Washington State Medicare insurance is sponsored by the US federal government to provide health insurance coverage to those who meet the program’s eligibility requirements. The beneficiaries are persons over the age of 65, although workers with certain disabilities may qualify as well. The cost of Medicare is much more affordable than a typical private health insurance plan, and Washington state has programs to cut down the Medicare costs even further for some beneficiaries.
Medicare begins with Part A and Part B, which when combined, makes up Original Medicare. Part A covers hospital insurance, which includes services such as inpatient hospital or psychiatric care. Part B is for Medical insurance, covering medically necessary treatments, durable medical supplies, and preventive services.
Beneficiaries usually do not have to pay a premium for Part, although Part B requires typically one. This premium doesn’t cost much at a minimum of $134 per month for those whose annual earnings are less than $85,000. Both Part A and Part B also have deductibles, copays, and coinsurance costs that the Medicare beneficiary must pay out of pocket.
Some beneficiaries regard the Original Medicare coverage as insufficient. However, Medicare supplemental plans are available that can bolster the Medicare coverage. These plans can be purchased from Medicare-approved private carriers, and they will require a premium separate from the premiums for Original Medicare.
The supplementary plans can offer additional coverage for Medicare prescription drugs, and this type of coverage is also known as Medicare Part D. Some plans can also cover more health care services that are not covered by Part A and Part B. The plan may also help cover the deductibles, copays, and coinsurance costs of Original Medicare.
As there is already Medicare Part D, there is also Medicare Part C. This refers to Medicare Advantage Plans, which combine the benefits of Original Medicare and supplemental plans into one Medicare package. The Advantage Plan can offer Part A and Part B, along with Part D and other healthcare services that Original Medicare doesn’t cover.
These plans are also available from Medicare-approved private carriers. Beneficiaries need to check the details of each available plan, as they may offer different extra benefits in addition to Original Medicare benefits.
For some residents in Washington (where the poverty rate is at 13.2%), the costs of Medicare may be too expensive to afford. In recognition of this potential difficulty, the Washing state government offers Medicare Savings Programs (MSPs) to help cover at least part of the Medicare expenses.
These MSPs start with the program for Qualified Medicare Beneficiary (QMB), which pays for the premiums, deductibles, copays, and coinsurance for both Part A and Part B. An individual can qualify with an income of less than $1,032 per month, while a married couple needs to have a combined income of less than $1,392 per month.
Next is the Specified Low Income Medicare Beneficiary (SLMB) program, which pays for the Part B premium. SLMB benefits are available for those who also receive Medicaid benefits. To qualify for SLMB, an individual’s monthly income must be less than $1,234 while the income limit for a married couple is $1,666 per month.
The program for Qualified Individuals (QI) also pays for the Part B premium. However, the funding is limited for this QI program so late applications may not be granted. In addition, QI beneficiaries cannot receive Medicaid benefits at the same time. To qualify for this program, an individual cannot earn more than $1,386 a month, and a married couples’ combined income cannot exceed $1,872 a month.
These MSPs also have an asset limit of $7,560 for individuals and $11,340 for married couples. These programs all automatically qualify beneficiaries for the Low-Income Subsidy (LIS or “Extra Help”) program, which helps pay for Medicare Part D expenses.
The program for Qualified Disabled and Working Individuals pays for the premium for Part A. To qualify, an individual has to earn less than $4,132 a month while a married couple has an income limit of $5,572 a month. The asset limits are $4,000 for individuals and $6,000 for married couples.
The state of Washington has the Statewide Health Insurance Benefits Advisors (SHIBA) program that offers unbiased counseling and answers to Medicare beneficiaries regarding health insurance matters. To contact SHIBA, you may call 800-562-6900.