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Washington State Office of the Insurance Commissioner Statewide Health Insurance Benefits Advisors (SHIBA)October - December 2021 Approved Medicare Supplement (Medigap) plansBy federal law, high-deductible plans G and F have a 2,370 deductible for the year 2021The best time to enroll in a Medigap plan is during the first six months you have both Medicare Parts A and B.People enrolled in Original Medicare who have: A Medigap plan B through N can join any Medigap plan – except Plan A. Medigap Plan A can join any Medigap Plan A. More comprehensive health coverage than the Medigap plan they’re buying, can join any comprehensive Medigap plan – except Plan A.There’s no yearly open enrollment period for Medicare Supplement (Medigap) plans. If you’re already enrolled in a Medigap plan, youmay apply to buy or switch plans at any time. However, if you’re not currently enrolled in a Medigap but want to buy one, rules varywhether insurers may require you to pass a written health screening questionnaire. Not sure if you’ll need to take a health screening? Callour Insurance Consumer Hotline at: 1-800-562-6900.PreX1CompanyHealthscreen2ASURIS NORTHWEST HEALTH1-844-278-7472Age 65 and olderStandardized benefit plans & monthly costsANoYesB 167DGK 188 121LMPlans C & F*NCF 145 235 236Notes about Asuris Northwest: These plans are offered in the following counties: Adams, Asotin, Benton, Chelan, Douglas, Ferry, Franklin,Garfield, Grant, Kittitas, Lincoln, Okanogan, Pend Oreille, Spokane, Stevens, and Whitman counties.CIGNA1-866-459-4272ABDGKLMNCAge 65 and olderYesYesWith a high deductibleYesYes 173 185 136F 228 70*To buy a Medigap plan C or F, you must have been eligible for Medicare before Jan. 1, 2020.Note: Plans and premium costs listed are filed and approved by the Washington State Office of the Insurance Commissioner. Premiumslisted are for monthly payments through automatic funds transfer, if available. The premium costs may differ for different modes ormethods of payment, so be sure to check with the company.Companies may change their rates at various times throughout the year, so always check with the company for the latest availabilityand premiums. Plans issued before June 1, 2010 have different rates due to changes in Medicare.Questions? Call our Insurance Consumer Hotline at 1-800-562-69001
Washington State Office of the Insurance Commissioner Statewide Health Insurance Benefits Advisors (SHIBA)October - December 2021 Approved Medicare Supplement (Medigap) plansCompanyCOLONIAL PENN1-800-800-2254PreX1Healthscreen2Age 65 and olderNoYesWith a high deductibleNoYesFIRST HEALTH LIFE &HEALTH1-800-264-4000Age 65 and olderStandardized benefit plans & monthly costsABDGKLMN 158 192 197 288 108 186 171 182ABYes 154 189ABAge 65 and olderNoYes 170With a high deductibleNoYesGLOBE LIFE AND ACCIDENT INSURANCE CO1-800-801-6831Age 65 and olderYesYesWith a high deductibleYesYesGPM HEALTH & LIFE1-866-242-7573Age 65 and olderYesHUMANADENTAL INSURANCE CO1-866-205-0000YesYesWith a high deductibleYesYesLOYAL AMERICAN1-866-459-4272Age 65 and olderB 121 198YesPREMERA BLUE CROSS1-800-752-6663BYesYesWith a high deductibleYesYesKLM 211DDGNC 167KLF 227MN 163 159GKLMNCF 181 229 231 212D 224CF 280G 54KLM 279BD 154GNC 173KLM 200NBD 226C 161DG 189 47*To buy a Medigap plan C or F, you must have been eligible for Medicare before Jan. 1, 2020.2F 252 67KLM 237B 184GF 307 66AAge 65 and olderG 54AYes 311 75 192AAAge 65 and olderDF 64ANoC 75NoGARDEN STATE LIFE INSURANCE CO1-888-350-1488Plans C & F*NC 157KLMN 182F 310CF
Washington State Office of the Insurance Commissioner Statewide Health Insurance Benefits Advisors (SHIBA)October - December 2021 Approved Medicare Supplement (Medigap) plansPreX1CompanyREGENCE BLUECROSS BLUESHIELD OF OREGON1-844-734-3623Age 65 and olderNoHealthscreen2Standardized benefit plans & monthly costsAYesBD 173GK 201 131LMPlans C & F*NCF 160 249 251NCF 145 235 236Notes about Regence BlueCross BlueShield of Oregon plans: These plans are available only to Clark County residents.REGENCE BLUE SHIELD1-844-734-3623AAge 65 and olderNoYesBD 167GK 188 121LMNotes about Regence Blue Shield plans: These plans are offered in the following counties: Clallam, Cowlitz, Columbia, Grays Harbor, Island,Jefferson, King, Kitsap, Klickitat, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Skamania, Snohomish, Thurston, Wahkiakum, Walla Walla,Whatcom, and Yakima.SENTINEL1-888-510-0668Age 65 and olderNoYesSTATE FARM INSURANCE(Call local agent)Age 65 and olderYesYesTRANSAMERICA1-866-205-9120Age 65 and olderNoYesUNITED AMERICAN INSURANCE CO1-800-755-2137Age 65 and olderYesYesWith a high deductibleYesYesYesYesUnder age 65 Medicare disabilityUNITEDHEALTHCARE (AARP)1-800-523-5800Age 65 and olderMedicare Select Plan*3NoYesNoYesABD 307 342 365ABDG 206 207 167GKKLLMMNCF 423 428NCF 160 270 273ABDGKLMNCF 138 182 199 199 99 147 181 170 215 216ABDGKLMNCF 171 235 251 226 210 264 294 44 44 459AB 145 214DGKL 210 66 147 199*To buy a Medigap plan C or F, you must have been eligible for Medicare before Jan. 1, 2020.3MNCF 171 253 254 163 238 239
Washington State Office of the Insurance Commissioner Statewide Health Insurance Benefits Advisors (SHIBA)October - December 2021 Approved Medicare Supplement (Medigap) plansCompanyUNITED OF OMAHA LIFE INSURANCE CO1-800-667-2937Age 65 and olderWith a high deductiblePreX1NoNoUNITED WORLD LIFE INSURANCE1-800-775-6000Age 65 and olderWith a high deductibleUSAA1-800-515-8687NoNoAge 65 and olderNoHealthscreen2YesYesYesYesYesWASHINGTON STATE HEALTH CARE AUTHORITY (HCA)BLUE CROSS PREMERA PLANS1-888-208-6264Age 65 and olderNoNoUnder age 65 Medicare disabilityNoStandardized benefit plans & monthly costsABDABDABD 196 194 135AGKLMGKLMGKLM 243 54 198 54 185BDGPlans C & F*NCNCNC 146 140 142KLMNF 323 70F 253F 239CF 189No 321Note about Washington State HCA plans: These rates are for Washington state residents who are NOT a Public Employees Benefits Board(PEBB) members (PEBB members must enroll directly with the HCA). State residents can print off their own enrollment kit at:www.premera.com/documents/P202088.pdf or call the Blue Cross Premera number at 1-888-208-6264 and ask for a paper application for GroupID: 1000041, and for P2019196 (the HCA Plan G pre-sales enrollment kit).*To buy a Medigap plan C or F, you must have been eligible for Medicare before Jan. 1, 2020.Footnotes Explained:1 PreX (pre-existing condition) is a health problem you had within the three months before the effective date ofyour new plan. For this condition, a company cannot exclude benefits for that condition for more than threemonths after the coverage effective date. If you replace your policy and your previous policy was in effect for atleast three months, you have no waiting period for any pre-existing conditions.2 No health screen means the insurance company will not ask you any health questions to decide if they will enrollyou in its plan.3 You must be a member of an association to buy these plans.* Medicare Select policies may require you to use specific hospitals, doctors, or other health care providers to get fullcoverage. They must disclose network restrictions to you.The appearance of acompany on this listdoes not constitute anendorsement of acompany or its policiesby the Washington StateOffice of the InsuranceCommissioner, SHIBA, orits volunteers.Rev 9-30-20214
Washington State Office of the Insurance Commissioner Statewide Health Insurance Benefits Advisors (SHIBA)10 Standardized Medicare Supplement (Medigap) plans chartThis chart shows the benefits included in each of the standard Medigap plans effective on or after Jan. 1, 2021.The Medigap policy covers coinsurance only after you’ve paid the Medicare deductible (unless the policy you have also covers the deductible).Note about Plans C and F:Only applicants’ first eligible for Medicare before 2020 can buy/keep Plans C, F, and high-deductible Plan F. Medigap Plans C and F are no longer availableto people new to Medicare as of Jan. 1, 2020. If you were eligible for Medicare before Jan. 1, 2020, but not yet enrolled, you might be able to still buy aPlan C, F or high-deductible Plan F.How to read the chart: policy covers 100% of benefit; % policy covers that percentage; Blank policy doesn’t cover that benefitPlans available to all Medigap applicantsBasic benefitsPart A: Hospital coinsurance (plus costs up to anadditional 365 days after Medicare benefits end)Part A: Hospice care coinsurance or copayPart B: Coinsurance or copayMedicare preventive care Part B coinsuranceParts A & B: Blood (first 3 pints)Additional benefitsSkilled nursing facility care coinsurancePart A deductible: 1,484Part B deductible: 203Part B excess chargesForeign travel emergency (lifetime limit of 50,000)Out-of-pocket yearly limit**Medicare-eligible before 2020ABDG*KLMNCF* 50%50% 75%75% *** A B D G*50%K75%L M NCF* 50%50%75%75% 50% 80% 80% 80% 80%80%80% 6,220 3,110*Plans F and G offer a high-deductible plan. You pay for Medicare-covered costs up to the deductible amount ( 2,370 in 2021) before your plan pays anything.**After you meet your out-of-pocket yearly limit and Part B deductible, the plan pays 100% of covered services for the rest of the calendar year.***Plan N pays 100% of the Part B coinsurance except up to 20 copays for some office visits and up to 50 copays for emergency room visits (if the hospitaladmits you, the plan waives your emergency room copays).Need more help?There’s no yearly open enrollment period for Medicare Supplement (Medigap) plans. You may apply to buy or switch plans at any time. However, insurers may require you to pass ahealth questionnaire. If you have questions about who needs to take the questionnaire, call our Insurance Consumer Hotline. If you want individual help understanding all of youroptions, call our hotline and ask to speak with a SHIBA counselor in your area: 1-800-562-6900.This project was supported, in part by grant number 90SAPG0012-02, from the U.S.Administration for Community Living, Department of Health and Human Services,Washington, D.C. 20201.5SHP521-SHIBA-Medigap-plans-Rev. 12-2020
October - December 2021 Approved Medicare Supplement (Medigap) plans . By federal law, high-deductible plans G and F have a 2,370 deductible for the year 2021 . The best time to enroll in a Medigap plan is during the first six months you have both Medicare Parts A and B. People enrolled in Original Medicare who have:
