Original Medicare provides fairly comprehensive coverage, and allows you to see any doctor who accepts Medicare nationwide. But, while it’s a great program, you might find, like many Medicare recipients, that the out-of-pocket expenses associated with it are a burden. Like the 20% Medicare Part B coinsurance. If this is the case, or if you simply want to save some money, you should seek additional coverage through a Washington Medicare Supplement Plan.
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Medicare Supplement Plans are sold by private insurance companies to fill the coverage gaps in Medicare Parts A and B. Typically including your Part A deductible and Part B coinsurance of 20%. The government does standardize these plans, though. The Centers for Medicare & Medicaid Services (CMS) regulates Medicare Supplement Plans. CMS mandates that all plans with the same letter name provide the same benefit coverage nationwide.
Nevertheless, premiums can vary based on the insurance company you select, so it is essential to compare both Medicare Supplement Plans and insurers to find the best plan for you. EZ can assist you with comparing both, but first you should review our guide to Medicare Supplement Plans in Washington.
Washington Medicare Supplement Plans
A Medicare Supplement Plan is your best option if you require additional coverage to fill the gaps in Original Medicare. Such as the 20% coinsurance you must pay each time you access Medicare Part B services.
The first thing you should know if you’re looking for a Medicare Supplement Plan in Washington is that there are ten standardized plans. Each bearing a different letter of the alphabet (A, B, C, D, F, G, K, L, M, and N). Plan A must be made available by all insurance companies. Plans C and F are only available to those who became Medicare-eligible prior to January 1, 2020.
In Washington, monthly premiums for Medicare Supplement Plans can range from $61 to $465, depending on the plan and your location. With so many options available, it can be difficult to keep track of everything. So, we’ve outlined the coverage of each plan to help you get started.
Plan A
Plan A is the most basic Medicare Supplement Plan available. But despite its simplicity, it will cover what is arguably the most important thing that Medicare Supplement Plans cover: the 20% of outpatient treatments not covered by Medicare Part B. It also covers a select few other major expenses, as outlined below.
Plan A must be offered by all Medicare insurance providers, but some states do not require insurers to offer it to Medicare disability beneficiaries under the age of 65.
In Washington, Plan A premiums range from $132 to $334 a month.
Plan B
Medicare Supplement Plan B covers everything that Plan A does, including:
- Medicare Part A coinsurance and hospital costs – Part A only fully covers your first 60 days of inpatient hospital stays in a benefit period, after that you are required to pay a portion of your bills for each day after your initial 60 days. Days 61-90 have a coinsurance of $400 a day. If your stay is between 91 and 150 days, and you use your Lifetime Reserve days, your coinsurance will be $800 a day. Plan B covers 100% of these costs.
- Medicare Part B coinsurance or copay – You’ll typically have to pay Medicare Part B coinsurance for doctor visits and other outpatient care. That means Medicare Part B pays 80% of the Medicare-approved amount for covered services, leaving you to pay the remaining 20%. Plan B covers 100% of this.
- First 3 pints of blood – Original Medicare only pays for the fourth and subsequent pints of blood if you need blood during treatment. Plan B will pay for the first three pints.
- Part A hospice care and coinsurance – Hospice care is for patients who are nearing the end of their lives. These services are covered by Medicare, but copayments are required. These copayments include $5 for each symptom and pain relief medication prescription, as well as 5% of the Medicare-approved amount for inpatient assisted living. Plan B covers all expenses related to hospice care.
What makes Plan B a little less basic than Plan A is that it covers the Medicare Part A hospital deductible, which Plan A doesn’t. The Medicare Part A deductible is $1,600 per benefit period in 2023, and because this deductible is not charged annually, but rather based on 60-day benefit periods, you may be required to pay it multiple times in a single year. That means having a plan that covers this could be very advantageous.
In Washington, Plan B premiums range from $199 to $372 a month.
Plan C
This is one of the most comprehensive Medicare Supplement Plans on the market. Plan C covers everything except for Medicare Part B excess charges. This means Plan C covers both your Parts A and B deductibles, as well as the 20% coinsurance you’d normally have to pay for all outpatient care, as well as everything else.
Coverage includes the following:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B coinsurance and copayments
- Part B deductible
- Other Medicare-approved expenses associated with Part B coverage
Plan C is no longer available to Medicare recipients who became eligible for Medicare after January 1, 2020. If you had Plan C prior to that date, you can keep it, and if you were Medicare-eligible prior to January 1, 2020 but have not yet enrolled, you may still be able to purchase it.
Plan C monthly premiums in Washington range from $234 to $461.
Plan D
Medicare Supplement Plan D covers the majority of out-of-pocket medical expenses, including:
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Part B coinsurance
- First 3 pints of blood
- Skilled nursing facility (SNF) care coinsurance – After the 20th day of your stay as an inpatient in a skilled nursing facility, Medicare Part A requires you to pay coinsurance. Part A coinsurance for skilled nursing facility care is $200 per day in 2023.
- Part A deductible
- 80% of foreign travel emergency costs (up to plan limits)
Plan D does not cover the Medicare Part B deductible or Part B excess charges. If your doctor refuses to accept Medicare assignment, they can charge you more than Medicare will pay for the service, and you will have to pay the difference, known as an excess charge. Again, Plan D does not cover these excess charges, so if you think you might want to see providers who don’t accept Medicare assignment, you should look for a different plan.
In Washington, Plan D premiums can range from $206 to $398 a month.
Plan F
Medicare Supplement Plan F has long been the best-selling plan on the market. It covers all of your out-of-pocket expenses, meaning you’ll only pay your monthly Plan F premium if you have this plan. The covered expenses include:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B 20% coinsurance and copayments
- Medicare-approved doctor’s office fees
- Part B deductible
- Medicare Part B excess charges
- Other Medicare-approved expenses associated with Part B coverage
Plan F is not available to individuals who became eligible for Medicare after January 1, 2020. If you became eligible for Medicare before 2020, you may purchase one of these plans; if you have already purchased Plan F and are grandfathered in, you can keep your plan.
In Washington, premiums for Plan F cost between $235 and $465 a month.
Plan G
If you like the sound of Plan F, but are not eligible to purchase one of these plans, look into Plan G. This plan covers almost everything that Plan F does, including:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Blood transfusion (first 3 pints)
The only thing Plan G doesn’t cover is the Medicare Part B deductible. And the good news is that Plan G premiums are frequently very competitive, with premiums ranging from $99 to $279 in Washington, making these plans a better value than Plan F.
Plan K
Medicare Supplement Plan K reduces your Original Medicare out-of-pocket expenses, but it does not completely fill the gaps. Plan K only pays 50% of some expenses until you reach your out-of-pocket maximum. These expenses include:
- Medicare Part B coinsurance – Plan K covers half of these costs, so you will be responsible for 50% of the remaining 20%. For example, if your doctor charges $100 for a service, Medicare will cover $80, Plan K will cover $10, and you will cover the remaining $10.
- First 3 pints of blood
- Part A hospice care coinsurance or copayment – Plan K will pay for half of these costs.
- Skilled nursing facility care coinsurance – Plan K pays half of the coinsurance for medical care in skilled nursing care facilities.
- Medicare Part A deductible – Medicare Supplement Plan K will pay half of these deductibles, or $800.
Plan K requires you to pay more out-of-pocket than other plans. But it has an out-of-pocket maximum that most other plans (and Original Medicare) lack. This means that the most you’ll have to spend in a given year with Plan K is $6,620 (as of 2023). Once you spend that much out-of-pocket, Medicare Supplement Plan K will cover the remainder of the year’s approved costs. Your maximum will be reset at the beginning of every year.
In addition, while Plan K covers the majority of expenses at a rate of 50%, it covers 100% of Medicare Part A coinsurance. Which you would otherwise have to pay if you have a hospital stay that lasts longer than 60 days. This is the only basic benefit fully covered by Medicare Supplement Plan K.
Due to its higher out-of-pocket costs, Plan K’s premiums in Washington are lower than those of most plans, costing between $61 and $121 a month.
Plan L
Medicare Supplement Plan L also covers the majority, but not all, of the costs associated with Original Medicare, but it covers them at a higher percentage than Plan K does. It also has a lower out-of-pocket maximum ($3,310 in 2023) than Plan K; once you pay that amount in covered expenses for the year, your insurer will pay your bills in full.
Medicare Supplement Plan L covers all Medicare Part A coinsurance and hospital costs. It also covers a percentage of:
- Medicare Part B coinsurance – Plan L covers 75% of your Part B coinsurance.
- Blood – If you require blood while in the hospital, Plan L will cover 75% of the cost of the first three pints.
- Part A hospice care copayments – Plan L pays 75% of your Part A copays for hospice care.
- Skilled nursing facility care coinsurance – Plan L pays 75% of the $200 per day (after the 20th day of your stay) coinsurance for medical care in skilled nursing care facilities.
- Part A deductible – Medicare Supplement Plan L will cover 75% of your Part A deductibles for each 60-day benefit period. You must still meet your Medicare Part B deductible, which is $226 per year in 2023, if you choose Plan L.
Plan L premiums cost between $136 and $147 a month in Washington.
Plan M
Like Plan K and Plan L, Medicare Supplement Plan M covers the majority of the costs associated with Original Medicare, but not all of them. But unlike Plans K and L, it fully covers many of these costs.
Medicare Supplement Plan M covers all Medicare Part A coinsurance and hospital costs. It also covers:
- Medicare Part B coinsurance – Plan M pays your Part B coinsurance and/or copayments in full.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan M will cover the first three pints of blood in full.
- Part A hospice care coinsurance or copayment – Plan M will cover all of your hospice care coinsurance and copays in full.
- Skilled nursing facility care coinsurance – Plan M covers the entire cost of Part A skilled nursing facility coinsurance.
- Part A deductible – Medicare Supplement Plan M will cover half of your Medicare Part A deductible. If you have Plan M, you will have to pay half of the $1,600 (or $800) deductible rather than the full $1,600.
Plan M premiums range from $80 to $283 per month in Washington.
Plan N
Medicare Supplement Plan N fills the majority of Original Medicare coverage gaps. The only exceptions are the Medicare Part B deductible ($226 in 2023) and any Medicare Part B excess charges. Which are portions of physician bills that exceed the Medicare-approved amount. Plan N, though, does have copayments for some services, which most other plans do not.
This means that Medicare Supplement Plan N covers everything below:
- Medicare Part B coinsurance – Plan N will cover your Part B coinsurance costs in full, with the exception of a copayment of up to $20 for some office visits. For emergency room visits that do not result in an inpatient admission, a second copayment of up to $50 may be required.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan N will cover the first three pints.
- Part A hospice care coinsurance or copayment – Plan N pays your hospice care coinsurance and copayments in full.
- Skilled nursing facility care coinsurance – Your skilled nursing facility coinsurance will be fully covered by Medicare Supplement Plan N.
- Part A deductible – Medicare Supplement Plan N pays your $1,600 deductible in full for each 60-day benefit period.
- Foreign travel emergency care – Original Medicare typically does not cover medical care received outside of the United States. If you need emergency care while traveling outside of the United States, Medicare Supplement Plan N will cover 80% of the costs of qualified emergency medical care.
The price for Plan N can range from $139 to $210 a month in Washington.
When to Enroll
You can technically enroll at any time. However, the best time to purchase a plan is during your one-time, six-month long Medicare Supplement Open Enrollment Period. This period begins when you turn 65 and enroll in Medicare Part B. If you apply after these six months, insurance companies may be able to use medical underwriting to deny you or charge you more for coverage because of your health.
But the good news is that Washington is one of only a handful of states where state law prohibits Medicare Supplement insurers from using medical underwriting when an individual with a Medicare Supplement Plan wishes to switch to a different plan after their Open Enrollment Period has ended.
But with that being said, federal regulations do not guarantee access to Medicare Supplement Plans for individuals under 65. The majority of states have regulations to ensure that Medicare recipients with disabilities have some access to Medicare Supplement Plans. Although Washington has gone above and beyond federal regulations in terms of rating requirements and allowing Medicare Supplement enrollees to switch plans on a guaranteed-issue basis. The state does not require Medicare Supplement insurers to offer coverage to Medicare beneficiaries under the age of 65 who have a disability.
How To Choose
When it comes to Medicare coverage, don’t be afraid to ask questions. Speak to an EZ agent who can explain everything to you and help you to sign up. EZ can assist you in enrolling in Medicare, looking for a Washington Medicare Supplement Plan, or simply weighing your options. Our agents work with the best insurance companies in the country. So, they can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs and help you find a plan that works for you. To get started, simply enter your zip code in the bar below or give one of our licensed agents a call at 877-670-3602.
