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Medicare Plans in Washington, DC (District of Columbia) in 2022

As if enrolling in Medicare weren’t confusing enough, where you live can have a significant impact on what plans you have available to you and how much you pay for your coverage. 

Being aware of the Medicare regulations and policies in your area can help you to find the best plan options possible. Read on to learn more about your Medigap, Medicare Advantage, and Part D options in the District of Columbia.

How To Apply for Medicare in Washington, DC

If you are a Washington, D.C. resident who is only interested in enrolling in Original Medicare, you can do so through your local Social Security office. You can sign up in-person, online, or over the phone as early as three months before your 65th birthday.

However, if you want to enroll in a Medicare Advantage plan, Medicare Supplement Insurance, or Part D drug coverage, we recommend contacting a knowledgeable insurance agent. They can walk you through the process and help you to find the right plan for you. 

Reach out to an experienced insurance agent here at Medicare Plans Direct today to speak with a licensed insurance agent and have all of your Medicare-related questions answered.

Medicare Supplement Plans in Washington, DC

Which Medigap plans are available to you in Washington, D.C. will depend on a number of factors, such as which insurance company you enroll with and where you reside.

There were 11,546 Washington, D.C. residents enrolled in Medicare Supplement Insurance plans in 2019. This figure represented only 12.4% of all Medicare enrollees in the District.

That year, Plan F was by far the most popular Medigap plan in DC, with 63% of all Medigap beneficiaries in the District choosing this policy

However, beneficiaries who first became eligible for Medicare on or after January 1, 2020 will no longer be allowed to enroll in Plan F. Plans G and N are good alternatives.

Medigap Enrollment in Washington, DC

If you are interested in enrolling in Medigap insurance in Washington, D.C., the best time to do so is during your Medigap Open Enrollment Period (OEP)

This occurs when you first become eligible for Medicare and enroll in Part B, and it lasts for 6 months. During this time, you can enroll in any Medigap plan offered in your area regardless of your health history.

Unless you qualify for a guaranteed issue right, you may have to undergo medical underwriting if you want to sign up for a Medigap plan after your OEP finalizes. In this case, insurance companies reserve the right to deny you coverage and/or charge you higher premiums. 

In the District of Columbia, only the federal minimum standard guaranteed issue rights are granted to Medicare beneficiaries. Some examples include moving out of your Medicare Advantage plan’s coverage area or losing your employer coverage. 

Federal regulations do not require insurance companies to issue Medigap policies to beneficiaries under the age of 65 who qualify for Medicare because of a disability. Though some states choose to implement guaranteed issue protections for these individuals, the District of Columbia has not done so. 

Washington, D.C. beneficiaries who qualify for Medicare before they turn 65 can try to sign up for Medigap insurance during the first six months that they are enrolled in Medicare Part B. However, insurance companies are not required to provide them coverage. There are some insurers in DC that issue Medigap plans to disability enrollees under the age of 65, but they usually charge these individuals significantly higher monthly premiums. 

People who qualify for Medicare before they turn 65 will have another OEP during the six months following their 65th birthday. When this happens, they are allowed to sign up for any Medigap plan offered in their area without having to undergo medical underwriting.

Medigap Premiums in Washington, DC

According to the Medicare Supplement Insurance plan finder tool, there are 14 insurance companies that offer Medigap policies in Washington, D.C. Each company can decide how they set monthly premiums, and the vast majority of them offer attained-age rated policies. 

With attained-age rated policies, your monthly premium will likely increase as you get older, which is important to consider when choosing a Medigap plan. 

A few companies offer issue-age rated plans. In this case, premiums are determined by the age you were when you enrolled in the policy. 

One company offers plans with community-rated premiums. When it comes to these plans, premium rates are typically the same for everyone in your area. 

Though Medigap plans’ benefits are federally standardized, premium rates can vary significantly between insurance companies. For that reason, we always recommend consulting with a Medicare expert before deciding on a Medicare Supplement policy to ensure that you are getting the best value plan for you. 

Medicare Advantage Plans in Washington, DC

Another coverage option for people looking for more benefits than those offered by Original Medicare is Medicare Advantage. Also known as Part C, these plans provide the coverage that you get under Original Medicare on top of additional benefits, which can include drug coverage, hearing coverage, vision coverage, dental coverage, and more. 

In 2020, 22% of Washington, D.C. Medicare beneficiaries were enrolled in a Medicare Advantage plan. In 2022, there are 16 Medicare Advantage plans available in the District of Columbia. Medicare beneficiaries have access to all 16 Medicare Advantage plans offered in the District. 

When it comes to monthly premiums, what you pay for your Medicare Advantage plan depends on where you live, the plan that you choose, and more. In 2022, the average Part C monthly premium in the District of Columbia is $37.59. Plus, all Medicare enrollees in the state have access to at least one plan with a $0 monthly premium. 

Deciding which is the right Medicare Advantage plan for you is best done with the help of an experienced insurance agent. Here at Medicare Plans Direct we help you make the best Medicare choices possible at no extra cost to you. Reach out today to receive free Medicare advice.

Medicare Part D in Washington, DC

Another thing for Washington, D.C. Medicare beneficiaries to keep in mind are their Medicare Part D prescription drug coverage options. In 2022, there are 21 stand-alone drug plans available to DC Medicare enrollees. 

How much you will have to pay for your Part D premium depends on where you live and which insurance company you purchase your plan through. In 2022, the average Part D premium in the CMS region that encompasses Delaware, the District of Columbia, and Maryland is $42.53. The lowest monthly premium for a stand-alone drug plan in Washington, D.C. is $7.10.

You can also find drug plans with $0 deductibles, though insurance companies usually charge higher monthly premiums for these plans. In 2022, there are three no-deductible plans available to Washington, D.C. residents, and the lowest-cost stand-alone prescription drug plan with a $0 deductible has a monthly premium of $66.50.

It is typically a good idea to enroll in Medicare prescription drug coverage when you are first eligible if you foresee it being necessary in the future. If you don’t sign up for Medicare Part D when you first qualify and don’t have some other form of creditable drug coverage, you could face late enrollment penalty fees down the line.

You can get prescription drug coverage through some Medicare Advantage plans, but if you are enrolled in Original Medicare and/or a Medigap policy, you will need a stand-alone drug plan to cover your prescription medication costs. 

As you can see, it is important to understand the ins and outs of Medicare coverage when choosing a plan. Here at Medicare Plans Direct, we help seniors through the process of enrolling in Medicare. Reach out today for a free consultation with an experienced insurance agent.

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