Medicare in Washington
Key Takeaways
- U.S. citizens and permanent residents age 65 or older qualify for Medicare in Washington.
- The state’s Medicaid program assists residents facing financial need or a disability regardless of their age. It’s possible to be on Medicaid and Medicare in Washington at the same time.
- GoHealth insurance agents are licensed in the state of Washington to help you navigate Medicare resources.
I cannot tell a lie: Washington is the only state named for a U.S. President, and it produces more cherries than any other state.
But while the myth of George Washington chopping down a cherry tree in his youth isn’t dangerous, Medicare myths can be hazardous to your health.
GoHealth is here to make sure your understanding of Medicare in Washington is beyond reproach.
How Do I Apply for Medicare in WA?
If you are a U.S. citizen or a permanent resident of at least five years and approaching age 65 (or already there), you are eligible to apply for Medicare coverage:
- You can apply for Medicare in Washington online with the Social Security Administration, by visiting a Social Security office in Washington, or by calling 1-800-772-1213 (TTY: 1-800-325-0778).
Original Medicare
The starting point for health insurance at 65 is Original Medicare, featuring Part A (hospital insurance) and Part B (medical insurance). If you enroll in both parts, you can choose to enroll in Part D, which is drug coverage administered by private insurance companies under federal guidance. Medigap also is an option; it is supplemental insurance, also issued by private companies, that helps control out-of-pocket costs for people with Parts A and B.
Medicare Advantage
Medicare Advantage is private insurance approved by Medicare to meet all of the needs mentioned above while also offering benefits like dental and vision coverage.
Your Ideal Medicare Plan is out there.
Who Qualifies for Medicaid in Washington State?
Each state has its own plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need and/or disability regardless of age.
Washington’s robust program, administered by the Washington State Health Care Authority, also includes oversight of Medicare Savings Programs in the state and coverage options for various groups like noncitizens and foster parents along with a variety of eligibility rules and income limits.
Is Washington Apple Health covered by Medicare?
Apple Health is the name given to the Medicaid program administered by the state of Washington.
While Medicare and Medicaid cover similar needs, Medicare is primarily designed for Americans age 65 and older, while Medicaid is mostly for those facing financial hardships or a disability regardless of age. That being said, it is possible for residents researching Medicare plans in Washington to be dually eligible for Medicare and Medicaid.
Your Ideal Medicare Plan is out there.
What Is the Income Limit for Medicaid in Washington State?
Different programs offered by Medicaid in Washington feature different income limits for eligibility.
One of the most common situations involves Medicaid coverage for long-term care assistance when a person’s financial resources begin to dwindle. The American Council on Aging offers detailed information regarding Washingtonians’ eligibility in varying situations related to Medicaid and long-term care.
What Medicare Plans Are Available?
If you’re talking about Original Medicare, there’s only one plan — Parts A and B —which does open the option to add Part D and Medigap coverage from private insurance companies.
If you’re talking about Medicare Advantage in Washington, also known as Part C, there are many plans.
- Some Medicare Advantage plans mirror Original Medicare but are more affordable.
- Some Medicare Advantage plans include options for dental, vision, and hearing coverage.
- Some Medicare Advantage plans offer assistance with transportation costs or over-the-counter needs.
- Some offer all of the above.
Which Company Has the Best Medicare Advantage Plan?
The Centers for Medicare & Medicaid Services use a Medicare Star Rating system to assign a rating of up to five stars to individual Medicare Advantage plans, and Medicare Advantage beneficiaries have an annual opportunity to switch to a five-star plan.
While the rating system can shed light on Medicare Advantage plans’ performance, it’s not as easy as just picking the highest-rated plan. A GoHealth licensed insurance agent can help you compare plans and find the one that’s the right fit for you, all things considered.
Still have questions? GoHealth has the answers you need.
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 1,303,678 people are enrolled in Medicare Part A and B in Washington. The total number of beneficiaries enrolled in Medicare Advantage increased from 486,040 to 532,196 year over year. Medicare Advantage participation in Washington went from 38.30% to 40.82% year over year. If you’d like to dive deeper into how Medicare in Washington breaks down across the state, we provide a glance at who is using Medicare and how.
1,303,678 Beneficiaries with Part A & Part B
532,196 Medicare Advantage Beneficiaries
40.82% Medicare Advantage Participation Rate
53.26% Female
46.74% Male
85.49% Non-Hispanic White
2.26% African American
3.71% Hispanic
8.54% Other/Unknown
15.50% Eligible for Medicaid
0.9 Average HCC Score
$8,668.87 Actual Per Capita Costs
15.40% Hospital Readmission Rate
25.20% % of Beneficiaries with an Emergency Department Visit
486,040 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
38.30% Medicare Advantage Participation Rate, Previous Year
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
Statewide Health Insurance Benefits Advisors (SHIBA)
https://www.insurance.wa.gov/about-shiba-services
What should I know about SHIBA?
The renowned branch of the Office of the Insurance Commissioner offers free and confidential Medicare advice to all ages.
Washington State Department of Social and Health Services (DSHS)
Phone lines open M-F, 8 a.m. to 5 p.m.
https://www.dshs.wa.gov/node/71
What should I know about the Washington State DSHS?
The state agency’s services include assisting Washingtonians apply for Medicare Savings Programs.
Washington State Health Care Authority (HCA)
https://www.hca.wa.gov/about-hca/contact-hca
What should I know about HCA?
Administers the state’s Medicaid program, called Apple Health, for Washingtonians.
Washington State Department of Veterans Affairs (WDVA)
https://www.dva.wa.gov/about-wdva
What should I know about WDVA?
Washington veterans and their families can turn to the state agency for assistance with their healthcare benefits earned through military service.
Nationwide Resources
Speak with a GoHealth insurance agent that is licensed in Washington about your Medicare questions.
Mon – Fri, 8 a.m. – 6 p.m. CT
Centers for Medicare and Medicaid Services
You can reach the Social Security Administration by phone for general questions. Not all questions can be answered over the phone.
Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online
1-800-722-1213
TTY 1-800-325-0778
Speak to SSA Representative, Monday – Friday, 8 AM – 7 PM ET
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
- Apply for Benefits. SSA.gov.
- Social Security Office Locator. SSA.gov.
- Health care services and supports. WA.gov.
- Washington Medicaid Income & Asset Limits for Nursing Homes & In-Home Long Term Care. MedicaidPlanningAssistance.org.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.