Many residents obtain health insurance by signing up for Washington Medicare insurance coverage. Medicare is a federal national health insurance program for people who are 65 and over, as well as people with certain disabilities and health conditions. The Washington state government also offers various assistance programs to assist Medicare beneficiaries.
Washington Medicare Insurance Trends
The Centers for Medicare & Medicaid Services (CMS) reported the following information on 2022 Medicare trends in Washington:
- Currently, 1,427,600 residents of Washington are enrolled in Medicare.
- The average Medicare Advantage monthly premium went from $37.03 in 2021 to $34.45 in 2022.
- There are 159 Medicare Advantage plans available in Washington.
- 99% of Washington residents have access to a Medicare Advantage plan, and 98% have access to plans with $0 premiums.
- There are 12 different Medigap plans offered in Washington for 2023.
- The lowest monthly premium for a Medicare prescription drug plan is $6.60.
Medicare Offered in Washington
Medicare is a government-sponsored health care program that offers financial assistance to American citizens ages 65 and over or those with disabilities.
The primary coverage comes from Original Medicare, Part A, and Part B. Medicare Part A covers inpatient care in hospitals, critical access hospitals, and skilled nursing facilities. Hospice care and some types of home health care are included as well.
Medicare Part B covers doctor services and outpatient hospital care, and some health care services that are not covered in Medicare Part A. These include physical therapists and the use of durable medical supplies.
Medicare Part A does not typically require premiums, although in some cases, it may be required. Medicare Part B does require premiums based on the beneficiary’s income.
Both Medicare Part A and Part B may also require the beneficiary to pay for out-of-pocket expenses. These include deductibles, copays, and coinsurance costs.
Also known as Medicare Part C, these Medicare Advantage Plans can take the place of Original Medicare. These are also available from private carriers with approval from Medicare. These plans provide the primary benefits included in Original Medicare, plus additional benefits such as coverage for health care services that are not covered by Medicare Part A and Part B.
In 2023, companies offering Medicare Advantage plans in the state, with ratings, include:
- Regence Valience – 4/5 stars
- Community Health Plan of WA – 3.5/5 stars
- United Healthcare
These Medicare Advantage plans are based on medicare.gov and their overall rating of plan quality and performance, found here. The choices for your plan vary depending on the county you live in.
Medicare Supplement Plans
Medicare authorizes many insurance companies in Washington to provide supplemental plans for Original Medicare. These plans, also called Medigap, can cover extra health care services that Original Medicare does not include. People with Medicare Advantage plans don’t qualify for Medigap.
Companies who offer Medigap plans in Washington include:
- AARP – United Healthcare
- Garden State
- Premera BlueCross BlueShield of Washington
- Sentinel Security
- State Farm
Washington Medicare Enrollment
Citizens of Washington are eligible for Medicare if they are a U.S. citizen and above 65 years old, or are under 65 but are permanently disabled, have end-stage renal disease, or Amyotrophic Lateral Sclerosis. Use Medicare’s online eligibility tool to see if you qualify.
- You are 65 or older, and you or your spouse worked and paid Medicare taxes for at least 40 quarters.
- You are under age 65 and collect benefits from Social Security or the Railroad Retirement Board for at least 24 consecutive months.
- You have ESRD or ALS.
Enrollment Period Dates
Initial Enrollment Period
This is a seven-month window that allows you to sign up for a plan
- Begins 3 months before the month you turn 65
- Ends 3 months after the month you turn 65
Medicare Open Enrollment Period
This is when you can sign up for a plan, switch a plan or leave a plan
- Starts October 15th
- Ends December 7th
Special Enrollment Period
Special enrollment periods allow you to enroll outside the regular enrollment periods under specific circumstances.
General Enrollment Period
This is when you can sign up for Medicare Part A and/or Part B if you didn’t sign up when first eligible or if you’re not qualified for a Special Enrollment Period.
- Starts January 1st
- Ends March 31st
Medicare Advantage Open Enrollment Period
This is when you can switch or leave a Medicare Advantage Plan
- Starts January 1st
- Ends March 31st
Washington Enrollment Tips & Advice
Before you decide which plan is right for you and your individual needs, decide whether you want original Medicare or a Medicare Advantage plan, make sure you purchase a separate prescription drug coverage plan and a Medigap policy if you choose original Medicare, and look for a plan that has high ratings if you choose Medicare Advantage.
- Washington State Department of Social and Health Services
- Washington State Office of the Insurance Commissioner
- State Health Insurance Benefits Advisor
How Do I Enroll in a Medicare Plan?
If you’re not sure about your Medicare coverage, talk to one of our licensed agents so that they can find the plan best suited for you. We’ll find a plan that suits your needs and your budget!