With no annual out-of-pocket limit, it's no wonder so many Medicare beneficiaries choose to supplement their coverage in some way. Medicare Supplement plans in Washington, D.C. help cover a variety of healthcare costs.
What is Medigap in Washington, D.C.?
Medigap plans help cover some – or even all – of your out-of-pocket costs when you have Original Medicare. This includes Part A, inpatient services, and Part B, outpatient services.
There are 10 basic Medicare Supplement plans in Washington, D.C., each represented by a letter: A, B, C, D, F, G, K, L, M, and N. Some insurance companies also offer high-deductible options and not every insurer provides every plan.
Medigap plans are standardized, which means you get the same benefits with a particular plan regardless of your insurance company. Costs are not standardized, though, meaning premiums may vary considerably.
Unlike Original Medicare, you may be denied a Supplement plan if you don't have a guaranteed issue right. At all other times, your application goes through medical underwriting, which involves answering a series of health-related questions. Insurance companies use medical underwriting to decide whether to insure you and at what rate.
What does Medigap cover?
Benefits vary depending on the plan you choose. At a minimum, though, every Medigap plan pays your Medicare Part A coinsurance and gives you an additional 365 lifetime reserve days for inpatient care.
The following table details which benefits each Medigap plan includes:
No Medicare Supplement Insurance plan includes prescription drug coverage. To get this protection, you need to join a Medicare Part D prescription drug plan.
Who qualifies for Medicare Supplement Insurance in Washington, D.C.?
You qualify for Medicare Supplement Insurance in Washington, D.C. as soon as you're aged 65 or older AND enrolled in Original Medicare. Most states also require Medigap insurers to offer plans to beneficiaries who aren't yet 65 but qualify for Medicare due to a disability. Since D.C. isn't a state, though, federal guidelines apply. If you're under 65, Medigap insurers do not have to offer you a plan.
When is the best time to join a Medicare Supplement plan in Washington, D.C.?
The best time to join a Washington, D.C. Medicare Supplement plan is during your 6-month Medigap Open Enrollment Period (OEP). It begins the day you enroll in both Medicare Part A and Medicare Part B.
During your OEP, you have guaranteed issue rights. This means you cannot be denied a Medigap policy or charged more for it, even if you have preexisting conditions.
People who qualify for Medicare due to a disability also get a Medigap Open Enrollment Period when they turn 65. It includes the same protections as if they were new to Medicare.
Medigap Plan C and Medigap Plan F in Washington, D.C.
Medigap Plan C and Medigap Plan F are not available to people who qualify for Medicare on or after January 1, 2020. We recommend Medigap Plan D or Medigap Plan G instead. With the exception of the Medicare Part B deductible, these plans offer the same benefits as Plans C and F, respectively. They also usually give you a lower out-of-pocket overall.
How to choose a Medigap plan in Washington, D.C.
We recommend choosing a plan with the most comprehensive benefits you can afford. Unless you have a guaranteed issue right, your Medigap application goes through medical underwriting. If you wait, you may not be able to get the coverage you need.
The next concern is pricing. Most Medigap insurers use one of three pricing methods:
- Attained-age rated: Premiums start out low but go up as you age. These policies are usually the most expensive option over time.
- Community rated: Also known as no-age rated, because premium regardless of age. Over time, most experts agree that these are the cheapest Medigap plans.
- Issue-age rated: Premiums are based on your age at the time you join the plan, not your age throughout the life of the policy. They may rise over time due to inflation, though.
Washington, D.C. Medigap insurers mostly use attained-age and issue-age pricing.
Our Find a Plan tool makes it easy to compare Medigap plans in Washington, D.C. Simply enter your location information to review Medicare plan options in your area.
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