Medicare and You: Take the next step.
It's Time to Think About Your Medicare Options
Have questions about Medicare Coverage? PacMed can help!
PacMed accepts traditional Medicare (Parts A & B), Medicare Part D prescription drug coverage, Medigap/Supplemental plans, and some Medicare Advantage plans (Part C).
Each year, members of any of these plans can change to a different plan during Medicare Open Enrollment, from October 15–December 7.
- Medicare Plans Accepted at PacMed
- Free Resources: Information Sessions and Hotline
- Get Oriented: Understand Your Options
Medicare Plans Accepted at PacMed
PacMed accepts a variety of Medicare insurance plans, including original Medicare, Medicare Supplemental and Medicare Advantage plans.
Original Medicare (Parts A & B)
PacMed accepts original Medicare. Medicare-eligible services provided in PacMed clincs will be covered by Medicare Part B (outpatient coverage).
For a list of Medicare plans we are contracted with in King, Snohomish and Pierce Counties, see our Medicare Plans:
Medicare Advantage Plans (Part C):
PacMed accepts many Medicare Advantage plans.
For a list of Medicare Advantage plans we are contracted with in King, Snohomish and Pierce Counties, see our Medicare Plans.
Medicare Supplemental (“Medigap”) plans
PacMed accepts all Medicare Supplemental (“Medigap”) plans.
These pay secondary to Medicare and are automatically accepted for beneficiaries who also carry traditional Medicare.
Medicare Prescription Drug (Part D) coverage
PacMed accepts Medicare Part D through the Maxor pharmacies located in PacMed clinics.
Use the resources below to learn more and decide on the right set of Medicare Plans for you.Back to Top
Free Resources: Information Sessions and Hotline
PacMed partners with Connexion Insurance Solutions to provide free guidance and answers for navigating the Medicare options.
Free Virtual Info Sessions – Group or Individual
Periodically, we offer free virtual Medicare Basics 101 information sessions. These one-hour virtual sessions are for people new to Medicare or who want to better understand Medicare. The sessions are for informational purposes only; no plan- specific benefits or details will be shared.
You can also schedule time 1-on-1 to meet with a licensed insurance agent virtually to discuss your needs, for free.
Free Medicare 101 group sessions for Open Enrollment 2020:
Virtual Sessions in October
Virtual Sessions in November
Virtual Sessions in December
RSVP or schedule personal time with an agent:RSVP NOW
These sessions are presented jointly with our family of organizations, including Swedish and Providence Saint Joseph Health.
If you would like customized help, discussing specific plans or your personal situation, a call to a hotline might be right for you. Luckily, there are free hotlines that offer unbiased advice:
Connexion Hotline: 877.315.3279
Connexion will ask some questions about your situation and connect you with an insurance producer licensed to discuss all the Medicare options available in our state.
SHIBA Helpline: 800.562.6900
This free helpline is staffed by volunteers trained by the state as Statewide Health Insurance Benefits Advisors (SHIBA). Because of high call volumes, they usually take your contact information and get back to you in a few days.
In addition to these resources, there are other ways to learn about or enroll in Medicare coverage, including:
- Contacting Medicare Advantage or Supplemental plans directly
- Contacting any licensed insurance agent of your choice
- Visiting the insurance commissioner website to learn more: www.insurance.wa.gov/medicare
- Going directly to Medicare via 1.800.MEDICARE or www.medicare.gov
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Get Oriented: Understand Your Options
We understand how complex and confusing Medicare can be. In addition to the free sessions and hotlines above, the basic information and FAQ below can help you start to get oriented.
Stay with Original Medicare or choose ONE option
As a Medicare beneficiary, you can stay with Original Medicare (A+B), or choose either a Medicare Advantage plan or a Medigap (Supplemental) plan.
These options are designed differently, and each has its pros and cons. You cannot have Medicare Advantage and Medigap at the same time. You can only pick one:
Even within these basic options there are choices. There are over a dozen regulated Medigap (supplemental) plan types, and many custom Medicare Advantage plans designed by different insurers. It’s good to study the details of whatever plan you are considering to know what’s covered.
To read the fine print between Medicare Advantage and Medigap options, see this chart from the insurance commissioner.
For prescription drug coverage, you may also choose add Medicare Part D to some of these plans; others have prescription drug coverage included.
If you need help sorting through these options, you can attend an info session or call one of the free hotlines available or read our Frequently Asked Questions (FAQ) below.Back to Top
Frequently Asked Questions
What is Medicare?
Medicare Advantage Plans are offered by private insurance companies. Medicare Advantage plans offer the same rights and protections and, at a minimum, the same benefits as original Medicare offers. Often they include prescription drug coverage in their benefits package.
What age does Medicare start?
The most common way that participants get Medicare coverage is when they turn 65. The initial enrollment period for Medicare typically begins three months prior to the month when you turn 65, and it continues for three months after that birthday.
Medicare can begin at any age if you are diagnosed with End Stage Renal Disease or if you have been receiving Social Security Disability Income for 24 months.
Does Medicare cover dependents?
There is no family coverage under Medicare. If you have dependents that had been covered by your previous employer’s coverage, they may continue coverage under COBRA if you switch to Medicare.
When will I get my Medicare card?
If you’re automatically enrolled in Medicare (if you have paid into social security for 10 years), you should receive your Medicare card in the mail 3 months before your 65th birthday or your 25th month of getting disability benefits. Your Medicare card shows that you have Medicare health insurance. It shows whether you have Part A (Hospital Insurance), Part B (Medical Insurance) or both, and it shows the date your coverage starts.
How does Medicare work?
Medicare has four parts, Parts A, B, C and D and one additional type of plan called Medicare Supplement (Medigap):
- Part A: Sometimes referred to as hospital insurance, Part A helps pay for overnight hospital stays including your room, tests, and doctor fees. For most people (i.e. if you have paid into social security for 10 years), when they turn 65, they are enrolled into Part A automatically and there is no cost. All the other Medicare Parts have costs.
- Part B: Helps pay for outpatient care such as doctor visits, tests, and screenings. Parts A and B together are often referred to as Original Medicare.
OPTIONAL ALTERNATIVES / ADD-ONS TO MEDICARE
- Part C: An alternative to Original Medicare that is also known as Medicare Advantage. Part C is administered by private insurance companies and can include other benefits not included in Medicare Part B like vision, dental, hearing, prescription drug coverage. Please note that even if you choose a Medicare Advantage Plan, Part B premiums still apply.
- Part D: Optional Prescription Drug coverage that can be added to Parts A or B or may be included in a Medicare Advantage Plan.
- Medicare Supplement (Medigap): Optional additional coverage that “closes the gap” to cover some of the costs not covered in Parts A or B.
Keep in mind, original Medicare does not pay for 100% of the services that come with your Part A and B benefits. You may have to pay a deductible, co-pay or co-insurance for some covered benefits, as well as for services not covered. That is why some people chose an option to add to or replace original Medicare.
Remember also that beneficiaries can chose either Part C or Medigap, but not both.
What Medicare Plan is best?
Consumers should seek Medicare plans that are a fit for their individual unique circumstances. That can include, but is not limited to, an individual’s location, budget, health, prescriptions, and doctors. A consultation with a licensed Medicare insurance specialist is recommended so that they can help tailor a recommendation for you based on your specific needs.
What is Medicare Advantage?
Medicare has four parts: Part A, B, C and D and one additional type of plan called Medicare Supplement (Medigap). Part C, also known as Medicare Advantage plans, are provided through private insurance companies, but contracted with and approved by Medicare. They are required to offer at least all of the same benefits provided by original Medicare Parts A & B. Medicare Advantage plans pay at the same or higher rate as Medicare for services covered under original Medicare, and can provide additional coverage for prescription drugs, dental vision, hearing and gym memberships. It is important to note that not all Medicare Advantage plans offer the same benefits and not all are available in every state and county. There is competition between the carrier’s plans that are offered and consequently you can seek plans to meet your unique needs.
To learn more about Medicare Advantage, visit the Medicare Advantage page of the Washington Insurance Commissioner or learn more from Connexion.
Why Choose a Medicare Advantage Plan?
There are a variety of benefits to enrolling in Medicare Advantage. For example, Medicare Advantage plans often:
- Offer additional services, such as prescription drug coverage, vision, dental, hearing, memberships to health and wellness programs, and other benefits not provided by traditional Medicare
- Focus on wellness and improved health outcomes
- Have defined annual out-of-pocket limits for medical care
- In all cases, eliminate the need for Medicare supplemental (or Medigap) plans, which typically cover “gaps” in original Medicare, such as co-payments and deductibles
Medicare Advantage plans are an alternative to original Medicare coverage. They include all the benefits of original Medicare with additional benefits.
Who Can Join a Medicare Advantage Plan?
If you are enrolled in original Medicare, you can join a Medicare Advantage plan offered in your service area, even if you have a pre-existing condition, except for end-stage renal disease (ESRD). If you are turning 65, you have a seven-month window to join, starting three months before your birth month.
When Can I Join or Change My Medicare Advantage Plan?
Medicare Advantage plans are governed by the same enrollment regulations as original Medicare. In most cases, people join a plan during open enrollment in the fall and are enrolled in a plan for the calendar year. If you are turning 65, you have a seven-month window that starts three months before your birth month.
How does Medigap/Medicare Supplemental insurance work?
Medicare has four parts: Part A, B, C and D and one additional type of plan called Medicare Supplement (Medigap). Medicare Supplement Plans, also called Medigap Plans, are designed to help pay the remaining coinsurance for hospital and medical costs not covered by original Medicare (Parts A and B) and are sold by private insurance companies. Generally, you have to be enrolled in Medicare Parts A and B to buy a Medigap plan and continue to pay your Part B Premium. Medigap plans are designed and regulated according to definitions set by Medicare for various “plans.”
There are 10 Medigap plans in every state (except for Massachusetts, Minnesota, and Wisconsin), denoted with a letter A, B, C, D, F, G, K, L, M and N. The benefits of each Medigap plan type are standardized across the country although prices may vary across different insurers.
To learn more, visit the Medigap page of the Washington Insurance Commissioner.
What are Medigap plans A/B/D/G etc.—and how much do they cost?
There are 10 Medigap plans in every state (except for Massachusetts, Minnesota, and Wisconsin), denoted with a letter A, B, C, D, F, G, K, L, M and N. Each plan offers a different set of supplemental coverages,and carries a different cost.
While the supplemental coverage of each Medigap plan is standardized across the country, the premium prices and insurers offering each plan in your area may change year to year. To see the most current Medigap offerings in Washintgon State, visit this page from the Washington State Insurance Commissioner.
Generally, you must be enrolled in Medicare Parts A and B to buy a Medigap plan and continue to pay your Part B premium.
What and when is Medicare Open Enrollment?
The Annual Enrollment Period (AEP) for Medicare, also known as Open Enrollment, is between October 15 and December 7th. During AEP you can make changes to your coverage such as:
- Switch from one Medicare Advantage plan to another
- Switch from Original Medicare to Medicare Advantage or vice versa
What are the different Medicare Enrollment periods?
Whether you are already enrolled in a plan or first starting to look at your options, it is important to know the different Medicare enrollment periods and what actions you can take during each period. Enrollment periods include:
- Initial Enrollment Period (IEP) – the seven-month window beginning three months before through three months after your 65th birthday. If you intend to use Medicare, it is best to sign up during your IEP. If you enroll later, you may have a lifetime penalty added to your monthly Part B premium, and it goes up the longer you wait to sign up.
- Annual Enrollment Period (AEP) – runs from October 15 to December 7. Also known as Open Enrollment, this is your annual window to switch or make changes to your existing plan for the upcoming year.
- General Enrollment Period (GEP) – runs from January 1 to March 31. This period is primarily for those who missed their initial enrollment period. If you enroll during GEP, your coverage will start July 1. People signing up during GEP may pay a penalty for Part B premiums for not signing up during their Initial Enrollment Period.
- Special Enrollment Period (SEP) – occurs when certain qualifying events happen in your life. For instance, one may be when you move to a new service area. Or within the first 12 months of your first enrollment in a Medicare Advantage plan, you have a one-time opportunity to change back to a Medigap policy.
Curious to learn more? Download and search our full Medicare FAQBack to Top