Medicare in Washington

Steven Mott by Steven Mott | Licensed since 2012
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This article was updated on: 09/16/2018

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When shopping for a Medicare plan in Washington, Medicare.com can assist you with finding the plan that best suits your needs.

About Medicare in Washington

Medicare is a federal program that provides health insurance for United States citizens and permanent residents of at least five continuous years. Some individuals may also qualify, regardless of age, through disability or having certain conditions, such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease) or end-stage renal disease (ESRD).

When eligible beneficiaries in Washington enroll in Medicare, they can receive their benefits through Original Medicare, Part A and Part B, or enroll in a version offered by private insurance companies called a Medicare Advantage plan (Medicare Part C). Offering at least the same benefits as Medicare Part A and Part B (excluding hospice care), Medicare Advantage plans may include other benefits like routine vision, dental, hearing, and prescription drug coverage.

Types of Medicare coverage in Washington

Original Medicare provides inpatient hospital care under Medicare Part A, and physician services and some durable medical equipment through Medicare Part B.

Medicare Advantage plans are available in Washington, but not every plan may be available in each county. If you enroll in a Medicare Advantage plan, you will continue paying your Part B premium. For those who want prescription benefits (Medicare Part D), they have the option to get this coverage through a Medicare Advantage Prescription Drug plan.

Medicare Part D Prescription Drug Plans are available through private insurance companies. They are stand-alone drug plans that add prescription drug coverage to your Original Medicare, Part A and Part B, insurance. As mentioned, you can also get Medicare prescription drug coverage through a Medicare Advantage plan that includes drug benefits.

Medicare Supplement (Medigap) insurance plans cover some Original Medicare (Part A and Part B) out-of-pocket costs, like deductibles, copayments, and, in some of the policies, foreign travel emergency health care. Most states (including Washington) can offer up to 10 Medicare Supplement plans, though not every insurance company may offer all 10. Each plan is labeled with a letter and plan details are standardized, meaning that each plan’s benefits under the same letter category are the same throughout the state, no matter which insurance company you purchase from.

Local resources for Medicare in Washington

  • Medicare Savings Programs in Washington: If you are a Medicare beneficiary in Washington and have an income that is below the Federal Poverty Limit annually set by the government, then you may qualify for a Medicare Savings Program. These plans help with Medicare costs such as premiums, copayments, and coinsurance. Contact your state Medicaid department for more information.
  • Washington State Health Insurance Counseling and Assistance Program (SHIP): Statewide Health Insurance Benefits Advisors (SHIBA) can help you understand your health-care options and Medicare rights with free counseling.

How to apply for Medicare in Washington

You apply for Medicare in Washington as you would in any other state. To qualify for Medicare, you must be either a United States citizen or a legal permanent resident of at least five continuous years. You can enroll in person by visiting your local Social Security Administration office or registering online at SSA.gov. You may also apply over the phone.

  • Call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday through Friday, 7AM to 7PM.
  • Visit a local Social Security office to apply in person. For office hours, visit SSA.gov to look up the closest location to you.
  • If you worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772 (TTY users call 312-751-4701), Monday through Friday, 9AM to 3:30PM.

Washington residents may be enrolled automatically at age 65 if they already receive retirement benefits through Social Security or the Railroad Retirement Board. Disabled residents can be enrolled at any age, provided they receive Social Security disability benefits, or certain disability benefits from the Railroad Retirement Board, for 24 consecutive months; Medicare coverage starts automatically in the 25th month of disability benefits. Individuals with amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease) may be automatically enrolled in Medicare in the first month that their disability benefits start.

Not everyone is automatically enrolled in Medicare. If you aren’t yet receiving retirement benefits before you turn 65 or if you qualify for Medicare because of end-stage renal disease (ESRD), you’ll need to manually enroll. You’re generally first eligible to enroll in Original Medicare, Part A and Part B, during your seven-month Initial Enrollment Period. This takes place three months before you turn 65, includes the month you turn 65, and ends three months later.

If you qualify for Medicare because you have end-stage renal disease, the enrollment process works differently and may vary, depending on your situation. Contact Social Security for more information on enrollment.

Now that you know more about Medicare in Washington, you may be wondering what type of coverage is right for you. I always enjoy helping people figure that out. To get to know me better, take a look at my photo and profile below (just click on the “View profile” link). If you’d like to start out with some personalized information in front of you, use the links below, which let you schedule a phone appointment or have me email you details about plans. To take a look at all available Medicare plans right now, scroll back up and use the Compare Plans button on this page.

 

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