Washington DC Medigap Plans bridge gaps in Medicare coverage and can offer essential financial security to Capital residents. Medigap plans in the District of Columbia are subject to the same federal regulations that apply across the country. If you’re considering purchasing a policy, read the article and contact Senior65.com for specialized assistance.
Washington DC Medigap Basics
Medigap, also known as MedSupp or Medicare Supplement plans, fills gaps in Original Medicare and provides additional benefits. This guide explores essential things about Medigap in DC but if you’re new to Medigap, visit our Complete Medicare Supplement Overview Page:
• Medigap DC plans provide supplemental coverage. They are sold by private insurance companies and are designed to cover out-of-pocket costs such as deductibles, coinsurance, and copayments.
• In Washington DC, Medigap plans are standardized. Each plan offers the same basic benefits regardless of the insurance company you choose. However, costs may vary. All Medigap insurance carriers are required to offer at least the basic plan “A” but the majority of our clients end up electing for Medigap Plan G.
• Washington DC offers Guaranteed Issue Rights. During certain situations, such as your Medigap Open Enrollment Period or if you lose your existing coverage, insurance companies are required to sell you a Medigap policy without any medical underwriting. Give us a call to discuss your situation.
• With Medigap plans, you will have to pay a monthly premium to the insurance company in addition to your Medicare Part B premium. The premium amount can vary depending on the plan you choose and the insurance company. (Source)
Medigap Plans Chart of Current Plans
Plans available for those Medicare-eligible after January 1, 2020:
| Benefits | A | B | D | G* | K | L | M | N |
|---|---|---|---|---|---|---|---|---|
| Medicare Part A Deductible ($1,676) | 100% | 100% | 100% | 50% | 75% | 50% | 100% | |
| Part B Deductible ($257) | ||||||||
| Medicare Part A Hospital Coinsurance and 365 additional hospital days | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Medicare Part B Coinsurance | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| First 3 Pints of Blood for a Transfusion | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Medicare Part A Hospice Coinsurance or Copay | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Skilled Nursing Facility Coinsurance | 100% | 100% | 50% | 75% | 100% | 100% | ||
| Medicare Part B Excess Charges | 100% | |||||||
| Foreign Emergency Healthcare | 80% | 80% | 80% | 80% | ||||
| Max Out-of-Pocket | $7,200 | $3,610 |
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*Medigap Plan G High deductible ($2,870) is also available.
Note that Plans C and F are no longer available to people who are new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before that date, but not yet enrolled, you may be able to buy them. People eligible for Medicare on or after January 1, 2020, have the right to buy Plans D and G instead of Plans C and F.
When to Enroll in DC Medicare Supplement Insurance
If you are 65 or older, state and federal laws guarantee that for six months from the date you first enroll in Medicare Part B, you have a right to buy the Medigap policy of your choice. You cannot be denied Medigap insurance within this time period. Additionally, they must not delay your coverage. Moreover, they cannot charge more due to health issues. These rules ensure fair access to Medigap during enrollment.
Switching plans later can be challenging so we would live to help you pick the the right plan when you are first eligible. Feel free to call us at 800-930-7956. Medigap prices are regulated so no one can offer the same plan from the same provider lower than Senior65.com.
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What if I Regret Buying a Policy in DC?
Once you purchase a policy, you’ll find an important alert on the first page. It explains what to do if you reconsider. Specifically, the buyer has the right to return the policy or certificate within 30 days of receipt. If unsatisfied for any reason, after examining the policy or certificate, a full premium refund is available. Moreover, any refund due under this rule will be paid directly to the buyer by the issuer without delay. This ensures that you have the freedom to change your mind without financial loss. (Source: DC Official Code)
Switching Medigap Plans in DC
Thinking about switching your Medigap plan? Medigap plans in DC aren’t affected by AEP Open Enrollment (Oct 15 – Dec 7). So, if it’s been more than thirty days since you first bought your plan, keep in mind that you might need to go through a health review called “medical underwriting.” Expect around 20 health questions in the new Med Supp application. Based on your answers, rates may vary, or coverage may be declined.
To get a clear idea of what this means for you, take a look at our guide, “The Definitive Guide to Medicare Insurance Changes.” If you’re still unsure about anything, don’t hesitate to reach out—we’re here to help!
Medicare Excess Charges in DC
A Part B excess charge is when your doctor charges you more than the Medicare-approved amount. This happens if they don’t accept Medicare’s payment as full and can legally add up to 15% extra. Many Medigap plans, including Plan G, cover these extra costs for you. Learn more in our article, “How To Avoid Medicare Excess Charges.“
DC Medigap Plans Under 65
DC stands apart from US states by not regulating Medigap plans itself. This means the federal standards are used, and insurers aren’t obligated to provide Medigap to disabled individuals under 65. Learn more about Medigap Under 65 by clicking here.
DC Medigap Plans Discount
The Medigap Household Discount helps you save money if you live with others. It cuts the cost of your Medigap payments. To get this “Medigap HH Discount“, certain rules apply. You might be married or in a domestic partnership and share a home. With savings between 5% and 7%, it’s a valuable offer. Just hit the “household discount button” on our quote page to see your savings.
The Roommate Discount is another great choice with simple requirements. Find out more in our article, “What is the Medigap Roommate Discount and How Can You Get It?”.
Moreover, lots of Medigap companies give a discount for auto-pay. It makes paying easier. Set up auto-pay and get a steady discount on your payments. This makes bills simpler and saves you money on your plan. Read more about Medigap Discounts And Special Offers here.
DC´s Top Medigap Plans
According to the most recent data from America’s Health Insurance Plans (AHIP), over 12,000 residents of The Nation’s Capital have selected a MedSup policy. Although Plan F was historically the most popular due to its high enrollment numbers, it no longer accepts new to medicare members. Plan G is now our most popular Medigap plan in DC.
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What now, Washingtonians?
Get a quote for Washington District of Columbia effortlessly, either online or by dialing 800-930-7956. It’s just a call away!
Keep in mind, at Senior65.com, we’re ready to assist you for free. There’s nothing to lose! If you have questions leave a comment below or just give us a call.