Living in Washington state has advantages and provides a beautiful landscape to get away from the cares of life. Medicare beneficiaries seem to migrate to areas with more nature and less hustle and bustle. There are currently 890,922 Medicare members living in the state of Washington.

We will give some facts and figures about Washington and Medicare costs. Then, we’ll talk briefly about the coverage Traditional Medicare provides. Following that, we will cover what additional options are available and answer some common questions. Finally, we’ll explain how to get help with Medicare and your options.

Washington Medicare Facts & Figures

  • Currently, 772,329 beneficiaries are enrolled in Medicare Part A and Part B.
  • Of those, 671,312 are 65 years old or older.
  • The other 116,967 are on disability under the age of 65
  • A little under 399,954 enrolled in a Medicare Advantage plan
  • A little over 463,223 enrolled in a Medicare Drug Plan.

Medicare Costs in Washington for 2023

Many people preparing to start Medicare are surprised when they see there are costs. Many aren’t aware some premiums could be involved. Medicare has two main sections. Part A and Part B

Medicare Part A is your hospital and inpatient services. For most individuals, Medicare Part A won’t have a premium. They can qualify for a premium-free Part A because they paid Medicare taxes while working. When you use Medicare Part A for the hospital, you’ll pay a large deductible for each occurrence, covering up to 60 days in the hospital or 20 days in skilled nursing. After that time, you’ll pay a per-day copay.

  • Part A deductible is $1,600
  • Part A hospital coinsurance days 61-90 in the hospital is [GCBB#part-a-inpatient-coinsurance-days-61-90] per day

Medicare Part B covers your doctor visits, medical tests, and medical services. Part B will have a monthly premium of $164.90 for new Medicare members. In addition, when you use Part B coverage, you’ll pay 20% of the cost after you pay the $226 Medicare Part B deductible.

Medicare costs and coverage doesn’t change and will cover the same way no matter where you reside or travel in the United States.

Medicare Part A Costs in 2023 Medicare Part B Costs in 2023
  • Part A is premium-free for most
  • Part A deductible is $1,600 per benefit period
  • Inpatient hospital stay days 61-90 is $400
  • The standard Part B premium is $164.90
  • The annual deductible for Part B is $226
  • Medicare pays 80%, you pay 20% out-of-pocket

Original Medicare Coverage

As mentioned above, Original Medicare consists of Medicare Parts A and B.

Medicare Part A covers inpatient care in hospitals, skilled nursing care and facilities, hospice, and home health care. This portion of Medicare is premium-free for most beneficiaries.

Medicare Part B is your medically necessary and preventative services. These services include clinical research, ambulance services, durable medical equipment, mental health services, and drugs administered in the doctor’s office.

Medicare Part A (Hospital Coverage)

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care
Medicare Part B (Medical Insurance)

  • Services from doctors and health providers
  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Some preventive services

Supplemental Medicare Plans in Washington

There are several options to choose from when looking to supplement your Medicare coverage. Most people choose one of two options. Medicare Supplement or Medicare Advantage.

Medicare Supplement Plans

Medigap plans work with Original Medicare to fill the gaps and cover your out-of-pocket costs. Medicare Supplement plans only cover items and services covered by Original Medicare. If you choose a Medicare Supplement, you’ll also need to purchase a Part D plan for prescription coverage.

These plans allow you to retain the freedom to choose any doctor nationwide without needing a referral. With the addition of a Medigap plan, you’ll pay your monthly premium, and your plan will pay a portion, if not all, of your Medicare cost share. Medicare standardizes these plans, so the coverage is always the same. The only difference is the price.

Medicare Advantage Plans

Medicare Advantage plans take over your Medicare benefits and administer them for you. They usually have low to no premiums and fixed copays for most services.

Medicare Advantage plans are network-based plans. They do cover services and benefits that Medicare doesn’t, such as gym memberships and dental, vision, and hearing coverages, to name a few. These plans will vary depending on where you live, so a plan in one area may have different benefits than a similar plan in another. In many cases, Medicare Part C plans cover your prescriptions as well.

There are two ways to receive Medicare Prescription Drug coverage. If you stay with traditional Medicare and add a Medicare Supplement, you’ll want to enroll in a stand-alone Part D drug plan. If you choose Medicare Advantage, you must choose a drug coverage plan to have prescription coverage included.

Both options must follow the standard model the Centers for Medicare and Medicaid Services provides. The Medicare standard model has four phases.

  1. Deductible Phase
  2. Initial Coverage Phase
  3. Coverage Gap Phase – Donut Hole
  4. Catastrophic Coverage Phase

Prescription Plans can provide coverage that’s better than the Centers for Medicare & Medicaid Services model. For example, not all drug plans have a deductible.

Washington Medicare Resources

FAQs

What is the Original Medicare called in Washington?

Traditional Medicare is another name for Medicare. It’s a fee-for-service plan and allows beneficiaries to go to any hospital and see any doctor who accepts Medicare. Medicare pays its share for the services covered.

Is Original Medicare being phased out in Washington?

No, Medicare isn’t going away. Private insurance companies administer Part C, also known as Medicare Advantage plans. Those aren’t going away, either.

Can you change from Medicare Advantage to Medicare Original in the state of Washington?

Yes, you can switch to Traditional Medicare from your Medicare Advantage plan during the Medicare Annual Enrollment Period from October 15h to December 7. The coverage would become effective on January 1t.

What does Medicare D cost in Washington state?

The prices vary depending on the plan. The average national premium for a Part D plan is $33. Persons with a higher income pay a higher premium for prescription drug coverage.

Who is eligible for Medicare in Washington state?

If you’re 65 or older, a US citizen, or a permanent legal resident who has lived here for at least five consecutive years, you’re eligible for Medicare.

How do you know if you have Original Medicare?

You can check your enrollment status online at www.mymedicare.gov or by calling Medicare. Your enrolment status shows your plan’s name, the coverage type, and how long you’ve had the coverage.

How to Sign Up for Supplemental Medicare in Washington

Medicare can be a complex topic to decipher, but the good news is that you’re not alone. Our licensed experts specialize in all aspects of Medicare. Let us assist you in finding the plan that fits your needs.

We’ll help you through every step of the process. We’ll check to see which plan covers your prescriptions and doctors. As well as explore the programs that have the benefits you’re looking for. Then we can even assist with the enrollment process. Give us a call today, or fill out our online request form.

Written By:
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Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
Reviewed By:
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Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at Medigap.com. He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.