Medicare Coverage in Washington

Medicare Supplement & Medicare Advantage Plans and Quotes

Initial Enrollment Period

The Initial Enrollment Period (IEP) for Parts A and B is 7 months, starting 3 months before the month of your Medicare eligibility and ending 3 months after the month of eligibility. The month of eligibility is the month of your 65th birthday, if you become eligible for Medicare because you are turning 65 years old.

You simply choose the company and plan that you want with no underwriting.

Special Election Period

You may enroll in a medicare supplement plan without medical underwriting for any of the following reasons:

  • Loss of coverage
  • Moved to new area or state
  • Trial Right: You joined a Medicare Advantage Plan when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decide you want to switch to Original Medicare

Simply Want to Change?

If for some reason you just want to change plans or companies you need to understand that it is most likely that you will have to complete a full health questionnaire as part of your application and have your application underwritten by the company. There is no guarantee that the policy will be issued by the new company. DO NOT cancel your existing coverage until your new policy has been issued.

Washington Medigap Coverage

From Seattle, Tacoma, Everett, Marysville, Mount Vernon, Anacortes, Bremerton, Olympia, Spokane, Tri-Cities, Vancouver and all of Clark County, Moses Lake, Wenatchee, Aberdeen and the rest of the State of Washington it is important that you find the medicare coverage that fits your life and your lifestyle. We feel that the best care is received when you have your choice of Doctors, and you and your Doctor make your medical decisions. Medigap plans in Texas are available with no medical underwriting during your initial enrollment period. This is when you become eligible for Medicare Part B. You may however, apply to a company and fill out the medical underwriting questions at any time.

Medicare Supplemental Insurance (Medigap or MedSup) is specifically designed to supplement Medicare's benefits and is regulated by federal and state law, It must be clearly identified as Medicare Supplemental Insurance and it must provide specific benefits that help fill the gaps in your Medicare coverage. Other kinds of insurance may help you with out-of-pocket health care costs but they do not qualify as Medigap plans.

In Washington there are a lot of companies that sell Medigap Plans and we represent many of them. It's important to us that we can offer the best value to our clients.

How much does Medigap coverage cost?

"The Cost of Medigap policies can vary widely. There can be big differences in the premiums that insurance companies charge for exactly the same coverage."

From the page 19 of the Federal Choosing A Medigap Policy Brochure

Standard Medigap Plans:

To make it easier for you to compare Medigap insurance policies, all states (except Minnesota, Massachusetts and Wisconsin), U.S. territories and the District of Columbia limit the number of different Medigap policies that can be sold in any of those jurisdictions. The plans were developed by the National Association of Insurance Commissioners and incorporated into state and federal law. They have letter designations," with Plan A being the "basic" benefit package. Each of other plans includes package plus different combination additional benefits. Insurance companies are not permitted to change benefits letter designations of any of the plans.

What is Medicare?

Medicare is a national health insurance program for people 65 years of age and older, certain younger disabled people and people with permanent kidney failure. Medicare is run by the Centers for Medicare & Medicaid Services . The Social Security Administration helps CMS by enrolling people in Medicare and by collecting Medicare premiums.

Medicare is divided into two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Part A helps pay for care in a hospital, skilled nursing facility, some home health care, and hospice care. Part B helps pay for doctor bills, outpatient hospital care and other medical services not covered by Part A. Your Medicare card shows the Medicare coverage you have--Hospital Insurance (Part A), Medical Insurance (Part B), or both--and the date your coverage started.

The 2017 Medicare Part A deductible is $1,316 and the 2017 Part B deductible is $183. Part B annual increases are based on Part B medical cost increases and are related to income levels.

Medicare Premiums for 2017:

Part A: (Hospital Insurance) Premium

  • Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
  • The Part A premium is $226.00 per month for people having 30-39 quarters of Medicare-covered employment.
  • The Part A premium is $413.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.

Part B: (Medical Insurance) Premium

The standard monthly premium for Medicare Part B will be $134.00 for 2017, a 10 percent increase from the 2016 premium of $121.80. This may be higher depending on your income.

For those who receive Social Security benefits, the average Part B premium will be about $109.00, compared to $104.90 for the past four years. Individuals will pay a different premium amount in 2017 if:

  • They enroll in Part B for the first time in 2017.
  • They don't get Social Security benefits.
  • They have Medicare and Medicaid, and Medicaid pays their premiums.
  • Their modified adjusted gross income as reported on their IRS tax return from 2 years ago is above a certain amount.

Medicare Deductible and Coinsurance Amounts for 2017:

Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2017 = $1,316) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.

For each benefit period you pay:

  • A total of $1,316 for a hospital stay of 1-60 days.
  • $329 per day for days 61-90 of a hospital stay.
  • $658 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
  • All costs for each day beyond 150 days

Skilled Nursing Facility Coinsurance

  • $164.50 per day for days 21 through 100 each benefit period.

Part B covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment

  • $183.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $166.00 deductible.)

(please see the CMS information on this)

Enrollment in Medicare is handled in two ways: either you are automatically enrolled or you must apply. If you are getting Social Security or Railroad Retirement Board benefits before you turn 65, you are automatically enrolled and your Medicare card will be mailed to you about three months before your 65th birthday. If you are not receiving retirement benefits, you must apply by contacting a Social Security Administration office or, if appropriate, the Railroad Retirement Board. You should apply three months before your 65th birthday to avoid a possible delay in the start of your coverage. If you have been a disabled beneficiary under Social Security or Railroad Retirement for 24 months, you will automatically get a Medicare card in the mail.

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