Washington Medicare Plans in 2021

Which Medicare Advantage plans are available in Washington?

Medicare Advantage plans in Washington state are available from:

• Kaiser Foundation Health Plan of Washington
• Arcadian Health Plan
• UnitedHealthcare Insurance
• Premera Blue Cross
• Regence BlueShield
• Aetna Better Health of Washington
• Community Health Plan of Washington
• Health Alliance Northwest Health Plan
• Humana Insurance
• Sierra Health and Life Insurance
• Molina Healthcare of Washington
• Providence Health Assurance
• AmeriGroup Washington
• Health Net Life Insurance
• Anthem Insurance Companies
• PacificSource Community Health Plans

Your choice of plans will vary depending on where you live, as not all plans are available in every county.

If you choose a Medicare Advantage plan, you can select from four different types:

Health Maintenance Organization (HMO)

HMOs offer coverage from providers within the plan’s network and have specific rules you must follow to get your care covered.

• You choose a primary care provider (PCP) who is in charge of coordinating your care.
• Your PCP must provide a referral to see a specialist.
• Most out-of-network care is not covered, except in an emergency.

HMO Point-of-Service (POS)

An HMO-POS offers care within an HMO plan’s network, with an option to get some POS care outside the network.

• The same rules for HMO plans apply to HMO-POS.
• Care is available at some out-of-network providers as POS care.
• POS care may cost more than in-network care.

Preferred Provider Organization (PPO)

In a PPO, care is provided by doctors and facilities within a plan’s network.

• You don’t need a referral to see a specialist.
• You should still have a PCP to oversee your care.
• Care outside the network may cost more or may not be covered.

Special Needs Plans (SNPs)

SNPs are available if you have chronic health conditions and require more coordinated care. They are also available if you are dual-eligible for Medicare and Medicaid in Washington state. These plans are not open to every one, since you must meet eligibility requirements.

Who’s eligible for Medicare in Washington?

U.S. citizens and legal residents for 5 or more years are eligible for Medicare when you turn 65 years old. You may also be eligible before age 65 if:

• You’ve received Railroad Retirement or Social Security Disability benefits for 24 months.
• You had a kidney transplant.
• You have end-stage renal disease (ESRD or permanent kidney failure).
• You have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease.

If you’re not sure whether you qualify, use Medicare’s eligibility tool to check.