Washington Medicare questions, answered plainly

Nothing. Independent Medicare agents are paid by the insurance carriers when you enroll, so comparing plans, answering questions and reviewing your coverage each year is free to you. Your premium is the same whether you enroll through us, another agent or the carrier directly.

If you already hold a Medigap policy, yes. Washington law lets you move to another Medigap plan or carrier at any time of year without medical underwriting; the one limit is that a Plan A holder can move only to another Plan A. The rule is for existing policyholders and does not let a Medicare Advantage member into Medigap without a federal window or underwriting. Our switching guide walks through it.

It does not need one. Instead of a birthday window, Washington lets existing Medigap policyholders change plans year-round without health questions. Getting into Medigap in the first place still relies on your six-month open enrollment at 65 or a federal guaranteed-issue event.

Federal law does not guarantee a Medigap open enrollment before 65, and what a Washington carrier will offer, and at what price, depends on the carrier and current state rules. Ask us or Washington SHIBA before you assume either way; you get a full six-month open enrollment for every plan at 65.

It depends on the plan and the year. UW Medicine accepts Original Medicare and therefore every Medigap policy. For 2026 it has said it will not be contracted with Humana, PacificSource or Wellpoint plans, and its contracted list changes each fall. If UW Medicine, Fred Hutch, Providence Swedish, Virginia Mason Franciscan, MultiCare or Kaiser is your care, we confirm the plan’s status in writing before you enroll.

Advantage plans are sold by county and built on local networks, and many counties east of the mountains and along the coast lean on a single public hospital district with specialists a long drive away. Carriers offer fewer plans there, and nationally UnitedHealthcare, Humana and Aetna each left about 100 to 200 counties for 2026. Original Medicare with a Medigap policy works at every hospital in the state without a network, which is why so many rural Washingtonians keep one.

Usually neither. TFL pays secondary to Medicare and its pharmacy is creditable drug coverage. An MA-only Advantage plan can add dental or vision without duplicating the drug benefit. Our Joint Base Lewis-McChord, Naval Base Kitsap and Fairchild pages walk through it.

In most cases, yes. VA medical care is not creditable coverage for Part B, so delaying it triggers a permanent penalty and leaves you without coverage at a non-VA hospital. VA pharmacy is creditable for Part D.

Your Initial Enrollment Period is the seven months around your 65th birthday. The Annual Election Period runs October 15 to December 7; Medicare Advantage Open Enrollment runs January 1 to March 31. Moving counties, losing a plan, or qualifying for Apple Health opens a Special Enrollment Period, and Medigap policyholders can change plans any time.

Part B premium $202.90 a month, Part B deductible $283, Part A hospital deductible $1,736 per benefit period, Part D out-of-pocket cap $2,100. Higher earners pay IRMAA surcharges above $109,000 (single) or $218,000 (joint) of 2024 income. Our costs page has the full chart and calculators.

Possibly. The Medicare Savings Programs (QMB, SLMB and QI-1) pay the Part B premium for people with limited income, and QMB also covers Medicare’s deductibles and copays. For 2026 they have income limits only, with no asset test. Apply through DSHS at WashingtonConnection.org or call Apple Health customer service at 1-800-562-3022; Washington SHIBA (800-562-6900) can help.

Apple Health is Washington’s Medicaid program, run by the Health Care Authority. For people 65 and over and people with disabilities, eligibility is determined by DSHS, and long-term care runs through DSHS’s Aging and Long-Term Support Administration. Medicare pays first; a Dual Special Needs Plan on the Medicare side can coordinate the two.

Washington SHIBA, the Statewide Health Insurance Benefits Advisors, is the state’s State Health Insurance Assistance Program, run by the Office of the Insurance Commissioner with volunteer counselors in local offices: 800-562-6900. You can also call 1-800-MEDICARE or use Medicare.gov. We are an independent agency, not a government program, and we say so on every page.

No. We represent a number of insurance organizations and products in Washington, not all of them, and we will always say so. For the complete list, use Medicare.gov, 1-800-MEDICARE or Washington SHIBA. For help choosing among the plans we do offer, call (702) 706-6564.

Darin Weidauer holds Washington insurance license #1010707 (NPN 18580338). You can verify it through the Office of the Insurance Commissioner’s agent and company lookup at insurance.wa.gov or through the NIPR.

We work with Washingtonians statewide by phone and video, which is how most people prefer it on both sides of the Cascades. Our sister agency has walk-in offices in Mesa and Sun City, Arizona.