Medicare Plans in Washington in 2022
As you near your Medicare enrollment age, it is important for you to understand your coverage options. This blog post will explore what Medicare plans are available in Washington in 2022 and what they entail.
Being aware of your state-specific Medicare rights can help you to find the best plan options possible. That’s why it’s so important to have a good understanding of the nuances of Medicare in your state. Read on to learn more about your Medigap, Medicare Advantage, and Part D options in Washington.
How To Apply for Medicare in Washington
If you are a Washington 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 you speak with a licensed insurance agent. They can walk you through the process and help you to find the right plan for you.
Reach out to a team member here at Medicare Plans Direct today to have all of your Medicare-related questions answered.
Medicare Supplement Plans in Washington
Which Medigap plans are available to you in Washington will depend on a number of factors, such as which insurance company you enroll with and where you reside.
As of 2019, the most popular Medigap plan in Washington was Plan F, with 56% of Medigap enrollees in the state choosing this policy. The plan offers some of the most comprehensive coverage around.
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
If you are interested in enrolling in Medigap insurance in Washington, 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 Medicare 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 rates.
Some examples of guaranteed issue rights in Washington include moving out of your Medicare Advantage plan’s coverage area and losing your employer coverage.
However, Washington is unique in that it allows people who are already enrolled in Medicare Supplement Insurance to modify their coverage at any time, as long as they were enrolled in a Medigap plan during at least 90 days prior to the change.
Individuals who are enrolled in Plan A are able to switch to Plan A with a different insurance company. However, individuals who have any plan other than Plan A (including a high-deductible plan) can switch to any of the other Medigap plans B-N with any insurance company that offers Medicare Supplement Insurance.
This is a protection that you won’t find in other states, as it is typical to have to undergo medical underwriting even if you are already enrolled in Medicare Supplement Insurance and want to switch to another plan.
Another unique protection provided by Washington law is its limitation on preexisting condition waiting periods. In most states, insurance companies are allowed to instate waiting periods of up to six months for preexisting conditions. However, preexisting condition waiting periods for Medigap plans in Washington cannot exceed three months.
Accordingly, waiting periods can only apply to conditions for which medical advice or treatment was received (or for which treatment was recommended) during the three months immediately before a Medigap policy is issued. Having prior creditable coverage during the three months leading up to Medigap enrollment can shorten these waiting periods.
Medigap in Washington for Disability Enrollees
Beneficiaries under the age of 65 who qualify for Medicare because of a disability are not granted any special Medigap protections in Washington. They can try to enroll in Medicare Supplement Insurance during their 6 month Medigap OEP, but insurance companies are not required to provide them coverage.
According to the Medicare Medigap plan finder tool, there were only three Medigap insurance companies in Washington that sold Medigap plans to beneficiaries under the age of 65 in 2021. But it is common for these individuals to face significantly higher premiums should they choose to enroll in a Medigap plan.
However, the Washington State Health Insurance Pool (WSHIP) offers these individuals the option to enroll in the state’s high-risk health insurance pool. WSHIP makes their Medical Supplement Plan available to Medicare beneficiaries who have been denied Medigap coverage because of health reasons (e.g. disability beneficiaries) and people who live in an area where plans don’t offer coverage (as Medicare Advantage availability is scarce or nonexistent in certain parts of the state).
Many high-risk pools disappeared after the Affordable Care Act eliminated medical underwriting in the private insurance market. Washington, along with a handful of other states, has maintained their pool to provide coverage options to Medicare beneficiaries who aren’t guaranteed access to Medicare Supplement plans.
People who enroll in 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
There were 19 insurance companies that offered Medigap plans in Washington in 2021. State law requires Medicare Supplement Insurance companies to use a community rating system. This means that they cannot base premiums on a beneficiary’s age, and premiums are typically the same for everyone in a given area.
However, this rule only applies to applicants aged 65 and older, as Medigap providers are permitted to charge beneficiaries under the age of 65 higher monthly premiums.
Medicare Advantage Plans in Washington
Another coverage option for people looking for more benefits than those offered by Original Medicare is Medicare Advantage. Also known as Medicare 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.
99% of Medicare beneficiaries have access to at least one Medicare Advantage plan in 2022, and coverage is offered in 37 of the state’s 39 counties. Which Medicare Advantage plan options you have available to you depends on where exactly you reside, as plan availability varies significantly from county to county in Washington.
For example, Medicare enrollees who live in Pierce County can choose between 68 plans in 2022, while residents of smaller counties have significantly fewer options (there are only 3 plans offered in Whitman County).
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 for Washington Medicare beneficiaries is $34.45. And 98% of Washington Medicare enrollees 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
Another thing for Washington Medicare beneficiaries to keep in mind is their Part D prescription drug coverage options. In 2022, there are 23 stand-alone drug plans available to Washington 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 Washington is $48.17.
You can also find drug plans with $0 deductibles, though insurance companies usually charge higher monthly premiums for these plans. In 2022, there are four plans with no deductible available to Washington residents, and the lowest-cost stand-alone drug plan with a $0 deductible has a monthly premium of $68.90.
It is typically a good idea to enroll in 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.
Some Medicare Advantage plans include coverage for your prescription drugs, 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 make well-informed decisions when choosing your Medicare coverage. Here at Medicare Plans Direct, we help seniors navigate their Medicare enrollment journeys. Reach out today for a free consultation with a licensed insurance agent.