New to Medicare in Washington?
We’re here to guide you
and answer any questions you may have.
Know when you are eligible to receive it:
• 65 and older likely qualify
• younger than 65 with disabilities of 24 months or more may qualify
• People with end stage renal disease or other chronic conditions may be eligible
Medicare Costs 2019
Medicare Part A
Most people don’t pay a monthly premium for Part A (sometimes called “premium-free Part A”). If you buy Part A, you’ll pay up to $437 each month. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $437. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $240.
Part A hospital inpatient deductible and coinsurance
– $1,364 deductible for each benefit period
– Days 1-60: $0 coinsurance for each benefit period
– Days 61-90: $341 coinsurance per day of each benefit period
– Days 91 and beyond: $682 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
– Beyond lifetime reserve days: all costs
Part B deductible and coinsurance
$185 per year. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment (dme)
Part B premium
The standard Part B premium amount is $135.50 (or higher depending on your income).
Part C premium
The Part C monthly premium varies by plan. Medicare Advantage Plans in Washington starts at $0/month. You must have Medicare part A and B to enroll.
Part D premium
The Part D monthly premium varies by plan (higher-income consumers may pay more).
Medicare in Washington Enrollment Timeline
- Initial Enrollment Period (IEP): 7-month period. Begins 3 months before you are eligible for it (i.e., turning 65), and ends 3 months after your eligibility begins.
- General Enrollment Period (GEP): Jan 1 to Mar 31
- Annual Election Period (AEP): Oct 15 to Dec 7
- Special Enrollment Period (SEP): Anytime during the year
- Medicare Open Enrollment Period (OEP): Jan 1 to March 31
Things you can do if you already have Medicare Part A and Medicare Part B
- You can change or enroll on a new Medicare Advantage plan
- You can also go back to Original plan and enroll on a stand-alone Prescription drug plan from an Advantage plan
- If you have Advantage plan, you can also switch to Original Medicare, enroll on a stand-alone prescription drug plan and enroll on a Supplement plan.
A federal health insurance program for people ages 65 and above was created in 1965 and was called Medicare. People on this age bracket can sign up regardless of medical history, income and health status. Years passed and in 1972, Medicare was expanded to also give coverage to people aged below 65 who have a long-term disability.
Today, Medicare helps to pay for many health care services, including doctor visits, preventive services, hospitalizations, prescription drugs, home health care, skilled nursing facilities and hospice care for 60 million older people and younger people with disabilities. However, possible changes to the program are being considered by policymakers. This is to resolve the spiking annual growth rates on Medicare spending. But for the time being, Medicare will still continue to give access to quality care and affordable coverage to its beneficiaries.
Are there penalties
for late enrollment?
Yes. There are late enrollment penalties for Medicare Part B and Part D.
- If you do not sign up for Part B when you are first eligible, or if you drop Part B but enroll later, you may pay a late enrollment penalty:
Penalty in effect as long as you have it.
Monthly premium for part B may go up 10% each full 12-month period that you did not sign up for Part B but were eligible
- If you don’t sign up for Part D when you’re first eligible, you may pay a late enrollment penalty:
Penalty in effect as long as you have it.
Penalty calculated by multiplying 1% of the “national base beneficiary premium” times the number of full, uncovered months you were eligible but didn’t join a Prescription Drug Plan and went without other creditable prescription drug coverage.
Washington Medicare Special
There are special situations where you may qualify to enroll in a Medicare plan, or change the plan you may be currently enrolled in, even when enrollment has ended. Some of those situations include the following:
- You are turning 65
- You moved to a different address
- You lose your current coverage:
- You no longer eligible for Medicaid
- You left coverage from your employer or union
- You involuntary lose drug coverage
- You are eligible for both Medicare and Medicaid
- You qualify for extra help with your prescription drug coverage
- You have a severe or disabling condition such as Cardiovascular disease or diabetes and there’s a Medicare Chronic Care Special Needs Plan (SNP) available
- You can switch to a 5-star Medicare Advantage Plan, Cost Plan, or Prescription Drug Plan
- If you have a Medicare Advantage, you can switch one time from Jan- March.
Get In Touch!
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Health Plans in Washington is a website owned and operated by Insurance Marketplace Agency, Inc., a licensed health insurance agency doing business as Health Plans in Washington. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. Health Plans in Washington and our licensed agents are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877)486-2048), 24 hours a day/7 days a week or go to: medicare.gov