Washington Senior Health Programs and Medicare Plans (WA)
The original Medicare Plan is a pay-per-visit health plan that allows a beneficiary to all healthcare providers that accept Medicare nationwide. Part A of Medicare covers hospitalization and is provided, free of charge, to most seniors age 65 or older. Part B is optional medical insurance, and availing involves a monthly payment that is deducted from Social Security benefits. However, there are some costs, referred to as coverage "gaps" that are not fully covered, if at all.
Part D* is stand-alone insurance coverage for prescription drugs, and was added as an option as part of the Medicare Prescription Drug, Modernization and Improvement Act (MMA) passed by Congress in 2003. Medical Advantage plans fall under the provisions of Plan C, and prescription drug coverage may be an option bundled with it with or without a monthly premium.
In principle, Medical Advantage enrollees get extended benefits and have smaller out-of-pocket expenses than typically occurs with the original Medicare system, although because these are privately managed policies, it may require the use of provider network services such as accredited physicians, and in some cases these can actually result in paying more than will normally occur with just Medicare coverage if the enrolled plan is not carefully scrutinized.
Medicare in WA
In Washington, there are at minimum 66 plans available for part or the whole of the state, but some Medicare Advantage plans with prescription drug coverage such as:
- Essence Advantage [H1837 - 001]
- Evercare Plan MH [H5008 - 004]
- Community HealthFirst Medicare Complete Value [H5826 - 010]
Providers for Medicare plans available in Washington1
Asuris Northwest Health
Spokane Community Care
Group Health Cooperative
Puget Sound Health Partners
Providence Health Plan
Sierra Health and Life Insurance Company
HealthMarkets Care Assured
* You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:
1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week;
The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call, 1-800-325-0778; or Your State Medicaid Office