Last updated on: November 15, 2022
Medicare Supplements, also known as Medigap, are private insurance policies that help pay for things that Medicare doesn’t cover in Washington. Only available with original Medicare plans, in WA you cannot combine a medicare supplement plan with Medicare Advantage (MA). MA is used to help supplement Medicare coverage. Medigap only helps cover costs that aren’t taken care of by Medicare parts A and B.
Choosing the right supplement for your needs can be confusing. There are a total of ten standard Medicare Supplemental insurance policies available in the state of Washington. Each of the ten plans, A-N, has the same coverage across every insurance company. What might differ from one insurer to the other, is the premium charged per plan. It is important to note though, that they may not change their prices due to the condition of your health.
There are many factors to consider when choosing the right supplement for you. In the end, your choice will boil down to costs, personal preference, and medical needs. It’s impossible to predict what your future may bring, but choosing the right supplement plan in Washington will help prepare for most eventualities. It will also help protect against draining your retirement fund due to medical emergencies.
What to Consider When Choosing Medicare Supplement Plans in WA
The first in the list of factors to consider is if you meet the criteria. You must be eligible for Medicare and enrolled in either Part A or Part B in Washington, or both. You must also be a resident of the state offering the Medigap plan. If you don’t meet these requirements, you aren’t eligible for a supplement.
Other important factors to be aware of:
- A Medigap plan only covers one person in Washington. A separate plan must be obtained for a spouse.
- The plans do not cover prescription drugs. It is important to enroll in Medicare Part D for prescription coverage
- Premiums must be paid to the private Washington insurance provider monthly.
- No matter your health status, your plan is always renewable.
Once you are sure you meet the criteria and understand the additional factors, there are a few important things to consider if you live in Washington.
Cost of Medicare Supplement in Washington
You must understand what each plan will cost through premiums, deductibles, and other costs. Since every Medigap plan is different, the charge for hospital stays, doctor visits, and medical equippment will vary. Research any out-of-pocket limits and understand all the coverage rules. Medicare has no out-of-pocket limits without supplemental coverage. This is an important factor to consider when deciding whether or not to invest in Medigap.
Take your budget and medical needs into consideration when looking into how expensive of a plan you want to invest in.
Medicare Supplement Coverage in Washington
How well does each policy cover the services you need in WA? Is basic coverage enough, or do you need more? If you are in and out of the hospital frequently with severe conditions, higher coverage is better. If you are in general good health and just need help covering basic costs, more intensive coverage isn’t necessary.
Most Medicare Supplements allow you to see any doctor in the U.S. that accepts Medicare. The plans also help cover treatments in major medical facilities.
Be sure you understand how your supplemental coverage interacts with other coverages. If you have more than one coverage plan, speak to your insurance agent to ensure you comprehend how they work together.
Quality of Care
Are you happy with how you are cared for by your medical professionals? If not, you may need to find a new provider that accepts the plan you have. You might also need to switch to a new plan so you may see the provider that works best for you.
Choice of Doctors and Hospitals
When you are choosing a plan, consider if they allow you to choose your own doctor and hospital. If they require you to choose from a network, are you ok with that? Not all doctors take all medicare supplements. Be sure to choose a doctor that takes your plan and a plan that takes your doctor.
Also, take time to ask if referrals are required to see providers and specialists. Usually, with a Medicare Supplement policy, referrals aren’t necessary, but it is always good to check. Be sure to speak with your insurance agent to obtain all the necessary information.
Travel
Do you travel often? It’s important to note that not all supplemental plans cover international care. Be sure to pick a plan that has travel coverage so you aren’t stuck with difficult-to-cover bills if an accident occurs.
What is Medicare Supplement Coverage in Each Plan in Washington?
Each plan has slightly different coverage and it’s important to understand each one. Please note that you are not eligible for Plans C and F if you become eligible for Medicare on or after January 1, 2021.
Plan A in Washington:
- Medicare Part B Co-payments and Coinsurance
- Up to three pints of blood in case of a transfusion
- Part A hospice care coinsurance or co-payment
Plan B in Washington:
- Everything included in Plan A
- Coverage of part of Part A’s deductible
Plan D in Washington:
- Everything in Plan B
- Covers up to 80% of approved medical expenses outside the U.S. - Emergency treatment only with annual limit
Plan G in Washington:
- Everything in Plan D
- Covers Medicare Part B excess charges
Plan L in Washington:
Covers 75% of:
- Medicare Part B coinsurance or co-payment
- Medicare Part A Deductible
- Blood transfusions up to three pints
- Part A Hospice Care coinsurance or co-payment
- Coinsurance for care at a skilled nursing facility
Plan L has out-of-pocket limits and only covers expenses once you reach the limit.
Plan K in Washington:
Covers 50% of
- Medicare Part B coinsurance or co-payment
- Medicare Part A Deductible
- Blood transfusions up to three pints
- Part A Hospice Care coinsurance or co-payment
- Coinsurance for care at a skilled nursing facility
Plan K has out-of-pocket limits and only covers expenses once you reach the limit.
Plan N and M in Washington:
Partial versions of Plan D. Plan M covers half of Medicare Part A and Plan N covers all of Medicare Part B coinsurance.
With Plan N, emergency room visits that don’t end in inpatient admission cost $50. It also requires a $20 co-payment for doctor’s visits.
Enroll Medicare Washington
At Enroll Medicare, our goal is to make sure you have all the information you need about Medicare and its options in Washington. We want to help you to make the best decision for your future. Choosing the best plan at the best rate shouldn’t be a lonely and confusing path. If you have questions about what you are eligible for and what plan is best for you, visit our website today.
Categories: Medicare Articles, Medigap Plans, Medigap Eligibility, Medigap Coverage
