Washington, DC, is the capital of the United States, and while technically not a state, Medicare still applies. Washington, DC, is the capital of the United States of America, and while its technically not a state, the Federal Medicare program still works the same. More than 398,000 Medicare beneficiaries reside in the District of Columbia, with about 17% enrolling in Medicare Advantage programs. We’ll review Washington, DC, Medicare options below.
Medicare plans in Washington, DC
Below, we’ll discuss the most affordable Medicare Advantage plans, the cheapest Medicare Supplement health insurance, and discuss the average costs of Part D prescription drug plans. Then, we’ll wrap up with the available special needs plans, answer some frequently asked questions, and explain how to get help with Washington, DC, Supplemental Medicare plans.
Quotes shown in our charts below are for a 65-year-old female with a specific zip code. Program availability and costs could vary depending on your actual age or zip code.
Medicare Advantage plans
Medicare Advantage plans are growing in popularity each year. With low premiums and additional coverage in addition to Medicare benefits, these all-in-one programs have a lot to offer.
Medicare Advantage plans must cover the same benefits as Medicare Parts A and B. In addition, many also include Medicare drug coverage. More than 65,000 Medicare beneficiaries in DC are enrolled in Medicare Advantage plans. In Washington, DC, 14 Medicare Advantage plans are available.
The top PPO in the area goes to . Their 4-star PPO has no premium and a maximum out-of-pocket of $6,900. It boasts affordable copays and dental coverage.
Cigna comes in a close second with their 3-star rated PPO. Like the plan, it, too, has a $0 premium. The Maximum out-of-pocket is $7,000.
Kaiser has one of the few HMO options available in DC. Their HMO-POS has five stars and a maximum out-of-pocket of $6,900. Their top plan is an HMO-POS, meaning that you can see some providers that aren’t in the network.
The average cost of Medicare Advantage plans in Washington, DC
| PLAN | PREMIUM | MOOP | Plan Type | Star Rating |
| $0 | $6,900 | PPO | 4 | |
| Cigna | $0 | $7,000 | PPO | 3 |
| Kaiser | $0 | $6,900 | HMO-POS | 5 |
| Cigna | $0 | $4,200 | HMO | 3 |
| Aetna | $68 | $7,550 | HMO-POS | 3.5 |
Medicare Supplement plans
Washington DC Medicare Supplement plans help cover the out-of-pocket cost share left over after Original Medicare pays. These plans can cover Medicare costs such as deductibles, copay, coinsurance, and excess charges. Ten-letter plan options are available, and these standardized plans will cover the same regardless of where you are in the United States.
Plan N is arguably the most popular plan for new Medicare beneficiaries. A lower monthly premium and low copays give an excellent option for healthy Medicare beneficiaries. Plan N presents an affordable opportunity with comprehensive coverage with low fixed copays for office visits and the emergency room.
The most popular plan remains Plan F. The reason it’s so popular is that it covers 100% of the beneficiary’s cost-share amount. Plan F is available for anyone that became Medicare eligible before 2020.
Plan G offers the same coverage as Plan F, with one exception. This policy doesn’t cover the Medicare Part B deductible. Other than that, it allows a lower-cost option for total coverage.
UNLIKE PLAN N, Plan F, and Plan G cover Medicare Part B excess charges. In addition, plans F and G have a lower-cost, high-deductible plan option.
The average cost of Medicare Supplement plans in Washington, DC
| LETTER PLAN | LOWEST PREMIUM | HIGHEST PREMIUM |
| PLAN A | $77 | $232 |
| PLAN B | $105 | $259 |
| PLAN C | $131 | $325 |
| PLAN D | $146 | $201 |
| PLAN F | $133 | $328 |
| PLAN HDF | $29 | $89 |
| PLAN G | $111 | $310 |
| PLAN HDG | $24 | $51 |
| PLAN K | $43 | $129 |
| PLAN L | $72 | $179 |
| PLAN M | N/A | N/A |
| PLAN N | $81 | $288 |
Medicare Part D prescription drug plans
Medicare drug coverage is perhaps the most confusing and frustrating part of Medicare. Private companies administer Part D prescription drug plans, which the Centers for Medicare & Medicaid Services regulate. These plans must have coverage as good or better than the CMS Standard model. Medigap plans only cover Part A and B of Medicare, so you must enroll in a Part D plan or choose a Medicare Part C plan that includes drug coverage to have prescription drug coverage.
Even if you’re not taking prescriptions, enrolling in a drug plan is wise. If you don’t enroll in a program, you could be susceptible to a Part D late-enrollment penalty. Wellcare has the lowest premium Part D prescription drug plan in Washington, DC.
Mutual Of Omaha has the second-lowest premium but has a low star rating for 2023. They have a deductible of $505 and have some of the best customer service in the industry.
SilverScript has been one of the highest-rated drug plans for years. CVS/Aetna is now the parent company of SilverScript, making them part of one of the largest healthcare companies in the US. CVS is one of the preferred pharmacies for SilverScript drug plans.
The average cost of Medicare Part D plans in Washington, DC
| PLAN | PREMIUM | DEDUCTIBLE | STAR RATING |
| Wellcare | $10.10 | $505 | 3 |
| Mutual Of Omaha | $20.90 | $505 | 2 |
| $28.30 | $350 | 3 | |
| SilverScript | $35.60 | $505 | 3.5 |
| Humana | $39 | $505 | 3 |
Special Needs plans
Medicare Part C plans also include programs for Medicare beneficiaries with special needs. These Special Needs Plans or SNPs help beneficiaries with specific chronic health conditions, low income, or living in an institutionalized setting.
Chronic SNPs or C-SNPs help people with chronic illnesses such as diabetes, COPD, and heart conditions. Dual SNPs, or D-SNPs, have benefits catered to those with low income, and Institutionalized SNPs, or I-SNPs, are for those living in an institutionalized setting.
Washington, DC, has a minimal selection of Special Needs Plans.
has two of the three plans. Both of these UHS plans are for individuals with Medicare and Medicaid. They have the same premiums and maximum out-of-pocket maximums. Review the plan details to determine which programs have the right benefits for you.
Cigna Healthspring is the other insurance company that provides a Special Needs Plan. This plan is if for individuals which specific chronic conditions. It also has a $0 premium and low maximum out-of-pocket.
The average cost of Medicare Special Needs plans in Washington, DC
| PLAN | PREMIUM | MOOP | Plan Type | Eligibility |
| $0 | $12,450 | D-SNP PPO | Medicaid | |
| Unity | $0 | $12,450 | D-SNP PPO | Medicaid |
| Cigna | $0 | $3,450 | C-SNP | Chronic |
FAQs:
What’s the best Medicare Advantage plan in Washington, DC?
Everyone’s needs are different, so what may be best for one person may not fit the needs of another. The highest-rated Medicare Part C plan in Washington is the Kaiser Permanente HMO-POS. It boasts a 5-star rating and a $0 monthly premium.
What’s the difference between a Washington, DC, Medigap policy and Medicare Advantage plan?
Medigap policies provide coverage for expenses already covered by Original Medicare, while Medicare Advantage plans offer alternative coverage for medical services not typically covered by Original Medicare.
Medicare Advantage plans may include additional benefits like vision, dental, and prescription drug coverage. Medigap policies are supplemental policies offered by private insurers designed to help pay the coinsurance and copayments required by Original Medicare.
What’s the most popular Medicare Supplement in Washington, DC?
Plan F is the most popular Medicare Supplement plan. However, new Medicare beneficiaries can’t enroll in this plan. The majority of new Medicare beneficiaries are enrolling in Plans G or N.
Which Part D prescription drug plan is the best in Washington, DC?
Like with a Medicare Advantage or Medigap insurance policy, your needs determine what’s best for you. Wellcare has the least expensive Medicare Part D program, but it’s not the best for you if the plan doesn’t cover your prescriptions.
When is the best time to enroll in a DC Medicare Supplement Insurance plan?
Most people consider the Medicare Supplement Open Enrollment Period the best application time. During this enrollment period, you can choose any plan or carrier without needing to qualify medically. Outside of the OEP, individuals must pass medical underwriting to receive coverage unless they have a guaranteed issue right.
How to sign up for Medicare plans in Washington, DC
Finding the right Supplemental Medicare plan for your needs can be complicated. That’s where we can help. Our licensed insurance agents can educate and answer any Medicare-related questions. We’ll help review the plans in your area that meet your needs and wants. Then, we’ll help walk you through the process, making it quick and easy.
Fill out our online request form, or give us a call. We look forward to assisting you with all your Medicare needs.
