Determining Whether You Need Supplemental Insurance with Medicare in Washington State

When you have Medicare in Washington State, you have certain coverage for medical bills depending on the type of Medicare you have. Everyone has Part A coverage, which is mostly coverage for inpatient hospital and nursing home stays. If you opted for Part B, you have coverage for certain medical procedures and doctor visits in addition to your hospital coverage. Unfortunately, even those who opt for Part B still have a large out-of-pocket expense for medical procedures they might not be able to afford.

Gap Policies

For those consumers who do not have enough coverage to ensure full payment of their medical bills, there are various insurance companies that offer supplemental insurance. This coverage is strictly to help consumers pay for the co-payments they are liable for after Medicare pays for the portion that is covered. Each Medigap plan offers the same coverage; the one thing that differs is the premium each carrier charges.


The premiums that are charged by the various insurance companies that offer Medigap for those who are covered by Medicare in Washington State can vary widely. It is typically recommended to obtain gap coverage as soon as you turn 65 and accept Medicare Part B because the federal government prohibits any company from denying coverage for Medigap during the first 6 months. This will also provide you with the lowest starting premium. It is important to keep in mind that your premiums will increase with age. Before you sign any agreements, inquire about the increase increments to ensure it is something you can afford in the future as well.

Determining Eligibility

If you opt not to purchase Medigap during the first six months of obtaining Medicare Part B, you have to go through an eligibility process. The underwriting team at the insurance company will examine your medical history, looking for any long-term or complicated illnesses to determine your eligibility. There is typically a six-month exclusion period for any pre-existing conditions. Of course, there are exceptions your insurance agent will discuss with you, especially when it is a condition that is ongoing and needs immediate treatment.

If you have Medicare in Washington State or are soon becoming eligible, it can seem overwhelming, to determine the right coverage to obtain. If you are nearing 65, you should start talking with an insurance agent about your options and what the best solution would be for your exact situation. Each situation is different based on the individual’s medical history, predicted issues and financial status.

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