Last updated on: November 07, 2022
Think you understand Washington Medicare Supplement Plans? Test your knowledge with these 5 uncommonly known details that apply in Washington!
Many Washington residents are confused about Medicare Supplement Plans, how they work, and whether or not these types of plans are right for them. But Medicare Supplement Plans, also known in Washington as "Medigap Plans", are a great option for people who need to fill in the “gaps” in Original Medicare.
This is how a Medicare Supplement Plan in Washington works (this is the extent of what most people know):
Joan, a 65 year old Washington native, is enrolled in Original Medicare (Parts A and B), and pays her monthly Part B premium. This covers many healthcare-related costs, but not all of them, and not the full amount for all of them. Her copayments aren’t covered, and neither are her deductibles. So Joan looks to enroll in a Medicare Supplement Plan. This plan acts exactly like it sounds – it supplements her Original Medicare. If she has an expensive knee replacement surgery, for example, her Original Medicare would pay its share of the approved amount, and then her Medicare Supplement Plan would pay the rest, or whatever the policy’s share is.
Most Americans with any knowledge of Medicare Supplement/Medigap Plans understand that part. Yet there is much more to Medicare Supplement, and there many reasons why you should consider enrolling in a Medicare Supplement Plan if you are already enrolled in Original Medicare!
Here are 5 facts about Medicare Supplement that you probably don’t know!
1. All plan types – the Medicare Supplement “alphabet” – are standardized across the country. The only difference in Washington is price.
There are 10 types of Medicare Supplement Plans available in Washington, known as Plans A-N (as of January 1, 2020, two of them – Plan F and Plan C – have been phased out and are no longer available to new enrollees, though).
All of these plan types are the same no matter who you purchase them from; they cover the exact same services and costs as other plans with the same letter designation. A Plan G in California offered by one carrier is identical to a Plan G sold in Florida by a different carrier. The only difference is the premium cost!
(The only state exceptions to standardized plans are Massachusetts, Wisconsin, and Minnesota, who standardize their plans differently.)
Think of it like buying gas. When you drive down the road on empty, you’re not really comparing the quality of the gas station’s product, because gas is going to be the same no matter when you get it from. You’re rightfully more concerned about getting the lowest cost per gallon. When you purchase a Medicare Supplement Plan, as soon as you decide what coverage and plan type you want, your only consideration when comparing carriers should be cost.
2. In Washington, Medicare Supplement Plans can save you more than you think in healthcare-related costs.
Most people underestimate just how much a Medigap policy could save them in the state of Washington. Don’t simply think that the only thing a Medicare Supplement Plan is good for is avoiding a $50 deductible; you can save thousands of dollars every year when you purchase a plan. The Part A deductible in 2020 is $1,408. Original Medicare requires that this deductible be met for each 60-day benefit period; that means if you stay in the hospital, and then are admitted again after 60 days anytime that year, you would have to pay the deductible again. Medicare Supplement Plans B, D, G, N, K, M, and L cover either the full or partial deductible amount.
Original Medicare only covers the first 60 days of a hospital stay. From days 61-90, you will have to pay around $352 each day, and from days 91-151, you will have to pay $704 each day. While that many days in a hospital is rare, if there is an unfortunate circumstance and you have to stay longer, you could pay up to $4000 each day. Any of the 8 available Medicare Supplement Plan types covers the costs of days 91-151, and an additional 365 days of coverage.
Parts A and B of Original Medicare cover skilled nursing facility stays up to 21 days; after that, you have to pay $176 per day for the next 79 days. Plans D, G, M, and N cover the total cost of your stay, while plans K and L cover a portion of it.
Medicare Supplement plans also cover the expensive costs of blood transfusions, doctor fees, and foreign travel emergencies. Depending on your health and lifestyle, having a Medigap policy could save you from declaring medical bankruptcy.
3. If you develop a health problem, you can’t be dropped from your plan if you live in Washington and are enrolled in a Medicare Supplement plan.
Any Medicare Supplement Plan is “guaranteed renewable”. This means that even if you develop serious health problems while you are on the plan, your insurance company cannot drop your coverage. They are legally obligated to continue insuring you as long as you continue to pay the plan’s premiums. Say you develop sleep apnea, or diabetes three years after you enroll in a Medicare Supplement Plan – your carrier must continue to provide coverage if you pay your premiums on time.
4. You can choose your own doctors - anywhere in Washington.
Unlike with a Medicare Advantage Plan (another option for filling the gaps in Original Medicare), you can see any doctor or specialist you want, so long as they accept Medicare patients (which most do). You are also not required to have a referral in order to see a specialist. If you go to another state for a period of time, or are traveling, or move, your coverage goes with you – your coverage is not restricted to your network area. This is especially helpful for snowbirds, who spend large portions of the year away from home, or retired adults who travel frequently!
5. In Washington you can change carriers at any time of year.
If you find the same plan type offered in Washington by another Medicare Supplement insurance carrier for a lower premium, or if you realize you need more coverage than what your current Medigap policy offers, or if you realize your plan is covering more than you need and want to find one that offers less benefits and lower premiums, you can switch carriers. While it is best to do this during your six month Medicare Supplement Open Enrollment Period, because your application can’t be turned down. However, you can technically apply for a different Medicare Supplement Plan at any time. If you apply outside of your OEP, you may be faced with a higher premium and medical underwriting. That’s why it’s important to call your insurance company selling the plan you want to switch to and ask about the process!
If you want to learn more about Medicare Supplement insurance, or compare Washington Medicare Supplement Plans and find one that’s right for you, apply with EnrollMedicare! We can help you understand all of your options and simplify the enrollment process. It’s 100% online and 100% free!
Categories: Medicare Articles, Medigap Eligibility, Medigap Coverage
