Medicare Supplements

Medicare Supplements in Spokane

Medicare Supplement insurance—often called Medigap—works alongside Original Medicare (Part A and Part B). It can help pay some of the deductibles, copayments, and coinsurance that Original Medicare leaves to you. It is not a replacement for Medicare, and it is different from Medicare Advantage.

How Medigap works

With Original Medicare, Medicare generally pays its share first for covered services. Your Medigap policy then pays according to the benefits included in your lettered plan. You keep paying your Part B premium, plus a separate monthly premium to the private company that issues the Medigap policy.

Because you remain in Original Medicare, you can generally use any doctor or hospital in the United States that accepts Medicare. Most services do not require a referral or plan network, although you should still confirm that a provider accepts Medicare.

Medigap does not usually cover routine dental, vision, hearing aids, long-term care, or private-duty nursing. Policies sold after 2005 do not include outpatient prescription drug coverage. If you want drug coverage, you normally pair Original Medicare and Medigap with a separate Part D plan.

Standardized plan letters

Medigap benefits are standardized by plan letter in Washington. A Plan G from one company provides the same standardized medical benefits as Plan G from another company. The company, monthly premium, household or payment discounts, customer service, and future rate history can differ.

That makes the comparison a two-step process:

1. Choose the plan letter whose cost-sharing fits you.
2. Compare companies offering that same letter in Spokane, including the current premium, available discounts, financial strength, service, and pattern of rate changes.

Do not assume the lowest introductory premium will remain the lowest over time. Premiums can increase, and carriers may use different rating methods or discounts.

Plan G, Plan N, and High-Deductible Plan G

These are common options for people newly eligible for Medicare, but the right fit depends on how you prefer to balance monthly premiums and out-of-pocket costs.

Plan G

Standard Plan G pays most Medicare-approved cost-sharing after you pay the annual Part B deductible. In 2026, the Part B deductible is $283. Plan G can appeal to someone who prefers a higher monthly premium in exchange for predictable medical cost-sharing.

Plan N

Plan N generally has a lower premium than Plan G, but you pay the Part B deductible and may owe copayments for some office and emergency-room visits. Plan N does not cover Part B excess charges. It may fit someone comfortable accepting more cost-sharing to reduce the monthly premium.

High-Deductible Plan G

High-Deductible Plan G generally has a much lower monthly premium, but you pay Medicare-covered deductibles, copayments, and coinsurance until you reach the plan’s annual deductible. The deductible is $2,950 in 2026.

The 2026 Part B deductible of $283 is paid first and counts toward the $2,950. After the Part B deductible, Original Medicare generally pays 80% of the Medicare-approved amount for covered Part B services, and you pay the remaining 20% until your eligible cost-sharing reaches the $2,950 deductible. Medicare-covered Part A cost-sharing, including the Part A hospital deductible when applicable, also counts toward the $2,950. After the deductible is met, the policy pays according to Plan G’s standardized benefits for the rest of the calendar year.

The deductible resets each calendar year. High-Deductible Plan G can be worth comparing when standard Plan G or Plan N premiums have become expensive, but you should be prepared to pay the deductible if significant care occurs early in the year.

When to enroll

Your federal Medigap Open Enrollment Period lasts six months. It begins the first month you are both age 65 or older and enrolled in Medicare Part B. During this one-time period, an insurer generally cannot deny you a policy or charge more because of health conditions.

This is different from Medicare’s fall Open Enrollment Period. The October 15–December 7 period does not create a new annual Medigap open enrollment right.

Outside your Medigap Open Enrollment Period, an insurer may use medical underwriting unless you have a guaranteed-issue right or another protection. Do not cancel current coverage until the replacement policy has been approved and you have confirmed its effective date.

If you are under 65 and have Medicare because of disability or End-Stage Renal Disease, Medigap choices may be limited in Washington. Review current availability and your rights before making a change.

Changing an existing Medigap policy in Washington

Washington provides protections that can make certain Medigap-to-Medigap changes possible without medical underwriting. The rules depend on your current plan, the plan you want, and the timing of the application. A move from Medicare Advantage to Medigap follows different rules and may require underwriting unless a federal or state guaranteed-issue right applies.

Before changing coverage:

• Confirm in writing whether the new application is guaranteed issue or medically underwritten.
• Compare the same plan letter across companies.
• Confirm the new premium, discounts, effective date, and household eligibility.
• Keep the old policy active until the new policy is issued and accepted.
• Consider whether returning to your former coverage would be possible if you later change your mind.

What Medigap does not do

A Medigap policy is not a Medicare Advantage plan and cannot be used to pay a Medicare Advantage plan’s copayments or deductibles. It also does not replace Part D drug coverage. You generally cannot have a Medigap policy and a Medicare Advantage plan at the same time.

Medigap only supplements Medicare-approved services. If Original Medicare does not cover a service, the Medigap policy normally does not create coverage for it unless the policy contains a specific additional benefit, such as limited foreign-travel emergency coverage in certain plan letters.

A practical Spokane comparison

When comparing options, look beyond the first-year premium. Estimate the full annual picture:

• Twelve months of Medigap premiums
• The Part B premium and deductible
• Expected Plan N copayments or high-deductible cost-sharing
• A separate Part D premium and expected prescription costs
• Dental, vision, hearing, or hospital-indemnity coverage you may choose separately
• The effect of possible future premium increases

Also think about travel, preferred Spokane-area doctors and hospitals, tolerance for bills during the year, and how much premium you can comfortably carry if rates rise.

Before you apply

Bring your Medicare card, current coverage information, preferred effective date, household details needed for discounts, and a complete medication list for a separate Part D review. If underwriting may apply, answer health questions accurately and do not assume approval until the insurer confirms it.

Health Insurance Options LLC can help Spokane-area residents compare the standardized benefits and current premiums of the Medigap companies we represent. We do not offer every plan available. You can also compare policies through Medicare.gov or contact Washington SHIBA for free, unbiased counseling.

Benefits, premiums, deductibles, underwriting rules, and plan availability can change. Verify current information before enrolling. This guide is educational and is not legal or medical advice.