Updated October 29, 2021 | Reading time: 6 minutes
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Washington residents have so many options between Original Medicare and Medicare Advantage plans that it can be hard to know where to start.
You should spend your retirement enjoying all that Washington has to offer, not comparing health insurance plans. Look no further because we’ve got you covered with our list of the best Medicare Advantage plans in Washington.
Did you know you can save time and money with the Insurify Medicare comparison tool? Discover plans, compare your options, and find the Medicare plan that’s right for you. Check it out now!
What Are the Best Medicare Advantage Plans in Washington State?
Kaiser Permanente offers many great Medicare Advantage plans to Washingtonians. Of the top eight plans, seven are from Kaiser Permanente, and three are rated five stars. Here’s a look at how the plans stack up to one another.
Whether you’re in Spokane, Snohomish, Pierce, Whatcom, Thurston county, or somewhere in between, there’s a plan that’s right for you!
Best Medicare Advantage Plans In Arkansas
1. Kaiser Permanente Senior Advantage Value (HMO) - Score: 73.84 (Tie)
1. Kaiser Permanente Senior Advantage Standard (HMO) - Score: 73.84 (Tie)
5. Kaiser Permanente Medicare Advantage Columbia (HMO) - Score: 72.59 (Tie)
Let’s take a closer look at each of the top plans in Washington.
#1: Kaiser Permanente Senior Advantage Value
Insurify Composite Score: 73.84
Monthly Premium: $0
Deductible: $0
Out-of-Pocket Maximum: $5,600
With no monthly premium or deductible, this plan includes an easy-to-understand prescription drug plan with reasonable rates. Inpatient hospital costs are $335 per day for the first six days. Full coverage kicks in from day seven.
As with the previous KP plans, you need to add the supplemental benefits package for $44 per month to get preventive dental, comprehensive dental, eyewear, and hearing aids.
#2: Kaiser Permanente Senior Advantage Standard
Insurify Composite Score: 73.84 (Tie)
Monthly Premium: $44
Deductible: $0
Out-of-Pocket Maximum: $4,900
This plan is similar to the Senior Advantage Enhanced plan above but with a less expensive monthly premium. The prescription drug pricing is straightforward, with most medications being a flat dollar amount rather than a percentage and dollar amount. The stipulation is that you pay the greater amount.
Inpatient hospital stays are $265 for the first six days. From day seven through 90, the cost is $0. Medicare Part B drugs follow the co-pay or coinsurance model and range from $0 to $45 or 0 to 15 percent. Like the previous plan, you will need to add the supplemental package for $44 a month to get the best coverage for dental, vision, and hearing.
#3: Kaiser Permanente Senior Advantage Enhanced
Insurify Composite Score: 73.84 (Tie)
Monthly Premium: $127
Deductible: $0
Out-of-Pocket Maximum: $3,000
With a good Medicare Advantage prescription drug plan, this five-star plan also has low co-pays of $5 for primary care doctors and $25 for specialists. Inpatient hospital stays are $200 per day for the first six days; day seven and beyond cost $0.
There is excellent coverage for mental health services, with group therapy only $2 and individual therapy $5 per visit. This plan lacks good coverage for hearing, dental, and vision services, but an optional supplemental benefits package is available for an additional $44 per month.
#4: Regence BlueAdvantage
Insurify Composite Score: 73.01
Monthly Premium: $0
Deductible: $200
Out-of-Pocket Maximum: $5,500
This BlueCross BlueShield plan offers a lot of low-cost care. You’ll find $0 to $24 copays for Tier 1 and Tier 2 drugs from preferred retailers. You’ll also find $0 copays for preventive and primary care office visits, many diagnostic procedures, preventive dental visits, and routine vision care.
Costs for specialists, mental health, and podiatry are at $40 per visit. Admittedly this isn’t the lowest rate we’ve seen, but it’s still affordable. Not to mention a fairly low out-of-pocket threshold.
#5: Kaiser Permanente Medicare Advantage Vital
Insurify Composite Score: 72.59 (Tie)
Monthly Premium: $28
Deductible: $0
Out-of-Pocket Maximum: $5,800
With this plan, you get some fairly low prescription rates. You’ll pay $3 to $21 for Tier 1 and Tier 2 drugs whether you use a preferred retailer or not. Preventive care is $0 per visit, while primary care is $5. Specialists are $35 per visit. Urgent care and most diagnostic needs are $25 or less. Hearing and vision exams are $ to $35.
The main drawback of this plan is that beyond basic exams, there is no vision or hearing coverage. You also won’t find any coverage for preventive or comprehensive dental.
#6: Kaiser Permanente Medicare Advantage Key
Insurify Composite Score: 72.59 (Tie)
Monthly Premium: $0
Deductible: $100
Out-of-Pocket Maximum: $6,600
Though this plan has a lower monthly premium, you should note the higher out-of-pocket limit. While you may not reach that limit given a good health year, you are making the bet that you won’t need a lower limit.
Odds aside, this plan still offers a lot to love. That includes low or no copays for primary and preventive care visits, hearing and exams, urgent care and most diagnostic procedures. Though again, this plan offers limited coverage for hearing and vision, and no coverage for any dental care.
You can still buy stand-alone vision, dental, and hearing coverage to bridge that gap. Just be sure to keep those costs in mind when weighing the total cost of your healthcare.
#7: Kaiser Permanente Medicare Advantage Harbor
Insurify Composite Score: 72.59 (Tie)
Monthly Premium: $48
Deductible: $150
Out-of-Pocket Maximum: $5,950
This plan offers similar low rates for prescriptions. You’ll also find low or no-cost copays for preventive and primary care, vision and hearing exams, and most diagnostic services.
But this plan does offer extended hearing and vision benefits. Plus it includes preventive and comprehensive dental coverage often with $0 copays.
#8: Kaiser Permanente Medicare Advantage Columbia
Insurify Composite Score: 72.59 (Tie)
Monthly Premium: $48
Deductible: $0
Out-of-Pocket Maximum: $4,800
This plan pairs a modest monthly premium and out-of-pocket limit with very low-cost services. Included for $0 are primary care visits, diagnostic procedures, lab services, outpatient X-rays, dental services, and transportation services (excluding ground ambulance).
Coverage for vision and hearing plus mental health services, rehabilitation services, and foot care is included with minimal co-pays.
Did you know that you can use the Insurify free Medicare comparison tool to find the right Medicare plan for you? Shop Medicare Advantage plans as low as $0/month—all you need is your ZIP to get started. Try now!
How Much Does Medicare Advantage Cost in Washington?
Medicare Advantage costs vary by person, but the average Medicare beneficiary in Washington pays more than $40 monthly for their Medicare Advantage plan. Some plans are free, while others are over $100.
Additional factors that will influence how much you pay for Medicare coverage include:
Monthly premiums
Medicare Part A and Part B
Prescription drugs
Co-pays
Coinsurance
Deductible
Out-of-pocket costs
You may be eligible for Extra Help, a program to cover Medicare costs. You can get more information on this program by calling the Centers for Medicare & Medicaid Services at 1 (800) MEDICARE. TTY users should call 1 (877) 486-2048.
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What Is Medicare Advantage?
Medicare Advantage, which is Medicare Part C, is an alternative to Original Medicare. It uses private insurance companies to facilitate health insurance plans for Medicare beneficiaries. With MA plans, you bypass the need for a Medicare Part D plan and Medigap coverage because it’s all included in your plan.
What Types of Medicare Advantage Plans Are Available in Washington?
Each Medicare Advantage plan falls under one of these four types of health insurance. Here’s an overview of each one.
Health Maintenance Organization (HMO ): This plan keeps costs low by requiring you to seek services within their network of physicians. You will have a primary care physician (PCP) and need a referral to see a specialist.
Prefered Provider Organization (PPO ): A PPO offers more choices; you can get care from out-of-network doctors for slightly higher fees. You do not need a PCP, nor do you need referrals to specialists.
Special Needs Plan (SNP ): Each SNP is unique because it caters to a specific need, such as those with end-stage renal disease ( ESRD ), those living in nursing homes, or people with eligibility for both Medicaid and Medicare.
Private Fee-for-Service (PFFS ): With a PFFS plan, you can see any doctor who will accept your plan’s payment terms. There is no network to stay within, but not all physicians and hospitals accept PFFS plans.
FAQ: Washington Medicare Advantage
You can enroll in Medicare Advantage after you complete your Medicare enrollment process. Once you have Medicare Part A and Part B, you can get an MA healthcare plan. Those who want to switch from Original Medicare will have to wait until the Open Enrollment Period, which runs from October 15 through December 7 every year.
No, you can’t have both; plus, they serve a similar function. Medicare Supplement Insurance plans work with Original Medicare and cover the gaps left by Medicare Parts A, B, and D (prescription drug coverage).
Medicare Advantage plans are from an insurance company and offer Medicare beneficiaries a complete health insurance plan that meets Washington Medicare standards.
Some disadvantages to MA plans offered by private insurance companies may include monthly premiums, limited service area coverage, and plan options that don’t meet your needs. If you find that MA doesn’t work for you, you can change your health plan during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31 every year.
Conclusion: Comparing MA Plans Online Saves You Time and Money
Choosing a Medicare Advantage plan may seem like a daunting task, but once you know what you want in a plan, you can quickly narrow down your options. Ask yourself some of these questions to help find the perfect plan:
How much of a monthly premium can you afford?
Are your medications included in the formulary?
Can you keep your current healthcare providers?
Is it an HMO plan?
How much are the co-payments?
Get started comparing plans and save money with the Insurify Medicare comparison tool. Uncover options in your area at no cost to you. Try it today!
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Charlotte EdwardsInsurance Writer
Charlotte Edwards is a freelance writer with a passion for educating others in the areas of personal finance, health, and education. An educator-turned-writer, she has written for publications worldwide over the past decade. In her spare time, she enjoys reading, watching classic movies, and spending time with her husband and two children. You can learn more about her work and life abroad at www.livinginchinawithkids.com.
