Washington Medicare Supplement
Medicare Supplements are were created by the federal government as a means to fill in the gaps that Original Medicare could not, due to budget constraints. Also called Medigap, they are standardized across the country and have the same set of benefits, regardless of the insurance seller, to ensure that all senior citizens in the United States have access to uniform healthcare products and services. In Washington State, there are dozens of insurance providers that offer all 10 or some of the such standardized policies.
What a Medigap Plan Is and Why You Need It
A Medigap plan is sold by private insurance agencies and is designed to shoulder costs that Medicare does not cover, such as deductibles, coinsurance, and copayments. Depending on the type of the policy you have, you stand to pay zero of hospitalization or medical bills when Medicare and Medicare Supplements are combined. There are 10 at present, labeled alphabetically, and each offers a mix of benefits and coverages depending on your monthly budget for premium payments.
The most basic Medigap plan is Plan A, while the most comprehensive (and highest priced) is Plan F. Plan A covers 100% of the cost of Medicare Part A coinsurance or copayment (hospitalization), Medicare Part B coinsurance or copayment (outpatient), the first three pints of blood, and Part A hospice care coinsurance or copayment. Plan F covers all these, plus 100% of skilled nursing facility care coinsurance, Part A deductible, Part B deductible, Part B excess charges, and 80% of foreign travel emergency expenses.
The other policies, Plan B, Plan C, Plan D, Plan G, Plan K, Plan L, Plan M, and Plan N offer different combinations and percentages of coverage of the same benefits.
Generally speaking, Medigap plans are optional and you can certainly purchase another private insurance product or a Medicare Advantage plan in its place. However, the latter two might not have the same set of benefits and could also possibly be more expensive compared to the federal government-regulated Medicare Supplement policies. In addition, given the rising cost of medical expenses and healthcare in general, Medigap plans seem more like a necessity than an option.
Cost of Medicare Supplements in Washington
In Washington, the average cost of Medicare Supplements as of 2018 is $132.41 per month or $1,589 per year. The state belongs to the middle rank across the country, with the highest average recorded in Massachusetts at ____ and the lowest in Hawaii at ___.
It is important to note that these figures are averages, which means the actual cost per policy can go higher or lower, depending on what type of plan you are getting and the insurance provider selling it. Washington insurers, as with other states, are allowed to sell only a selected number of Medigap plans as they see fit, though they are all required to make Plan A available. Companies are also mandated to offer either Plan C or Plan F to those who are not new to Medicare or either Plan D or Plan G to buyers who are new to Medicare.
The type of policy you buy will depend mostly on your capacity to pay, as well as your past and present health status and future health projection. Thus, it is important that you shop around first to find out which providers have the plan you want on offer and to compare how much they sell it for. In addition to deciding what types of plans to make available, insurance providers also have the right to set their own pricing.
When to Apply for a Medigap Policy
The most ideal time to apply for any Medigap plan is during your Open Enrollment Period. This six-month window depends on the date the person applying turns 65 years old. For instance, if you are turning 65 on August 2, then your OEP starts on August 1 and ends six months after. If you were born September 17, then your OEP starts September 1.
It is important that you apply during this time because of the following:
– Insurance providers cannot use medical underwriting to assess your health status
– Insurance providers cannot charge you a higher rate than its regular prices
– Your application is guaranteed approved
If you miss your OEP, then you run the risk of getting disapproved of your application. If you do get approved, then there’s nothing that prohibits your insurance provider from charging you a higher monthly premium.
Also, take note that a Medigap plan is designed for one person only and is not transferrable. If you and your spouse are applying, you will have to purchase a policy separately.
Changes Happening to Medicare Supplements Starting 2020
There are several changes happening to Medigap plans starting the year 2020. Starting January 1, 2020, policies that contain the Part B deductible benefit will no longer be sold to new Medicare beneficiaries. This means that Plan C, Plan F and high-deductible Plan F will no longer be sold. However, if you were able to avail these before the change, then you may continue to use them as usual.
You are not affected of this change if:
– You turn 65 before January 1, 2020
– You become first eligible due to age, ESRD, or disability before January 1, 2020
The second means you can still purchase Plan C or Plan F after January 1, 2020, and will not lose your coverage if you already had one prior. No insurance agent should force you to let go of the policy and purchase a new one because it will still be very much valid. In addition, your Medicare Supplement coverage is also guaranteed renewable, which means the insurance agency cannot cancel your coverage as long you keep paying your premiums diligently.
Have More Questions About Medigap Plans in Washington?
The many aspects surrounding Medigap insurance can be overwhelming, especially if this is your first time. To make things easy, our team of licensed Medicare Supplement advisers are always at the ready to provide you with answers to any question you might have. If you’re still unsure which type of policy would work best for you, we will also guide you through the entire decision making process. Don’t hesitate to get in touch with us at 1-800-791-0150.
