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Turning 65 is a big milestone. Here's what every Washington resident should understand about Medicare before enrolling.
Covers inpatient hospital stays, skilled nursing, hospice, and some home health care. Premium-free for most people who paid Medicare taxes for 10+ years. You're automatically enrolled if you're receiving Social Security.
Covers doctor visits, outpatient care, preventive services, lab tests, and medical equipment. The standard monthly premium is $202.40 in 2026. You must actively sign up — it's not automatic unless you're on Social Security.
Separate prescription drug coverage from private insurers. Plans vary widely in what drugs they cover and what they cost. Premiums range from $7 to $100+/month. Skipping Part D can mean permanent late penalties.
Private insurance that fills the 'gaps' in Original Medicare — copays, coinsurance, deductibles. Plans are standardized (Plan G, Plan N, etc.) so benefits are identical regardless of insurer, but prices vary. Best enrolled within 6 months of Part B start.
An alternative to Original Medicare run by private companies. Often includes drug coverage, dental, vision, and fitness benefits. Many have $0 premiums but require using network doctors. Can't combine with Medigap.
Washington State has a unique Medigap rule: within 30 days of your birthday each year, you can switch Medigap plans without medical underwriting. No health questions, no denial — a huge advantage most states don't offer.
The Initial Enrollment Period (IEP) is a 7-month window centered on the month you turn 65. Missing it can mean permanent penalties.
Your enrollment window opens. This is the ideal time to start comparing plans and talking to a broker. Coverage can start the 1st of your birth month.
Compare Original Medicare + Medigap vs. Medicare Advantage. Consider Part D plans for prescriptions. Review your current medications against plan formularies.
Happy birthday! If you haven't enrolled yet, this is the month. Sign up for Part A and Part B. Choose your drug plan and supplement. Coverage starts the 1st of this month if enrolled on time.
Still in your IEP window. If you have employer coverage from a company with 20+ employees, you may be able to delay without penalty.
Last chance to enroll without penalties. After this, you'll have to wait for the General Enrollment Period (Jan-Mar) and may face permanent premium increases.
⚠️ Late enrollment penalty: If you miss your IEP, Part B premiums increase by 10% for every 12 months you could have had coverage. This penalty lasts for life.
Here's a realistic breakdown of what you'll pay. Costs vary by plan and location.
Real answers to the questions people actually ask.
Medicare is personal. You deserve guidance from someone who actually cares.
CFO & Licensed Insurance Agent — iCoach Solutions™
I'm a licensed insurance broker who helps people navigate Medicare and health insurance. My wife Sharon and I run iCoach Solutions as a husband-and-wife team. No corporate scripts, no high-pressure sales — just honest guidance from people who believe everyone deserves good coverage.
I run free Wednesday Zoom classeswhere I walk people through their Medicare options step by step. Whether you're turning 65 next month or next year, I'm here to help — at no cost to you.
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