Medicare Advantage Plans in Washington State
Medicare Advantage Plans in Washington State is a different way to get your Original Medicare benefits (Medicare Part A and Part B). Under a Medicare Advantage plan, also called Medicare Part C, you get your Part A and Part B coverage through an independent insurance company instead of the federal government.
Top-rated Medicare Advantage Plan Providers in Washington State
- Premera Blue Cross Medicare Advantage
- Amerivantage Classic
- Regence BlueAdvantage
- Regence MedAdvantage Basic
- Community HealthFirst
- Group Health Cooperative Clear Care Vital
Popular Medicare Advantage Plan Types in Washington State
Best network freedom: Medicare Advantage PPO
- Larger network
- No referrals
- Premium range: $0 to $100 a month
Best for lowest out-of-pocket: Medicare Advantage HMO Plan
- Average premiums: $0
- Out of pocket: lower because HMOs use a referral network
Best for low income or health conditions: Medicare Advantage D-SNIP
A SNIP (Special Needs Insurance Plan) is for individuals who have both Medicare coverage and Apple Health, Washington’s Medicaid program:
- Combines Medicare and Apple Health coverage into one plan
- Dual coverage lowers out-of-pocket costs on copays and premiums
- Not available in every county
Washington Enrollment growth:
Medicare Advantage is showing steady growth regarding health care coverage for Medicare beneficiaries. For example, Washington State saw a 10% growth over 2020. We believe MA plans provide good coverage and are helping transform the healthcare industry.
- Number enrolled in Medicare Advantage nationwide: 19.89 million
- Percentage of Medicare beneficiaries enrolled in Medicare Advantage nationwide: 34%
- Number enrolled in Advantage: 387,101
- Percentage of Medicare beneficiaries enrolled in Advantage in Washington: 31%
Number enrolled by the plan in Washington:
Local HMO: 331,871
Local PPO: 55,230
Regional PPO: 0
How much does Medicare Advantage in Washington State cost?
CMS reports there are 157 Advantage plans available in 2021:
- Premiums vary by county
- Premiums vary by type of plan: HMOs typically have a $0 premium. PPOs can have a $0 premium, but the trend is toward having a premium
- The average premium for MA plans is $39.34
- The average monthly premium for plans that include Part D coverage is $41.10
How much do Advantage Plans cost in Washington State?
PPO Plan $0.00 to $39.34
HMO Plan $0.00
When can I enroll in a Medicare Advantage plan?
The Centers for Medicare and Medicaid Services oversees the Medicare program and sets enrollment guidelines.
Initial Enrollment Period
Your Initial Enrollment Period begins when you’re first eligible for Medicare Part A and Part B.
- When you turn 65 (aging into Medicare)
- Starts three months before you turn 65 and ends three months after
- Eligibility for Medicare Advantage hinges on staying enrolled in the Medicare program and paying your Part B premium.
If you’re still working and have employer insurance — or your spouse still works and has insurance that covers you — you don’t have to enroll in Medicare when you turn 65. Instead, you’ll qualify for a special enrollment period when you decide to enroll.
Open Enrollment Period – AKA Annual Election Period
Your Open Enrollment Period is October 15 through December 7 each year. During this time, you can:
- Join or leave any Washington Medicare Advantage plan
- Change to another plan
- Return to Original Medicare
- Buy a Medicare Part D plan (if you return to Original Medicare)
The effective date of your new plan is January 1.
Medicare Advantage Open Enrollment Period
Medicare Advantage open enrollment is from January 1 through March 31 each year. During this time, you can:
- Leave Medicare to join Original Medicare
- Switch to another Advantage plan
- Pick up or drop Medicare Part D if you’re changing plans
The effective date of your new plan is the first day of the month after you switch.
Special Enrollment Periods
In certain situations, Medicare beneficiaries can change plans outside their Annual Election Period. Following are a few of the special circumstances that qualify for special enrollment:
- Move in or out of a service area
- Insurance company ends its contract with Medicare
- Lose group health care coverage
Call one of our licensed insurance agents to learn more about special enrollment periods.
5-star Special Enrollment Period
Medicare rates each Advantage plan in Washington State. A 5-star rating is the highest. You can use the 5-star Special Enrollment Period once between December 8 and November 30 to switch to a 5-star plan.
Special Enrollment Periods if you get “Extra Help”
- Eligible for Medicare and Medicaid: You can join, drop, or change plans once between January-March, April-June, and July-September.
- Extra help for drug coverage: You can join, drop, or change drug coverage once between January-March, April-June, and July-September.
- Enrolled in State Pharmaceutical Assistance Program: You can join a Part D or Advantage plan once each calendar year.
Medicare Advantage Highlights:
Following are the highlights of Medicare Advantage insurance plans in Washington:
- Increasing in popularity each year
- Private insurance companies handle claims and customer service
- Must be enrolled in Medicare Part A and Part B to qualify
- Most plans in Washington include prescription drug coverage
- Require you to see network healthcare providers
- Cover all of the medically necessary care included in Original Medicare
- Typically include extra benefits such as over-the-counter medicines, wellness programs, and meal delivery
- Have Special Needs Plans for those with chronic conditions such as end-stage renal disease
- Frequently have low or $0 monthly premium
Ready to Learn More?
We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Call us today, or request a quote online to learn more about plan options.
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