent are age 65 or older. The average retirement age in Washington is 64. Here are some other facts about Medicare in Washington:
- Washington State has nearly 1.3 million Medicare beneficiaries representing 17 percent of the population.
- Eighty-five percent have Medicare due to age.
- About 70 percent have Original Medicare; 30 percent have Medicare Advantage.
- Medigap Plan F is the most popular Medicare supplemental plan in Washington.
When Should I Apply for A Washington Medigap Plan?
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To apply for Washington Medigap insurance, you must meet the following conditions:
- Be a resident of Washington
- Be age 65
- Be enrolled in Original Medicare Parts A and B
There is no yearly enrollment period or annual changes for Washington Medicare supplement plans. You can apply to buy a policy or switch plans anytime you want to, but if you are outside of a special open enrollment period, the insurance carrier can require you to pass a health screening.
The best time to buy Washington Medicare supplement insurance is within the first six months that you become eligible. The six-month window starts the month that you are 65 and enrolled in Part B. During your open enrollment period, you have certain protections, called guaranteed rights:
- Insurance companies cannot deny your application.
- Insurance companies cannot make you pass a physical examination or health screening.
- Insurance companies cannot charge you higher rates based on your health history or status.
Medicare supplemental insurance companies can, however, make you wait up to three months before they cover a pre-existing condition. A pre-existing condition is a health concern you had within three months of the date your coverage goes into effect. Insurance companies in Washington cannot exclude that condition for more than three months after your policy becomes effective. If you are replacing your Medigap policy, you had a previous policy in place for at least three months before signing up for WA Medicare supplement insurance, and you did not have a break in coverage for more than 63 days, you will not have any waiting period for your pre-existing condition.
Your guaranteed issue rights expire at the end of the six-month Medicare supplement open enrollment period. It’s critical that you understand that once your guaranteed issue rights expire, you cannot get them back except under a few specific situations:
- You lose Medigap coverage because your carrier goes bankrupt or ends coverage
- You leave an employer’s group health plan, or the group plan ends its coverage
- You move out of the service area covered by your Medicare supplement SELECT plan
- Your Medicare Advantage plan leaves Medicare, discontinues coverage in your area or you move from the coverage area
- You drop coverage or leave a plan because the company deceived you or did not follow regulations in some manner
You also have “trial” guaranteed rights in two situations:
- You dropped a Medigap policy to try a Medicare Advantage or Medicare SELECT plan and want to return to your Medigap policy within 12 months
- You chose a Medicare Advantage or PACE plan when you first joined Medicare Part A, and within 12 months you want to switch to Original Medicare
How Are Washington’s Medicare Supplement Rates Calculated?
The private insurance companies selling Washington Medicare supplemental plans set their premiums. Not all carriers price their Medigap plans the same way, but they typically use one of three methods:
- Community-rated: Monthly premiums are the same for everyone regardless of age.
- Issue age-rated: Monthly rates are calculated based on your age when you buy your WA Medigap plan.
- Attained age-rated: Rates are based on your current, or “attained” age. Rates will increase as you get older.
Washington requires insurance companies to use the community-rated method for pricing their Washington Medicare supplement plans.
Does Washington Affect My Medicare Supplement Price?
The cost of health care in different geographic regions is one of the factors that influence the cost of Medicare supplement insurance. If Medicare spends more because health conditions such as obesity and diabetes are more prevalent or health outcomes are poor because of the socioeconomic levels of the residents, the Medicare supplement price will be higher.
Nationally, Washington State ranks 20th in total Medicare spending and averages about $8,496 a year for each WA beneficiary. The average spending amount also varies among Washington’s 39 counties, as shown by the following:
- Jefferson County, $6,811
- Skagit County, $7,755
- Cowlitz County, $8,316
- Skamania County, $9,280
Do Washington Medicare Supplement Plan Rates Vary by Company?
The outline of coverage for each Medicare supplement plan will be the same throughout the state, but because private insurance carriers set the Medicare supplement rates, the cost can vary widely. Your benefits under Medicare supplement Plan G will be the same in Spokane as in Brewster, but the price will differ in the two zip codes. Some insurance companies offer discounts if your spouse also has coverage through the company, or if you pay your premium either via electronic transfer or in one annual lump sum. These special discounts also account for price differences.
Just as it’s a mistake to assume the more expensive quotes are the best, it’s also a mistake to think that a cheap policy gives you the same high level of service. Insurance companies can range from industry giants to mom-and-pop companies that only sell a few hundred policies a year. Here are some traits to look for that will tell you that the insurance carrier you buy your WA Medigap insurance through can meet its obligations:
- Competitive rates
- Financial strength of the company
- Accurate and prompt claims service
- Customer Service
Because industry reviews show they are stable, reliable companies and offer competitive quotes, especially for Medicare supplement Plan G, we recommend that you buy your WA Medicare supplemental insurance through one of the following companies:
We are not endorsed by any of these companies. We recommend them based on their historically positive performance reviews.
Which Washington Medicare Supplement Plans Should I Compare?
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When you compare quotes for Washington Medicare supplement insurance, it’s important to make sure you’re comparing the same plan and the same benefits package. Which Medigap plan you choose can depend on several factors:
- Your overall health
- The level of risk you’re willing to incur with deductibles
- Your monthly budget
- How often you go to a doctor
Nationally, the three most popular Medigap plans are Medigap Plan F, Medigap Plan G and Medigap Plan N. Here are sample online quotes that will give you an idea of how the costs compare between the three plans. The online quotes are from a well-respected insurance carrier in Washington and based on a non-smoking, 65-year-old female in zip code 98501.
- Medigap Plan F: $227.10
- Medigap Plan G: $175.43
- Medigap Plan N: $140.19
We are not endorsed by this carrier; the quotes are simply to give you an idea of the price difference between the three plans.
Can I Use My Washington Medicare Supplement Plan in Other States?
The beauty of Medicare supplemental insurance is that it can be used anywhere in the country as long as the doctor you see or the health care facility you use accepts Medicare. Crossing state lines is not a problem because there are no preferred provider networks or referral requirements you have to meet. One of the primary benefits of a Medigap insurance plan is that it gives you the freedom to seek the best care, whether it’s in Washington or Maine.
Can I Keep My Washington Medicare Supplement Plan if I Move to Another State?
The Medicare supplement plans offered in WA are the same as in 46 other states. This means that the outline of coverage for Medicare supplement Plan F is the same in North Carolina as it is in Washington. Because the plans are standardized, you can keep your same plan as long as you stay enrolled in Original Medicare. Remember, though, that your premium amount might change in your new location. The cost could go higher or lower because Medicare supplemental rates are based on the cost of health care in specific geographic regions.
Three states — Massachusetts, Minnesota, and Wisconsin — have different standards. If you are planning to move to one of these states, it’s best to call your insurance carrier and find out what your options are.
Do I Have to Change My Washington Medicare Supplement Plan Every Year?
Medicare supplement plans do not require annual changes like Medicare Part D or Medicare Advantage plans do. With Medicare supplement plans, once you choose your plan and your insurance carrier, you do not have to worry about renewing or updating your policy.
Can I Switch Companies for My Washington Medigap Plan in the Future?
You always have the freedom to change insurance companies whenever you want. Just remember that if you change insurance carriers outside of a guaranteed issue right enrollment period, the new insurance company can ask you health questions, deny your request or charge you higher premiums based on your health status. That’s why it is so important to compare companies before buying your WA Medigap insurance.
Can I Purchase a Washington Medicare Supplement Plan if I’m on Disability and Under Age 65?
Washington state law does not require insurance carriers to offer Medicare supplement insurance to those under 65 years old. Some insurance companies may choose to offer Medicare supplement plans to those under 65, but they are allowed to use medical underwriting before issuing you a policy. Medical underwriting means your policy may be limited in coverage and cost more.
Can I Qualify for Extra Help if I’m Low Income?
Washington does not have a program that helps low-income individuals pay for their Medicare supplement insurance. The Medicare Savings Program does, however, offer help paying all or part of your Medicare Part A and Part B premiums, deductibles or copayments if you qualify. The federal Extra Help program provides help with paying your Medicare Part D (prescription drug) premiums. You can apply online or call your local Social Security Administration office and talk with an advisor.
Washington State Medicare Resources
- Office of the Insurance Commissioner
- Statewide Health Insurance Benefits Advisors
- Washington Association of Area Agencies on Aging
- Washington State Council on Aging
How Do I Apply for a Washington Medicare Supplement Plan?
We realize that shopping for Medicare supplement insurance can be confusing. That’s why we take our job seriously and do whatever we can do to help you find the best plan. We can help you compare quotes and provide reviews of the insurance companies licensed to sell Medigap plans in Washington.
We also offer a way to compare 2018 Medicare supplement plans in Washington. To make an online comparison, just choose Washington from the drop-down menu to get started. You can also call us at 888-414-4547 and talk with one of our Medicare specialists. Our Medicare experts can walk you through all of your options; they can even help you enroll over the phone.