When it comes to Medicare, 328,919 beneficiaries call Spokane, Washington home. The second-largest city in Washington is Spokane. Lilac City is located on the Spokane River and is Father’s Day’s birthplace.
Medicare plans in Spokane, Washington
Supplemental Medicare plans generally come in one or two types, Medicare Supplement or Medicare Advantage. We will discuss a few affordable Medicare Advantage options and the cheapest Medicare Supplement plans.
Following that, we’ll review the average cost of Part D plans and learn what a special needs plan is. Finally, we’ll answer some frequently asked questions and how to find the best Spokane, Washington, Original Medicare plan for your situation.
The information provided below is based on a woman living in Spokane that is 65 years old.
Medicare Advantage plans
The Medicare Advantage plans in Spokane are numerous. Medicare residents of the city have access to more than 50 options. About 30% of all Spokane Medicare beneficiaries choose to enroll in Medicare Part C.
Medicare Advantage plans in Spokane, Washington, are essentially all-in-one, network-based plans that provide your Medicare Parts A, B, and in many cases, D wrapped up in one plan. Insurance companies like Humana and administer these plans. They usually include additional benefits above what is covered by Traditional Medicare.
Regarding Medicare plan providers, you’d be remiss if you didn’t recognize . They are the largest provider of Medicare plans in the nation. Backed by , they have a strong foothold in the industry.
Aetna is another big player in the Medicare plan market. Aetna is owned by CVS, making them one of the biggest healthcare companies in the United States. In addition to Medicare Advantage options, they also have Part D and Medigap options.
Kaiser Permanente is a regional carrier that specializes in certain areas. They have the only 5-star plan available in Spokane. They focus on VIP-style services where all your providers and tests are in one location. While this makes for a great patient experience, it also significantly limits the providers you can see.
The average cost of Medicare Advantage plans in Spokane, Washington
PLAN | PREMIUM | MOOP | Plan Type | Star Rating |
Humana | $0 | $5,700 | HMO | 4 |
Kaiser Permanente | $0 | $4,950 | HMO | 5 |
$0 | $5,500 | HMOPOS | 4 | |
Molina Healthcare | $0 | $7,550 | HMO | 3 |
Aetna | $0 | $5,500 | HMOPOS | 3 |
Medicare Supplement plans
The most common choice for beneficiaries in Spokane, Washington, is a Medicare Supplement. Medicare Supplements, sometimes called Medigap, are plans that combine with Original Medicare to help cover your costs.
Since these plans work with Medicare and don’t replace them, you can choose any healthcare provider nationwide without needing referrals.
Supplement plans are standardized, which means the coverage is the same no matter where you live or which insurance company you enroll with. They don’t cover prescription drugs, so you must enroll in a Part D drug plan.
Most people choose to enroll in one of the top three Medigap plans. Plan F is the most comprehensive and expensive plan option.
When enrolling in Plan F, your portion of the Medicare cost-share is paid 100% by the plan. Plan G is identical to F. The only difference is that it doesn’t cover the Medicare Part B deductible. Plan G is the most popular plan for new Medicare members.
Plan N is a very popular plan. Many beneficiaries choose it based on its balance of cost vs. coverage. Plan N has solid coverage similar to Plan G.
The biggest difference is that Plan N has small copays when you visit the doctor or emergency room. Seniors that want a lower monthly cost with a higher deductible can explore the HDG and HDF plans.
The average cost of Medicare Supplement plans in Spokane, Washington
LETTER PLAN | LOWEST PREMIUM | HIGHEST PREMIUM |
PLAN A | $132.00 | $334.52 |
PLAN B | $199.11 | $372.83 |
PLAN C | $234.68 | $461.14 |
PLAN D | $206.46 | $398.06 |
PLAN F | $235.84 | $465.99 |
PLAN HDF | $44.00 | $73.17 |
PLAN G | $99.35 | $279.16 |
PLAN HDG | $44.00 | $66.22 |
PLAN K | $61.24 | $132.00 |
PLAN L | $136.80 | $147.25 |
PLAN M | N/A | N/A |
PLAN N | $139.78 | $210.00 |
Medicare Part D prescription drug plans
Prescription drug coverage with Medicare can be tricky. With many things, we look at the monthly cost when deciding what plan is best for our budget.
You can’t take that same approach to drug plans. Otherwise, you open yourself up for potential issues. When making that decision, you should consider the amount per month of your premiums and the costs of your drugs.
Different plans cover drugs differently, so getting assistance from a licensed agent is best to ensure you enroll in the best plan.
You can receive drug coverage through a Medicare Part C plan or a stand-alone Medicare Part D. Most Spokane, Washington beneficiaries choose Part B.
Part D plans are used with Original Medicare and Medicare Supplements to cover scripts you pick up from the pharmacy.
All drug plans follow the same outlined example provided by Medicare. Plans can have coverage that’s better than the standards call for.
Four phases of coverage
Each drug plan has four phases of coverage. As you pick up your scripts, you’ll move through the phases.
- Deductible
- Initial
- Coverage Gap – Donut Hole
- Catastrophic
Aetna’s SilverScript brand is among the national leaders in Part D coverage. They have been at the top for several years. They have excellent customer service and have plan options to fit almost anyone’s needs.
Wellcare has great prescription plans as well. Not only do they have the second-lowest premium in the area, but they are one of the premier Medicare providers in the nation.
Elixir is a smaller Medicare Drug company that offers coverage to residents of Spokane. They have an affordable premium and great drug coverage options.
The average cost of Medicare Part D plans in Spokane, Washington
PLAN | PREMIUM | DEDUCTIBLE | STAR RATING |
Aetna | $7.70 | $480 | 3 |
Wellcare | $11.60 | $480 | 3 |
Clear Spring | $16.20 | $480 | 2 |
Elixir | $20.30 | $480 | 3 |
Humana | $22.70 | $480 | 4 |
Special Needs plans
One of the plan options available through Medicare Advantage is called a Special Needs Plan. These plans are for those that have extraordinary needs. You must meet certain criteria to qualify for Medicare Advantage SNP in Spokane, Washington. There are three kinds of Special Needs Plans; Dual, Institutionalized, and Chronic.
To qualify for a Dual SNP, you must be enrolled in Medicare and Medicaid. These plans will assist those with low income by providing additional benefits like flex cards that help cover food and, in some cases, utilities. In addition to the additional benefits, Medicare and Medicaid pick up most of the costs.
Institutionalized SNP
For an Institutionalized SNP, you must be residing in an institutionalized setting. Chronic SNPs are designed to provide a higher coverage level for benefits and prescriptions related to a specific health condition. The most common conditions that qualify are diabetes, COPD, and heart disease.
Molina Healthcare offers a similar style of coverage as Kaiser. This can be helpful for those with low income, as it limits the amount of traveling they need for services. Most Molina facilities will have doctors and can provide lab and medical services.
Amerigroup is a small insurance company that a group of doctors started. The goal was to provide hassle-free medical coverage for their patients. In Spokane, they offer a great C-SNP plan.
Community Health Plans of Washington is a nonprofit organization that offers Medicare Advantage plans. They aim to provide support for the health and well-being of their Members. Community Health has been providing Medicare plans to Washington since 1992.
The average cost of Medicare Special Needs plans in Spokane, Washington
PLAN | PREMIUM | MOOP | Plan Type | Eligibility |
Molina Healthcare | $0 | $7,550 | HMO | Dual |
Amerigroup | $0 | $5,900 | HMO | Chronic or Disabling |
Wellcare | $0 | $3,450 | HMO | Dual |
Humana | $0 | $6,700 | HMO | Dual |
Community Health | $0 | $7,550 | HMO | Dual |
How to sign up for Medicare plans in Spokane, Washington
Spokane is located in one of the most populous areas of Washington. This leads to plenty of healthcare options. The hard part is narrowing down the choices and finding the right plan for you. That’s where we come in.
Not only can our licensed brokers assist you with identifying what type of coverage fits your situation, but we can also help check your prescriptions and doctors.
This ensures you have a smooth transition into the plan of your choosing. Give us a call for customized assistance based on your needs.
Or, if now isn’t the best time, you can fill out our online request form. One of our licensed experts will reach out to assist.