October 6, 2016
Washington residents enrolled in Original Medicare (Part A and Part B) have the option to enroll in a Medicare Supplement (Medigap) plan to cover the out-of-pocket costs that Original Medicare does not cover, including deductibles, copayments, coinsurance, and other out-of-pocket expenses. In most states, there are 10 standardized Medigap policy options, each labeled with a letter with all plans of the same letter offering the same benefits.
Generally, Medicare Supplement (Medigap) plan enrollment is available to Washington residents who are age 65 and older. The Medigap Open Enrollment Period begins the first day of the month when Washington beneficiaries turn age 65 or older and enroll in Part B, and the Medicare Supplement Open Enrollment Period lasts for six months. During this period, Medicare beneficiaries are generally able to enroll in a Medicare Supplement plan with an insurance company without being subject to medical underwriting (although waiting periods may apply). Medical underwriting is when insurance companies use previous medical and health conditions to limit, refuse, or charge more for health coverage. Insurance companies in Washington aren’t required to offer Medicare Supplement enrollment to beneficiaries under the age of 65. Some companies may offer to sell Medigap policies to those under 65, but due to the use of medical underwriting, coverage may be limited and cost more.
Please refer to the chart below that shows the 10 standardized Medigap plans, which may be available in Washington, so you can understand how each Medicare Supplement plan works alongside Original Medicare to help cover out-of-pocket expenses. In this chart, X indicates that the service (or item) is 100% covered; a percentage indicates what percent of the service/item is covered; and a blank cell indicates it is not covered.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional
365 days after Medicare benefits are exhausted
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility (SNF) care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B ‘excess charges’||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Medicare Part B preventive care coinsurance||X||X||X||X||X||X||X||X||X||X|
|Out-of-pocket limits apply**|
*Medicare Supplement Plan F offers a high-deductible version in which beneficiaries pay a certain deductible amount before the plan begins coverage. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for a copayment of up to $20 on doctor visits and up to $50 on emergency room visits that don’t result in an inpatient admission.
Medigap plan benefits in Washington do not vary between plans for the same type (labeled by a letters A through N). However, the costs for each Medigap plan will vary depending on which carrier is offering the plan. Washington Medicare beneficiaries should first see what Medicare Supplement plans are available in their state, decide which plan type is best for their health needs, and then customize their search to find a Medigap plan that may suit their budget.
Comparison shopping is vital when purchasing a Medigap policy in Washington. To start comparing Medicare Supplement plans in Washington today, enter your zip code above for a customized list of plans available in your area.
Learn more about how Medicare plans work in Washington including:
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.